Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4)

Lotte Kramer Schmidt*, Kjeld Andersen, Anette Søgaard Nielsen, Theresa B. Moyers

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Resumé

Background and aims: The Motivational Interviewing Treatment Integrity code (MITI) measures fidelity to, and the quality of, Motivational Interviewing (MI), and can also be used when MI is combined with other treatment methods. The current study presents a fidelity measurement with the MITI 4.2.1, in both Motivational Enhancement Therapy sessions and the combined Community Reinforcement Approach-Senior (CRA–S). Method: The MITI 4.2.1 was used to evaluate treatment sessions provided in the Elderly Study, a multi-national randomized trial evaluating treatment for alcohol use disorders in the elderly. Following expert recommendations, training was conducted at two international sites as well as at the Danish site. Twenty percent of the sessions at the Danish study site were rated. Twelve percent were multiply rated by all raters. Interrater reliability was assessed by the Intraclass Correlations Coefficient (ICC). Results: Mean ICC of the 52 sessions rated by all raters was 0.78 (95% CI: 0.70; 0.86). The rare measures confront and emphasize autonomy, and the global measure softening sustain talk only reached fair levels of ICC, while the remaining measures were good or excellent. In the sessions of MI combined with other treatment approaches in the CRA–S, the MITI 4.2.1 has a similar reliability as in MET sessions only, except for the measure persuade with permission. Conclusion: The MITI 4.2.1 is a reliable instrument for measuring fidelity to Motivational Interviewing elements, also in the context of Community Reinforcement Approach Senior. However, in softening sustain talk, the rare measures, and persuade with permission it has proved more difficult to reach high levels of interrater reliability.

OriginalsprogEngelsk
TidsskriftJournal of Substance Abuse Treatment
Vol/bind97
Sider (fra-til)59-67
Antal sider9
ISSN0740-5472
DOI
StatusUdgivet - 1. feb. 2019

Fingeraftryk

Motivational Interviewing
Alcohols

Citer dette

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title = "Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4)",
abstract = "Background and aims: The Motivational Interviewing Treatment Integrity code (MITI) measures fidelity to, and the quality of, Motivational Interviewing (MI), and can also be used when MI is combined with other treatment methods. The current study presents a fidelity measurement with the MITI 4.2.1, in both Motivational Enhancement Therapy sessions and the combined Community Reinforcement Approach-Senior (CRA–S). Method: The MITI 4.2.1 was used to evaluate treatment sessions provided in the Elderly Study, a multi-national randomized trial evaluating treatment for alcohol use disorders in the elderly. Following expert recommendations, training was conducted at two international sites as well as at the Danish site. Twenty percent of the sessions at the Danish study site were rated. Twelve percent were multiply rated by all raters. Interrater reliability was assessed by the Intraclass Correlations Coefficient (ICC). Results: Mean ICC of the 52 sessions rated by all raters was 0.78 (95{\%} CI: 0.70; 0.86). The rare measures confront and emphasize autonomy, and the global measure softening sustain talk only reached fair levels of ICC, while the remaining measures were good or excellent. In the sessions of MI combined with other treatment approaches in the CRA–S, the MITI 4.2.1 has a similar reliability as in MET sessions only, except for the measure persuade with permission. Conclusion: The MITI 4.2.1 is a reliable instrument for measuring fidelity to Motivational Interviewing elements, also in the context of Community Reinforcement Approach Senior. However, in softening sustain talk, the rare measures, and persuade with permission it has proved more difficult to reach high levels of interrater reliability.",
keywords = "Cognitive behavioral therapy, Fidelity, Integrity, MITI4, Motivational interviewing, Reliability",
author = "{Kramer Schmidt}, Lotte and Kjeld Andersen and Nielsen, {Anette S{\o}gaard} and Moyers, {Theresa B.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.jsat.2018.11.004",
language = "English",
volume = "97",
pages = "59--67",
journal = "Journal of Substance Abuse Treatment",
issn = "0740-5472",
publisher = "Elsevier",

}

Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4). / Kramer Schmidt, Lotte; Andersen, Kjeld; Nielsen, Anette Søgaard; Moyers, Theresa B.

