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Providing objective feedback in supervision in motivational interviewing: results from a randomized controlled trial

Published online by Cambridge University Press:  05 November 2019

Maria Beckman Open the ORCID record for Maria Beckman [Opens in a new window] ,
Lars Forsberg ,
Helena Lindqvist  and
Ata Ghaderi
Maria Beckman*
Affiliation:
Centre for Psychiatric Research, Karolinska Institutet, and Stockholm Health Care Services, Stockholm County Council, Sweden
Lars Forsberg
Affiliation:
MIC Lab AB, Stockholm, Sweden
Helena Lindqvist
Affiliation:
Centre for Psychiatric Research, Karolinska Institutet, and Stockholm Health Care Services, Stockholm County Council, Sweden
Ata Ghaderi
Affiliation:
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

The effects of the use of objective feedback in supervision on the supervisory relationship and skill acquisition is unknown.

Aims:

The objective of this study was to evaluate the effects of two different types of objective feedback provided during supervision in motivational interviewing (MI) on: (a) the supervisory relationship, including potential feelings of discomfort/distress, provoked by the supervision sessions, and (b) the supervisees’ skill acquisition.

Method:

Data were obtained from a MI dissemination study conducted in five county councils across five county councils across Sweden. All 98 practitioners recorded sessions with standardized clients and were randomized to either systematic feedback based on only the behavioral component of a feedback protocol, or systematic feedback based on the entire protocol.

Results:

The two different ways to provide objective feedback did not negatively affect the supervisory relationship, or provoke discomfort/distress among the supervisees, and the group that received the behavioural component of the feedback protocol performed better on only two of the seven skill measures.

Conclusions:

Objective feedback does not seem to negatively affect either the supervisor–supervisee working alliance or the supervisees’ supervision experience. The observed differences in MI skill acquisition were small, and constructive replications are needed to ascertain the mode and complexity of feedback that optimizes practitioners’ learning, while minimizing the sense of discomfort and distress.

Keywords

clinical supervisionmotivational interviewingobjective feedbacktraining
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 4 , July 2020 , pp. 383 - 394
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019

