An Assessment of Social Workers and
Counselors Understanding and Application of
Motivational Interviewing
Angela R. Wood, Ph.D., LCSW-BACS
Assistant Professor, Social Work Program
Abstract
Motivational interviewing (MI) is generally accepted as an
evidence-based practice across many areas of service
provision within human services as well as healthcare. Most
studies focus on the implementation of motivational
interviewing among training participants, yet we know little
about the extent of use of motivational interviewing across
disciplines regardless of formal or informal training. This
study aims to describe practitioner knowledge of MI,
attitudes toward MI, and self-perceptions of
implementation of the spirit and principles of MI across
human service-oriented professionals. Future study with
the current data set will also explore how well practitioners’
self-perceptions of motivational interviewing match the
application of skills. A cross-sectional survey was developed
and distributed via email and social media by the author and
co-researcher. In an early analysis of the collected data,
results show previous training in MI is correlated with higher
scores on knowledge and increased positive attitudes
toward MI while previous training in MI was not associated
with self-perceptions of the application of MI principles in
practice.
Data Collection
The sample targeted individuals who work in human or social
services at any degree level, e.g. counselors, substance abuse
professionals, social workers, and school counselors.
A 37-item electronic survey focusing on knowledge (13 items),
attitudes (5 items), self-perceptions (6 items) of the application of
motivational interviewing principles, and motivational
interviewing behaviors was available via a web link. Participants
were recruited using email to invite known contacts of the
researchers as well as professional list-serves and social media
across the U.S.
Data Analysis
Frequencies were run on the number of correct answers on the
knowledge section, average ratings for attitudes toward
motivational interviewing, and ratings for self-perceptions of the
application of motivational interviewing spirit and principles.
Correlations between level of training/education in MI and the
variables knowledge (overall score), attitudes (average), and selfperceptions (average) were conducted using Pearson’s r.
Results
Literature Review
The implementation of evidence-based practices (EBPs) has
been widely recommended and researched. Related to
dissemination and implementation of motivational interviewing,
training effectiveness (e.g. Barwick, et al., 2012); barriers and
facilitators to adoption, such as individual factors (e.g. Ager, et
al., 2011), and organizational factors (e.g. Tooley, 2014); and
sustained practice change (e.g. Hall, et al., 2015) have been
investigated. From this research, concerns remain whether MIconsistent practices can be obtained and sustained. We need a
greater understanding of successful implementation fidelity to
MI in real world settings (Hall, et al., 2016). This study aims to
discover evidence of the implementation and application of MI
across real world settings among human service professionals.
Discussion
Methods
68 respondents, 85.3% female, most had masters’ degrees, and
all but one had at least one credential.
Most worked in mental health/behavioral and/or addictions.
Years of experience varied: over 45% had less than 10 years of
experience, 29.4% had 10-19 years of experience, and 25% had
20 or more years.
42.6% had minimal to no prior training or experience with MI;
42.6 % reported moderate training, and 14.7% reported extensive
training/experience in MI.
72% of the sample passed the knowledge questions with a 70% or
better.
Only 29.4% of respondents had a more positive or agreeable
attitude toward MI. 29.4% were neutral and 10.3% had a more
negative or disagreeable attitude toward MI.
Self-perceptions of the application of MI principles in practice
show that 60.3% often or always follow the principles.
As would be expected, participants who had limited or no prior
education or training in motivational interviewing tended to score
lower on the knowledge portion (summary score) and hold more
negative attitudes toward motivational interviewing (average
rating). Interestingly, participants overall tended to view themselves
as using most of the MI principles. Sixty-three (92.6%) of the
participants report demonstrating accurate empathy often or
always, as well as positive regard (95.5%). When asked about
eliciting FIRST from the client and asking permission before
providing suggestions or information, only 67.6% and 52.9% of the
participants respectively indicated “often” or “always.”
Limitations and Future Research
Limitations
The knowledge questions were adapted from Moyers, et al., 2005) to
encompass later revisions to MI. Additionally, the questions used to measure
attitude and self-perception of skills may have reliability and validity issues.
Respondent bias could be present, however, 42% of the respondents had
minimal to no previous training in MI. Organizational and other individual
level factors that may predict adoption of MI are not included in this study.
Future Research
Data from this study will also seek to determine whether practitioners’ selfperceptions of their use of motivational interviewing principles match the
actual application of the principles and skills of motivational interviewing
across disciplines (by credential) and level of training/education in
motivational interviewing. Skills-related items have not been scored at this
time.
References
Ager, R., Roahen-Harrison, S., Toriello, P. J., Kissinger, P., Morse, P., Morse, E., Carney, L., & Rice, J.
(2011). Predictors of adopting motivational enhancement therapy. Research on Social Work Practice,
21(1). 65-76.
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, 34(9). 1786-1795.
Hall, K., Staiger, P. K., Simpson, A., Best, D., & Lubman, D. I. (2015). After 30 years of dissemination, have
we achieved sustained practice change in motivational interviewing? Addiction, 111. 1144-1150.
Hall, K., Staiger, P. K., Simpson, A., Best, D., & Lubman, D. I. (2016). Continuing the conversation: 30 years
of motivational interviewing dissemination. Addiction, 111. 1131-1159.
Moyers, T. B., Martin, T., Christopher, P. (2005). Motivational interviewing knowledge test.
https://casaa.unm.edu/download/ELICIT/MI%20Knowledge%20Test%20Key.pdf
Tooley, E. (2014). Organization factors and therapist attitudes in the prediction of MI adoption.
[Doctoral dissertation, University of New Mexico]. https://digitalrepository.unm.edu/psy_etds/138