A criterion-based stepwise approach for training counselors in motivational interviewing.

This pilot study evaluated a criterion-based stepwise approach for training counselors in motivational interviewing (MI). Three sequential steps of training in MI were provided to 26 counselors who worked within the U.S. State of Connecticut Veterans Administration addiction treatment programs: a distance learning Web course (Step 1), a skill-building workshop (Step 2), and a competency-based individual supervision (Step 3). Counselors first participated in the course and then only received the next step of training if they failed to meet an independently rated criterion level of adequate MI performance. The results showed that counselors who showed inadequate MI performance immediately after taking the Web course and who subsequently participated in a workshop or supervision improved their adherence to fundamental MI strategies over time, whereas those who performed MI adequately following the Web course continued to demonstrate similar levels of fundamental and advanced MI adherence and competence over a 24-week period without additional training. The pilot study's findings, although preliminary, suggest that different counselors likely require different types and amounts of training to perform a behavioral treatment well.