Implementation Strategies
Implementation strategies are the actions needed to implement Motivational Interviewing for Opioid Use Disorder (MI-OUD). Ideally, implementation strategies should be selected to address the barriers to implementation discussed in the "Common Barriers and Facilitators" tab. Click the buttons on the left to read more about implementation strategies people have used to implement MI-OUD and to access educational resources. In addition, view the RASC guide Strategies Timeline, Activities & Resources (STAR) log to discover a practical way to track these strategies, and The Partner Engagement Guide to access practical recommendations to engage partners in your implementation strategies.
Workshop training is the strategy most commonly used to implement Motivational Interviewing, though additional support strategies, including performance feedback, coaching, and leadership support, are recommended.
Implementation of Motivational Interviewing for Opioid Use Disorder (MI-OUD) has been far less studied than implementation of Motivational Interviewing for Substance Use Disorder (MI-SUD). We therefore discuss implementation strategies, such as workshop training and leadership support, that have been used to promote MI-SUD and that are relevant to this guide on MI-OUD.
Studies on MI-SUD suggest that expert-led workshops and train-the-trainer models are among the most common forms of MI-SUD training and are more effective than self-study in helping providers attain performance standards. A meta-analysis of MI-SUD training for real-world agency staff found that MI skills are enhanced by a series of training sessions delivered over a larger timeframe.
Several studies have found that proficiency in MI-SUD skills can be developed through workshop training, though additional support may be required to retain skills over time. Two frequently recommended types of additional support are performance feedback and coaching. Performance feedback commonly involves giving providers feedback on either practice or actual MI-SUD sessions using an MI-SUD coding system. Coaching typically involves one-on-one session reviews between a provider and a trained MI leader (in or outside of oneβs organization). In an analysis of MI-SUD training studies, an average of 3-4 performance feedback and coaching sessions over 6 months sustained MI-SUD skills, whereas studies that did not include these components reported eroded MI-SUD skills over the same period.
Leadership and managerial support for MI-SUD may help resolve implementation barriers of high turnover rates by helping providers overcome concerns about adopting a new practice, and can help foster an MI-SUD culture that resolves personal provider conflicts with other addiction treatment philosophies. This support may include regular team meetings to discuss MI-SUD implementation, adequate allocation of funding and time to effective training practices, and the opportunity to adjust training and MI-SUD workflow to fit provider and patient needs.