A Pilot Study of Introductory Motivational Interviewing
Training for Supported Employment Case Managers
Trevor J. Manthey, MSW, Ph.D. Candidate
University of Kansas
School of Social Welfare
1545 Lilac Lane
Lawrence, KS 66044-3184
Citation:Manthey TJ (2013) A Pilot Study of Introductory Motivational Interviewing Training for Supported
Employment Case Managers. International Journal of
Psychosocial Rehabilitation. Vol 18(1) 133-138
To conduct an initial pilot study to determine if introductory
motivational interviewing will lead to initial knowledge and
attitudinal shifts within case-managers who work in an employment
Using a pre-post design, 20 participants attending an introductory MI
training filled out a questionnaire meant to assess an individual’s
general knowledge of motivational interviewing and an individual’s
attitudes about how to work with individuals attempting to gain
There were statistically significant improvements in motivational
interviewing knowledge and attitude shifts about how to work with
individuals attempting employment.
Introductory MI training may be an important initial step in an overall
implementation effort to integrate motivational interviewing in
employment rehabilitation contexts. In other words, initial
training may open the door for the more in-depth skill building efforts
required to adequately build and sustain counselor skills in MI by
helping counselors first shift their attitudes about how they work with
individuals seeking employment.
has been suggested that the field of vocational rehabilitation move
toward greater use of evidence based practices (Chan, Travydas,
Blalock, Strauser, & Atkins, 2009, Chan, Miller, Pruett, Lee, &
Chou, 2003). Motivational interviewing is an evidence-based
practice which has been shown to be effective in a wide variety of
behavior change fields outside of vocational rehabiltiation (Lundahl,
Tollefson, Gambles, Brownell, & Burke, 2010; Miller & Rollnick,
While many researchers have discussed
conceptually how MI fits well within a vocational rehabilitation
paradigm (Brooks, 2005; Graham, Jutla, Higginson, & Wells, 2008;
Larson, 2008; Lloyd, Tse, Waghorn, & Hennessy, 2008; Manthey, 2011;
Manthey, Jackson, & Evans-Brown, 2011; Muscat, 2005; Wagner &
McMahon, 2004) and the few studies which have been conducted in
employment settings outside of vocational rehabilitation have been
encouraging (Larson, Boyle, Barr, Glenn, & Kuwabara, 2007;
Leukefeld, McDonald, Staton, Mateyoke-Scrivner, et al., 2003; Rose,
Saunder, Hensel, & Kroese, 2005), there has not yet been a pre-post
or controlled trial to assess the effectiveness of MI within the unique
vocational rehabilitation setting. Despite this, some
valuable lessons have been learned. A large scale implementation
project of motivational interviewing occurred in the Washington state
vocational rehabilitation system to help facilitate a system wide
cultural shift (Manthey, Jackson, Evans-Brown, 2011). A
post hoc analysis of outcomes from this project suggested that MI may
have helped improve outcomes for clients in areas such as length of
time to plan and overall cost per client (Evans-Brown, Jackson, Knizek
& Copeland, 2011). It was also found that skill development
in MI took more than just introductory training in order to sustain
skills. A broad level systems change approach had to be
undertaken in order to build MI skills and then later sustain
them. This is consistent with the motivational training
literature found in other fields (Madson, Loignon, & Lance, 2009;
Miller & Rollnick, 2012). However, the results of the
Washington State implementation project were tentative due to a lack of
randomization, control group, and pre-post testing.
purpose of this pilot pre-post study was to determine what types of
realistic initial gains might be expected from an initial introductory
training. In other words, if introductory trainings alone do not
lead to sustained MI skill development, then what might be the benefit
of conducting an introductory MI training within an employment
rehabilitation setting? We hypothesize that initial training in
MI may lead to initial knowledge and attitude shifts which may make
participants more amenable to the more intensive training and
implementation efforts required by an agency to sustain MI skill
participants participated in an introductory MI training in
Kansas. Seventeen of the participants were case-managers; the
other three were supervisors. All participants were employed
either as supported employment workers or case-managers that had
employment rehabilitation focused duties. Nine of the
participants were from urban areas and 11 of the participants were from
rural. Eleven of the participants were male and 9 were female.
pilot pre-post design was used to assess whether there would be
increases in initial motivational interviewing knowledge and shifts in
motivational interviewing attitudes. As participants entered the
training, they were given the Motivational Interviewing Knowledge and
Attitudes Scale – Vocational Rehabilitation (MIKAT-VR) (described
further in the measures section). At the conclusion of the
introductory training participants were asked to fill out the MIKAT-VR
again and then were asked to fill out their regular training
The Introductory MI Training
training was facilitated by members of the Motivational Interviewing
Network of Trainers (MINT). The training included didactic,
experiential, and written activities. In addition, the training
included a classroom response system (CRS) which allows for individual
members of the course to confidentially answer questions in the middle
of the training via remote responders and get immediate feedback
regarding whether their answers were correct or not. The training
provided introductory training regarding the spirit and principles of
MI, and introduced the four processes of MI. Initial core skill
development was also practiced.
MIKAT-VR is a scale meant to assess MI knowledge and attitudes that are
essential for learning MI skills. The MIKAT-VR is adjusted in
language from the original MIKAT (Leffingwell, 2006) which served the
same purpose except the language reflected MI knowledge and attitudes
for learning MI in substance abuse settings as opposed to vocational
samples t-test was used to determine if there were statistically
significant differences between the pretest and posttest scores on the
indicated a significant difference between the pre (M = 7.26, SD =
1.62) and posttest (M = 11.26, SD = 1.28) MIKAT scores; t(19)=
-14.51, p = .001. Employment workers who participated in
introductory MI training shifted MI inconsistent attitudes and
increased their knowledge of motivational interviewing.
this pilot study does include a pre and posttest the results of this
study are interpreted with caution due to the limitations associated
with limited sample size, lack of randomization and control
group. However, given these limitations it appears that initial
training in motivational interviewing can lead to important attitude
shifts and knowledge of MI. While this does not mean the
individuals participating in introductory MI trainings have increased
their ability to do MI, it does mean that participants may have shifted
personally held attitudes that are essential for practicing MI.
Essentially this means that introductory MI trainings may be an
important initial step in the goal of long-term MI
implementation. While the current MI training research indicates
that introductory MI trainings alone are not effective at building and
sustaining MI skills (Madson et al. 2009) the present study indicates
that introductory trainings may still have value in shifting attitudes.
This pilot study may serve
as a launching point for further exploration of MI implementation, MI
training, and systems change efforts within vocational rehabilitation
contexts. Future controlled trials may need to focus on
evaluating what introductory training paired with advanced training,
audio-coding, and other intensive MI implementation efforts produce
regarding sustained MI skill development. In addition, research
within vocational rehabilitation which can link MI skill development
with outcomes such as improved client working alliance, and related
employment outcomes will be essential. This pilot pre-post
study lends support to the contention that initial training in MI can
produce important knowledge and attitude shifts. These attitude
shifts may be an important first step when planning for the advanced
implementation efforts needed to develop MI skills and sustain
them. This current study provides some initial footing for
continued MI implementation research in vocational
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