Clinician training is used to help clinicians broaden their methods of approach when treating clients. Training involves teaching clinicians how to develop higher levels of motivational interviewing (MI) using cues and feedback. These training sessions are usually conducted in workshop settings and involve role-playing. Another popular training technique that has been shown to provide positive skill enhancement for clinicians is the review of taped sessions. Clinicians tape sessions with clients and then have them reviewed by supervisors who provide suggestions on how to improve their MI skills and overall therapeutic technique. Although both workshop training and tape reviews offer the opportunity for therapists to hone their clinical skills, the effects are not usually sustained long-term. Advances made in workshops may not be wholly effective in real-life situations with clients, and tape reviews are conducted long after sessions have taken place, creating a missed opportunity to make changes to the therapeutic approach in real-time settings.
Jennifer L. Smith of the Department of Psychiatry at Columbia University recently led a study to test the effectiveness of more immediate clinician training. Teleconferencing supervision (TCS) involves remote supervision of therapy sessions while they occur. In this study, Smith evaluated 97 therapists who received training through workshops, tape reviews, or live TCS using an earpiece during substance abuse treatment sessions involving client actors. The participants conducted sessions over 5 weeks and were assessed for MI during the treatment and again 8 and 20 weeks after.
Smith found that the therapists in the TCS condition developed higher levels of MI, resulting in more empathy toward their clients than was achieved by the other groups of participants. The MI gains also reflected less argumentative engagements and negative confrontation during sessions and at follow-up. When Smith compared all three conditions, she found that TCS was the most effective, followed by taped reviews and then workshop training. However, Smith also noted that some of the clinicians in the TCS condition relied too heavily on the remote supervision and that more open-ended prompts should be used in place of direct suggestions to allow clinicians to strengthen their ability to select the appropriate course of action during therapy. She added, “The present findings suggest a longer duration of supervision, involving a combination of techniques embodied in TCS and tape, might be tested with the goal of bringing a greater proportion of community-based counselors to high levels of proficiency.”
Smith, J. L., Carpenter, K. M., Amrhein, P. C., Brooks, A. C., Levin, D., Schreiber, E. A., et al. (2012). Training substance abuse clinicians in motivational interviewing using live supervision via teleconferencing. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028176
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