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References

Abernethy, C., & Cook, K. (2011). Resistance or disconnection? A relational-cultural approach to supervisee anxiety and nondisclosure. Journal of Creativity in Mental Health, 6, 2–14. doi: 10.1080/15401383.2011.560067CrossRefGoogle Scholar
Bambling, M., King, R., Raue, P., Schweitzer, R., & Lambert, W. (2006). Clinical supervision: its influence on client-rated working alliance and client symptom reduction in the brief treatment of major depression. Psychotherapy Research, 16, 317–331. doi: 10.1080/10503300500268524CrossRefGoogle Scholar
Barwick, M. A., Bennett, L. M., Johnson, S. N., McGowan, J., & Moore, J. E. (2012). Training health and mental health professionals in motivational interviewing: a systematic review. Children and Youth Services Review, 34, 1786–1795. doi: 10.1016/j.childyouth.2012.05.012CrossRefGoogle Scholar
Bearman, S. K., Schneiderman, R. L., & Zoloth, E. (2017). Building an evidence base for effective supervision practices: an analogue experiment of supervision to increase EBT fidelity. Administration and Policy in Mental Health, 44, 293–307. doi: 10.1007/s10488-016-0723-8CrossRefGoogle ScholarPubMed
Beckman, M., Bohman, B., Forsberg, L., Rasmussen, F., & Ghaderi, A. (2017a). Supervision in motivational interviewing: an exploratory study. Behavioural and Cognitive Psychotherapy, 45, 351–365. doi: 10.1017/S135246581700011XCrossRefGoogle Scholar
Beckman, M., Forsberg, L., Lindqvist, H., Diez, M., Eno Persson, J., & Ghaderi, A. (2017b). The dissemination of motivational interviewing in Swedish county councils: results of a randomized controlled trial. PloS One, 12, e0181715. doi: 10.1371/journal.pone.0181715CrossRefGoogle ScholarPubMed
Bernard, J. M., & Goodyear, R. K. (2014). Fundamentals of Clinical Supervision (5th edn). Boston, MA, USA: Pearson.Google Scholar
Busseri, M. A., & Tyler, J. D. (2003). Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form. Psychological Assessment, 15, 193–197. doi: 10.1037/1040-3590.15.2.193CrossRefGoogle ScholarPubMed
Chur-Hansen, A., & McLean, S. (2006). On being a supervisor: the importance of feedback and how to give it. Australas Psychiatry, 14, 67–71. doi: 10.1080/j.1440-1665.2006.02248.xCrossRefGoogle Scholar
Cicchetti, D. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284–290.CrossRefGoogle Scholar
Clarke, P. B., & Giordano, A. L. (2013). The motivational supervisor: motivational interviewing as a clinical supervision approach. The Clinical Supervisor, 32, 244–259. doi: 10.1080/07325223.2013.851633CrossRefGoogle Scholar
Cummings, J. A., Ballantyne, E. C., & Scallion, L. M. (2015). Essential processes for cognitive behavioral clinical supervision: agenda setting, problem-solving, and formative feedback. Psychotherapy (Chic), 52, 158–163. doi: 10.1037/a0038712CrossRefGoogle ScholarPubMed
de Roten, Y., Zimmermann, G., Ortega, D., & Despland, J. N. (2013). Meta-analysis of the effects of MI training on clinicians’ behavior. Journal of Substance Abuse Treatment, 45, 155–162. doi: 10.1016/j.jsat.2013.02.006CrossRefGoogle ScholarPubMed
Decker, S. E., Carroll, K. M., Nich, C., Canning-Ball, M., & Martino, S. (2013). Correspondence of motivational interviewing adherence and competence ratings in real and role-played client sessions. Psychological Assessment, 25, 306–312. doi: 10.1037/a0030815CrossRefGoogle ScholarPubMed
Decker, S. E., Nich, C., Carroll, K. M., & Martino, S. (2014). Development of the Therapist Empathy Scale. Behavioural and Cognitive Psychotherapy, 42, 339–354. doi: 10.1017/S1352465813000039CrossRefGoogle ScholarPubMed
Dunn, C., Darnell, D., Atkins, D. C., Hallgren, K. A., Imel, Z. E., Bumgardner, K., … & Roy-Byrne, P. (2016). Within-provider variability in motivational interviewing integrity for three years after MI training: does time heal? Journal of Substance Abuse Treatment, 65, 74–82. doi: 10.1016/j.jsat.2016.02.008CrossRefGoogle ScholarPubMed
