Teaching students to use motivational interviewing in their practice works!
When I developed the curriculum for the Think Ahead programme, I aimed to provide training for students which they could use directly in their practice. We selected a range of interventions which had some evidence that if they were fully implemented they could improve outcomes for people with mental health problems. These included approaches that could be used with individuals, families or communities.
One of these approaches was motivational interviewing, commonly used in a range of social work settings. We supported students to use the methods and techniques of motivational interviewing in their placements (predominantly in mental health settings) to support people to make decisions and consider their options about changes to make in their lives. Students were supported both by their practice educators, who we also trained in motivational interviewing, and their university tutors, to apply the theory and model in their practice.
The aim of this was to take a proactive approach to practice learning. Rather than retrofitting theory onto practice, we aimed to support students to identify opportunities when they can use particular techniques which may benefit people in particular situations. By teaching the theory and practice of motivational interviewing, we aimed to equip the students with the knowledge and skills required to do this effectively.
To assess whether or not this was successful, we undertook a thematic analysis of their practice learning placement reports to assess the extent to which they were able to apply it in their practice. We selected students at random from the first two cohorts trained at the University of York and obtained their informed consent for this analysis. Ethical approval was obtained through the University of York Department of Social Policy and Social Work Ethics Committee.
We looked at 16 placement reports in total and found many examples of students’ adherence to motivational interviewing principles and practice, facilitated by their self-reported knowledge and confidence in using the approach. For example, students used terms such as ‘ambivalence’, ‘change talk’, ‘eliciting’ and DARN (motivational interviewing shorthand for desire, ability, reason and need). Others demonstrated communication skills congruent with motivational interviewing, including the use of reflections and affirmations. These written accounts of practice were supported by practice educators’ reports and feedback from service users.
The analysis also found some students who struggled to utilise it because of a poor understanding or a practice context that mitigated against its use. For example, some reports did not mention it at all or made only a passing reference to its use in their practice. Some students reported how their practice learning opportunities revolved around procedural or legislative-driven work which mitigated against the use of their practice skills.
Overall, though, we found evidence that it is possible to train social work students to use motivational interviewing during their final placement. Motivational interviewing was mentioned by 14 of the 16 students and 9 of them demonstrated good adherence. Given that this is likely to improve outcomes for people with mental health problems (though this wasn’t evaluated in this study), it is worthwhile considering how full training in motivational interviewing could be provided routinely within social work curricula.
Further reading
If you want to find out more about this study, the paper reporting our findings – co-authored by Tracy Almond and Sara Ward – has just been published by Social Work Education: The International Journal (open access):