Motivational Interviewing Training and Fidelity Monitoring in School-Based Research: A Scoping Review

Background and Purpose: Recently, the use of Motivational Interviewing (MI) in K-12 school-based settings has increased. Yet there has not been a comprehensive review documenting training models used to facilitate MI skill development, or methods used to report MI fidelity in school-based research. The purpose this presentation is to present a scoping review that (a) documents current training approaches and techniques used to teach school-based personnel to use MI, (b) examines the extent to which fidelity data are being collected, coded, and reported within school-based MI research, (c) identifies evidence of pragmatic fidelity measurement development, and (d) describes changes in our own training structures that have resulted from the review.

Methods: We identified the articles for this review via a multi-step process conducted iteratively between February 2020 and April 2023. We conducted searches in the following electronic databases: ProQuest Social Science Premium Collection, PsychINFO, and MEDLINE combining the search term “motivational interview*,” with “school*,” “teacher,” or “principal.” We also combined the search term “school*” with search terms for interventions that utilize motivational interviewing and are implemented in school-based settings. Each reviewer conducted a full-text review of each article to obtain detailed information specific to the objectives of this study.

Results: There were 62 unique studies eligible for inclusion. The articles were published between 2005 and 2022 with the majority (83.9%) being published since 2012. Thirty-nine articles (62.9%) reported a randomized controlled trial (RCT). Six studies (9.7%) used a quasi-experimental design, and five studies (8.1%) used a sing-subject design. The remaining 12 studies (19.4%) were training outcome studies. Twenty-one percent of the studies targeted social-emotional, behavioral, or related difficulties; 19.4% of studies targeted substance use; 17.7% targeted nutrition and exercise; 14.5% focused on improving academic achievement; 11.3% focused on improving teacher effectiveness (e.g., classroom management); and 9.7% targeted parenting behavior. Typically, MI was used to support students (66.1%) and less frequently parents (21%) or teachers (14.5%). Only 26 studies (42%) provided at least some information on the MI training delivered to prepare implementers to use MI. Forty-three (69.4%) studies reported collection of intervention fidelity and 30.6% did not. Of the 43 that did, 10 included interventions in which MI was described as part of a multi-component intervention or used in combination with another EBP. Less than one-third of the studies (n = 19) included data on MI quality.

Conclusions and Implications: This review provides the most comprehensive description of the prevalence and type of MI applications in schools to date, including a detailed account of the characteristics of the professionals who are implementing MI-based interventions in school settings, the recipients of these interventions, and the targets of behavior change. In doing so, the review provides empirical data to support the conclusions of several research groups that have called on the school-based MI researchers and practitioners to attend to and report more transparently on how MI is used, the type of training interventionists receive, and the extent which MI is implemented with fidelity.