Edmunds, J. M., Beidas, R. S., & Kendall, P. C. (2013). Dissemination and implementation of evidence-based practices: training and consultation as implementation strategies. Clinical Psychology, 20, 152–165. doi: 10.1111/cpsp.12031Google ScholarPubMed
Ellis, M. V. (2010). Bridging the ccience and practice of clinical supervision: some discoveries, some misconceptions. The Clinical Supervisor, 29, 95–116. doi: 10.1080/07325221003741910CrossRefGoogle Scholar
Ellis, M. V., Hutman, H., & Chapin, J. (2015). Reducing supervisee anxiety: effects of a role induction intervention for clinical supervision. Journal of Counseling Psychology, 62, 608–620. doi: 10.1037/cou0000099CrossRefGoogle ScholarPubMed
Falender, C. A., & Shafranske, E. P. (2007). Competence in competency-based supervision practice: construct and application. Professional Psychology: Research and Practice, 38, 232–240. doi: 10.1037/0735-7028.38.3.232CrossRefGoogle Scholar
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: a synthesis of the literature. Available at: https://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdfGoogle Scholar
Forsberg, L., Forsberg, L., Forsberg, K., van Loo, T., & Rönnqvist, S. (2011). Motivational interviewing treatment integrity 3.1 (MITI 3.1): MITI kodningsmanual 3.1. Retrieved from: https://www.miclab.org/sites/default/files/files/MITI%203_1%20SV.pdfGoogle Scholar
Friedberg, R., Gorman, A., & Beidel, D. (2009). Training psychologists for cognitive-behavioral therapy in the raw world – a rubric for supervisors. Behavior Modification, 33, 104–123. doi: 10.1177/0145445508322609CrossRefGoogle ScholarPubMed
Gooding, H. C., Mann, K., & Armstrong, E. (2017). Twelve tips for applying the science of learning to health professions education. Medical Teacher, 39, 26–31. doi: 10.1080/0142159X.2016.1231913CrossRefGoogle ScholarPubMed
Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233. doi: 10.1037/0022-0167.36.2.223CrossRefGoogle Scholar
Imel, Z. E., Baldwin, S. A., Baer, J. S., Hartzler, B., Dunn, C., Rosengren, D. B., & Atkins, D. C. (2014). Evaluating therapist adherence in motivational interviewing by comparing performance with standardized and real patients. Journal of Consulting and Clinical Psychology, 82, 472–481. doi: 10.1037/a0036158CrossRefGoogle ScholarPubMed
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., … & Oxman, A. D. (2012). Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 6, CD000259. doi: 10.1002/14651858.CD000259.pub3Google Scholar
Kerfoot, B. P., Baker, H. E., Koch, M. O., Connelly, D., Joseph, D. B., & Ritchey, M. L. (2007). Randomized, controlled trial of spaced education to urology residents in the United States and Canada. Journal of Urology, 177, 1481–1487. doi: 10.1016/j.juro.2006.11.074CrossRefGoogle ScholarPubMed
La Rochelle, J. S., Durning, S. J., Pangaro, L. N., Artino, A. R., van der Vleuten, C. P., & Schuwirth, L. (2011). Authenticity of instruction and student performance: a prospective randomised trial. Medical Education, 45, 807–817. doi: 10.1111/j.1365-2923.2011.03994.xCrossRefGoogle ScholarPubMed
Ladany, N., Mori, Y., & Mehr, K. E. (2013). Effective and ineffective supervision. The Counseling Psychologist, 41, 28–47. doi: 10.1177/0011000012442648CrossRefGoogle Scholar
Lombardo, C., Milne, D., & Procter, R. (2009). Getting to the heart of clinical supervision: a theoretical review of the role of emotions in professional development. Behavioural and Cognitive Psychotherapy, 37, 207–219. doi: 10.1017/S135246580900513XCrossRefGoogle ScholarPubMed
Madson, M. B., Loignon, A. C., & Lane, C. (2009). Training in motivational interviewing: a systematic review. Journal of Substance Abuse Treatment, 36, 101–109. doi: 10.1016/j.jsat.2008.05.005CrossRefGoogle ScholarPubMed
Miller, W. R., & Moyers, T. B. (2017). Motivational interviewing and the clinical science of Carl Rogers. Journal of Consulting and Clinical Psychology, 85, 757–766. doi: 10.1037/ccp0000179CrossRefGoogle ScholarPubMed
Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change. New York, USA: Guilford Press.Google Scholar
