By The New England ATTC and Stephen Andrew, LCSW, LADC, CCS, CGP
The New England ATTC is collaborating with the Health Education & Training Institute in an effort to implement Motivational Interviewing (MI) systems-wide throughout Tri-County Mental Health Services of Maine. Tri-County Mental Health Services provides integrated behavioral health care for clients with substance use and mental health problems, and they are seeking to integrate MI across their entire continuum of care. MI is a client-centered, evidence-based method for enhancing clients’ intrinsic motivation to change. It was selected as the focal intervention because of its potential to improve client engagement, retention, and substance-related treatment outcomes. The goal of this MI initiative is to optimize sustainability within the organization by creating an internal group of trainers and coaches who will learn to use and teach/coach MI.
The intensive technical assistance (TA) initiative is targeted towards counselors, supervisors and community workers with varying levels of experience in MI and will ultimately be delivered across 5 Tri-County locations in Maine. It begins with three days of face-to-face instruction followed by a virtual MI Master Class using Zoom conferencing. The Master Class provides continued coaching and skill building. Additionally, there are on-going monthly Zoom calls for core staff over a 12-month period and assigned MI activities to practice concepts during existing staff meetings.
On-site trainings are conducted by Stephen Andrew, LCSW, LADC, CCS, an internationally renowned MI and MIA-STEP (Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency) trainer, and long-standing member of the International Motivational Interviewing Network of Trainers (MINT). Stephen has been a consultant and trainer for the New England ATTC since 2007.
During the first two days of face-to-face training, Stephen provides an introduction to the clinical method of MI with a focus on intervention basics. Participants have the opportunity to explore creative ways of integrating MI techniques and skills. After orientation to the underlying spirit, structure, and principles of MI, application of practical exercises helps participants strengthen their empathy skills, recognize and elicit change talk, and roll with resistance.
The third day of training is titled Advancing the Practice using MIA-STEP. MIA-STEP is a training for those that supervise or mentor treatment providers in a clinical setting whose roles involve providing feedback and coaching to help practitioners improve their skills and effectiveness. This training provides clinical supervisors practical tools to enhance treatment providers' MI skills. To date, 25 Tri County Mental Health Services staff have completed the two-day MI basics training and 16 staff have participated in the MIA-STEP one-day training at the first location in Lewiston, ME.
Participants have referred to the in-person trainings, and Stephen, as “amazing” saying, “the whole audience loved it.” When asked which training aspects were most useful, staff indicated they now had “a better way to work with clients who are ambivalent about sobriety,” and “insightful … tools for [their] work ‘tool box’ Further, staff reported feeling better equipped to understand their own “personal shortcomings and … to normalize ambivalence,” ,” to “meet clients where they dream,” and to “sit with clients ambivalence and suffering” until the client felt ready to move forward.
The monthly virtual Master Class is conducted by Kathryn Hartileb, PhD, RDN, an Assistant Professor at Florida International University’s Herbert Wertheim College of Medicine. Kathryn is an expert in health communication and behavior change. Like Stephen, she is a long-standing member of the MINT network. Kathryn’s main goal when leading the Master Class is to build participants’ MI skills through exploration of Bill Miller's "Master Class" exercises and practice diving into the Four Processes of Engaging, Focusing, Evoking, and Planning. The Zoom Master Class is designed to provide the opportunity for participants to practice MI Spirit and skills alongside a supportive network of peers facing similar professional challenges as well as the opportunity to consult about clients who struggle with substance-related concerns. The first Master Class was launched on October 9, 2019, with seven participants in attendance. Classes will continue through September 2020.
The New England ATTC is excited to partner with the Health Education & Training Institute to offer this intensive TA initiative to Tri-County Mental Health Services of Maine!