Teaching Motivational Interviewing to Child Welfare Social Work Students Using Live Supervision and Standardized Clients: A Randomized Control Trial

Background:This study examined the attainment of Motivational Interviewing (MI) skills with a sample of social work (SW) students with a child welfare placement to evaluate the utility of a two-day live supervision (LS) training approach using standardized clients.  Though there had been studies that examine the efficacy of live-supervision training for clinician gain in MI proficiency, none of them offer a manual for training nor examine skill gain among SW students or those in child welfare.  Additionally, many of the available research assess MI competency through clinician self-reports, and Miller et al. (2004) noted that self-report of skill acquisition is generally unrelated to actual behavioral demonstration of MI skills.  Hence, an assessment of a manualized training method that targets child welfare SW students based on the students’ interviews with standardized clients is necessary.

Methods: Sixty students enrolled in a BSW/MSW education program with a child welfare placement were recruited.  The average age of the students was 29.7 and 95% (n=46) were female.  Participants attended a six-hour didactic training and then were randomly assigned to either a LS teaching group (n=26) or a Teaching As Usual (TAU) group (n=28).  The LS group completed a two-day intensive training that provided experiential learning opportunities using a one-way mirror and standardized client actors.  The TAU group received MI training through a self-paced online course consisting of independent reading and MI training video clips.  Interviewing skills were assessed on student’s use of MI through recorded interviews at four data collection points: prior to the study, following a six-hour didactic training seminar, after completion of LS/TAU training, and at 5 months follow-up.  Participants also completed surveys measuring empathy and self-efficacy at each of the four data collection points.  T1 interviews were coded using the Empathy global score from the Motivational Interviewing Treatment Integrity 3.1.1 (MITI) Code; T2-T3 standardized client interviews were coded using the full MITI scheme. 

Results: One way ANOVA and chi-square analyses evaluated differences in demographics between the LS and TAU groups; no significant differences were observed.  Repeated measures factorial ANOVA assessed for differences across, T2, T3, and T4 for each of the MITI and the surveys.  There was a significant group x time interaction effect (F(2, 46)=3.49, p =.039) and a significant main effect for Percent Complex Reflections (F(2,46)=3.69, p=.033) favoring the LS group.  For Empathy, there was a significant group x time interaction (F(2,46)=2.925, p=.06), with the LS group scoring trending higher than the TAU group. No significant differences were observed for the Self-Efficacy survey; however, for Perceptions Survey, both groups had comparable increase between T2 and T4 by an average of 7 points.

Implications: The findings suggest that this manualized training of two day LS can be potentially helpful to SW schools and training programs looking for a curriculum that promotes the development and assessment of beginning MI proficiency in a relatively brief education experience.  The study is replicable, and continued efforts to evaluate the LS model with not just standardized client interviews but actual client interviews will be beneficial.