Milne, D., & Reiser, R. P. (2012). A rationale for evidence-based clinical supervision. Journal of Contemporary Psychotherapy, 42, 139–149. doi: 10.1007/s10879-011-9199-8CrossRefGoogle Scholar
Moyers, T. B., Martin, T., Manuel, J. K., Hendrickson, S. M., & Miller, W. R. (2005). Assessing competence in the use of motivational interviewing. Journal of Substance Abuse Treatment, 28, 19–26. doi: 10.1016/j.jsat.2004.11.001CrossRefGoogle ScholarPubMed
Moyers, T. B., Martin, T., Manuel, J. K., Miller, W. R., & Ernst, D. (2010). Revised global scales: Motivational Interviewing Treatment Integrity 3.1.1 (MITI 3.1.1). Retrieved from: http://casaa.unm.edu/mimanuals.htmlGoogle Scholar
Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D. & Houck, J. M. (2016). The Motivational Interviewing Treatment Integrity Code (MITI 4): rationale, preliminary reliability and validity. Journal of Substance Abuse Treatment, 65, 36–42. doi: 10.1016/j.jsat.2016.01.001CrossRefGoogle ScholarPubMed
Parsons, M. B., Rollyson, J. H., & Reid, D. H. (2012). Evidence-based staff training: a guide for practitioners. Behavior Analysis in Practice, 5, 2–11. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23730462CrossRefGoogle ScholarPubMed
Rakovshik, S. G., & McManus, F. (2010). Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clinical Psychology Review, 30, 496–516. doi: 10.1016/j.cpr.2010.03.004CrossRefGoogle ScholarPubMed
Rakovshik, S. G., McManus, F., Vazquez-Montes, M., Muse, K., & Ougrin, D. (2016). Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision. Journal of Consulting and Clinical Psychology, 84, 191–199. doi: 10.1037/ccp0000079CrossRefGoogle ScholarPubMed
Schwalbe, C. S., Oh, H. Y., & Zweben, A. (2014). Sustaining motivational interviewing: a meta-analysis of training studies. Addiction, 109, 1287–1294. doi: 10.1111/add.12558CrossRefGoogle ScholarPubMed
Simpson-Southward, C., Waller, G., & Hardy, G. E. (2016). Supervision for treatment of depression: an experimental study of the role of therapist gender and anxiety. Behaviour Research and Therapy, 77, 17–22. doi: 10.1016/j.brat.2015.11.013CrossRefGoogle ScholarPubMed
Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1(3), 207–210. doi: 10.1037/1040-3590.1.3.207CrossRefGoogle Scholar
Turner, L. B., Fischer, A. J., & Luiselli, J. K. (2016). Towards a competency-based, ethical, and socially valid approach to the supervision of applied behavior analytic trainees. Behavior Analysis in Practice, 9, 287–298. doi: 10.1007/s40617-016-0121-4CrossRefGoogle ScholarPubMed
van Merrienboer, J. J., & Sweller, J. (2010). Cognitive load theory in health professional education: design principles and strategies. Medical Education, 44, 85–93. doi: 10.1111/j.1365-2923.2009.03498.xCrossRefGoogle ScholarPubMed
Vervliet, B., Craske, M. G., & Hermans, D. (2013). Fear extinction and relapse: state of the art. Annual Review of Clinical Psychology, 9, 215–248. doi: 10.1146/annurev-clinpsy-050212-185542CrossRefGoogle ScholarPubMed
Watkins, C. E. (2011). Does psychotherapy supervision contribute to patient outcomes? Considering thirty years of research. The Clinical Supervisor, 30, 235–256. doi: 10.1080/07325223.2011.619417CrossRefGoogle Scholar
Wheeler, S., & Richards, K. (2007). The impact of clinical supervision on counsellors and therapists, their practice and their clients. A systematic review of the literature. Counselling and Psychotherapy Research, 7, 54–65. doi: 10.1080/14733140601185274CrossRefGoogle Scholar
Young, J. Q., Van Merrienboer, J., Durning, S., & Ten Cate, O. (2014). Cognitive load theory: implications for medical education: AMEE Guide No. 86. Medical Teacher, 36, 371–384. doi: 10.3109/0142159X.2014.889290CrossRefGoogle ScholarPubMed
Zarbock, G., Drews, M., Bodansky, A., & Dahme, B. (2009). The evaluation of supervision: construction of brief questionnaires for the supervisor and the supervisee. Psychotherapy Research, 19, 194–204. doi: 10.1080/10503300802688478CrossRefGoogle ScholarPubMed
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