Q&A: What's the Best Way to Train People to Use Evidence-Based Practices?

Photograph of a woman talking with a teen girl. Both are smiling.

Psychologist Melanie Barwick is a co-author of “Training Health and Mental Health Professionals in Motivational Interviewing: A Systematic Review,” published in the September 2012 issue of the Children and Youth Services Review.

Barwick and her colleagues were curious about how evidence-based practices can be successfully implemented in service settings, including youth programs. The researchers reviewed 22 programs’ approaches to implementing an evidence-based practice called “motivational interviewing,” defined in their paper as “a collaborative, person-centered form of guiding [clients] to elicit and strengthen motivation for change.”

Perhaps unsurprisingly, Barwick and her colleagues found that the practice is most successful when staff have in-depth, prolonged training on how to use it.

“Training that consisted of theory and discussion produced only a modest gain in knowledge,” they write. “It was only when on-the-job coaching was added that large gains were seen in knowledge, ability to demonstrate the skills, and use of the new skills in the classroom.”

NCFY asked Barwick to explain these findings and the next steps in her research.

NCFY: What gave you the idea to review these studies?

BARWICK: We were trying to figure out what was the best way to introduce something like motivational interviewing into a provider setting. We know that it’s an effective counseling approach, it’s proven to be successful with children and youth.

The models that we use in mental health, whereby a trainer imparts knowledge for a period of time and then folks go back to their offices and struggle to implement what they’ve learned—we know that doesn’t work very well. What’s come to light is the importance of training and coaching beyond the normal two-day interface. [Youth workers need] to reconnect with an expert over a period of time, to ask questions, to receive support in how to actually apply what they’ve learned.

NCFY: How are you using this information in your own original research?

BARWICK: The paper addresses how best to train practitioners in motivational interviewing, and [we’re now using] this information to test the implementation of motivational interviewing in four mental health organizations. We provided the clinicians with an opportunity to get coaching and supervision once a month over a period of seven months. We also worked with a core group of people from each organization who came together as an implementation team, to facilitate organizational changes that occur as a result of a new practice. One of the things we’ve learned in the field is that, when you bring a new practice to a provider, you’re not only changing what the practitioner does, you’re also changing other things that go on in the organization. You might have impact on who gets hired, on the information systems, on how supervision happens and when it happens.

After a year, there’s a real recognition [among our clinicians] that learning is a long-term process. All of the clinicians have come back to say how valuable the coaching from the trainers has been.

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