The Effectiveness and Cost of Clinical Supervision for Motivational Interviewing: A Randomized Controlled Trial

J Subst Abuse Treat. 2016 Sep:68:11-23. doi: 10.1016/j.jsat.2016.04.005. Epub 2016 May 8.

Abstract

The effectiveness of a competency-based supervision approach called Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA: STEP) was compared to supervision-as-usual (SAU) for increasing clinicians' motivational interviewing (MI) adherence and competence and client retention and primary substance abstinence in a multisite hybrid type 2 effectiveness-implementation randomized controlled trial. Participants were 66 clinicians and 450 clients within one of eleven outpatient substance abuse programs. An independent evaluation of audio recorded supervision sessions indicated that MIA: STEP and SAU were highly and comparably discriminable across sites. While clinicians in both supervision conditions improved their MI performance, clinician supervised with MIA: STEP, compared to those in SAU, showed significantly greater increases in the competency in which they used fundamental and advanced MI strategies when using MI across seven intakes through a 16-week follow-up. There were no retention or substance use differences among the clients seen by clinicians in MIA: STEP or SAU. MIA: STEP was substantially more expensive to deliver than SAU. Innovative alternatives to resource-intensive competency-based supervision approaches such as MIA: STEP are needed to promote the implementation of evidence-based practices.

Keywords: Clinical supervision; Cost estimation; Implementation strategies; Motivational interviewing; Substance abuse treatment.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ambulatory Care / economics
  • Ambulatory Care / methods
  • Clinical Competence*
  • Costs and Cost Analysis
  • Evidence-Based Practice
  • Female
  • Follow-Up Studies
  • Guideline Adherence
  • Health Personnel / standards*
  • Humans
  • Male
  • Middle Aged
  • Motivational Interviewing / economics
  • Motivational Interviewing / methods*
  • Substance-Related Disorders / rehabilitation*
  • Young Adult