Effectiveness of Motivational Interviewing Supervision in Community Programs
Condition: Signs and Symptoms; Clinical Supervision
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The virtual requirement that substance abuse programs use evidence-based treatments (EBT) has
      prompted the development of dissemination strategies to promote EBT technology transfer.
      Implementation research, clinical trial training methods, and clinician training studies
      suggest that clinical supervision that involves direct observation, fidelity rating-based
      feedback, and coaching of therapeutic skills is a promising dissemination approach. However,
      clinical supervision delivered within substance abuse programs by on-site supervisors has
      never been directly tested in a randomized controlled trial to determine the impact of
      supervision on both clinician EBT skills and client treatment outcomes.

      Recent results from two NIDA CTN protocols testing the effectiveness of Motivational
      Interviewing (MI) have shown that community program clinicians can learn to deliver MI with
      fidelity when receiving MI supervision from their program supervisors after workshop training
      and that their implementation of MI early in treatment improves client retention and primary
      substance use outcomes. A MI supervision manual called MIA: STEP (Motivational Interviewing
      Assessment: Supervisory Tools for Enhancing Proficiency) was developed from these protocols
      and has begun to be widely distributed by NIDA in partnership with SAMHSA for community
      program use. The effectiveness of the MIA: STEP supervision approach is unknown.

      This study will directly test the effectiveness of MIA: STEP supervision on clinician MI
      fidelity and on client outcomes by randomly assigning 60 clinicians and 420 substance-using
      outpatients from 11 community programs within Connecticut to one of two conditions in which
      clinicians in both conditions will deliver a 1-session MI intervention to clients as the
      enter treatment. The conditions are: 1) workshop training plus MIA: STEP supervision, and 2)
      workshop training alone with supervision-as-usual practices used at each program. This
      project will be the first randomized trial to examine the impact of clinical supervision in
      an empirically based treatment on both clinician and client outcomes. Moreover, because it
      will provide workshop training and supervision completely within the context of community
      programs and utilize in-house program supervisors, it will provide a rigorous evaluation of a
      feasible model for disseminating EBTs such as MI.
    


Intervention name(s): SAU; MIA: STEP
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Supervision-as-usual; Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA: STEP
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: supervision; motivational interviewing; substance abuse; dissemination