I: Journal of Substance Abuse Treatment, Bind 97, 01.02.2019, s. 59-67.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4)

AU - Kramer Schmidt, Lotte

AU - Andersen, Kjeld

AU - Nielsen, Anette Søgaard

AU - Moyers, Theresa B.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Background and aims: The Motivational Interviewing Treatment Integrity code (MITI) measures fidelity to, and the quality of, Motivational Interviewing (MI), and can also be used when MI is combined with other treatment methods. The current study presents a fidelity measurement with the MITI 4.2.1, in both Motivational Enhancement Therapy sessions and the combined Community Reinforcement Approach-Senior (CRA–S). Method: The MITI 4.2.1 was used to evaluate treatment sessions provided in the Elderly Study, a multi-national randomized trial evaluating treatment for alcohol use disorders in the elderly. Following expert recommendations, training was conducted at two international sites as well as at the Danish site. Twenty percent of the sessions at the Danish study site were rated. Twelve percent were multiply rated by all raters. Interrater reliability was assessed by the Intraclass Correlations Coefficient (ICC). Results: Mean ICC of the 52 sessions rated by all raters was 0.78 (95% CI: 0.70; 0.86). The rare measures confront and emphasize autonomy, and the global measure softening sustain talk only reached fair levels of ICC, while the remaining measures were good or excellent. In the sessions of MI combined with other treatment approaches in the CRA–S, the MITI 4.2.1 has a similar reliability as in MET sessions only, except for the measure persuade with permission. Conclusion: The MITI 4.2.1 is a reliable instrument for measuring fidelity to Motivational Interviewing elements, also in the context of Community Reinforcement Approach Senior. However, in softening sustain talk, the rare measures, and persuade with permission it has proved more difficult to reach high levels of interrater reliability.

AB - Background and aims: The Motivational Interviewing Treatment Integrity code (MITI) measures fidelity to, and the quality of, Motivational Interviewing (MI), and can also be used when MI is combined with other treatment methods. The current study presents a fidelity measurement with the MITI 4.2.1, in both Motivational Enhancement Therapy sessions and the combined Community Reinforcement Approach-Senior (CRA–S). Method: The MITI 4.2.1 was used to evaluate treatment sessions provided in the Elderly Study, a multi-national randomized trial evaluating treatment for alcohol use disorders in the elderly. Following expert recommendations, training was conducted at two international sites as well as at the Danish site. Twenty percent of the sessions at the Danish study site were rated. Twelve percent were multiply rated by all raters. Interrater reliability was assessed by the Intraclass Correlations Coefficient (ICC). Results: Mean ICC of the 52 sessions rated by all raters was 0.78 (95% CI: 0.70; 0.86). The rare measures confront and emphasize autonomy, and the global measure softening sustain talk only reached fair levels of ICC, while the remaining measures were good or excellent. In the sessions of MI combined with other treatment approaches in the CRA–S, the MITI 4.2.1 has a similar reliability as in MET sessions only, except for the measure persuade with permission. Conclusion: The MITI 4.2.1 is a reliable instrument for measuring fidelity to Motivational Interviewing elements, also in the context of Community Reinforcement Approach Senior. However, in softening sustain talk, the rare measures, and persuade with permission it has proved more difficult to reach high levels of interrater reliability.

KW - Cognitive behavioral therapy

KW - Fidelity

KW - Integrity

KW - MITI4

KW - Motivational interviewing

KW - Reliability

U2 - 10.1016/j.jsat.2018.11.004

DO - 10.1016/j.jsat.2018.11.004

M3 - Journal article

VL - 97

SP - 59

EP - 67

JO - Journal of Substance Abuse Treatment

JF - Journal of Substance Abuse Treatment

SN - 0740-5472

ER -