Advanced Motivational Interviewing and Feedback Informed Treatment

Across health disciplines, client engagement is a fundamental challenge and responsibility of the clinician. Our first session or two are crucial in engaging people, and there are approaches that can help. Client-centered approaches such as Motivational Interviewing (MI) have an enormous contribution to make in the early stages of treatment. MI significantly increases the chance that clients will engage with, and adhere to, treatment, and also significantly reduces the chance of client drop out.

Using MI, the clinician creates a collaborative, evocative and respectful working relationship, in which a range of strategies are used to actively listen to the client to elicit the client’s own arguments for change or action. Along the way, strategies to build confidence and importance around these changes or actions helps the client to arrive at a sense of commitment regarding what they will do. This commitment early in treatment is predictive of actual change or action later.

In those early sessions and beyond, the working alliance between clinician and client is a key part of helping people change. Feedback Informed Treatment (FIT) seeks feedback on the alliance throughout treatment, clinicians can identify discord, make changes to style and approach, and further enhance their clients’ engagement for the duration of treatment, as well as their effectiveness with their clients. Some simple yet sophisticated approaches to obtaining and acting on this kind of feedback can have a remarkable effect on treatment.

Finally we need to ensure that our treatment is working for people in terms of their clinical outcome. Again, recent data suggests that using FIT to actively track outcomes every session allows us to properly monitor progress, share with our clients objective information about when our approach is working and when it is not, identify setbacks and lapses, and work with client priorities, all with a view of enhancing the treatment effectiveness for the client.

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