Deliberate Practice in Motivational Interviewing

Deliberate practice exercises help clinicians develop competence in fundamental motivational interviewing skills to better assist clients with change goals, like quitting addictive behaviors and developing healthier habits, and to improve treatment engagement and retention.

These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns.
 
The first 12 exercises focus on specific skills, such as offering simple and complex reflections and affirmations, eliciting change talk, supporting client autonomy, and collaboratively mapping session agendas. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into one session.

Step-by-step instructions guide participants through the exercises, identify criteria for skill mastery, and explain how to monitor and adjust difficulty. Guidelines and forms to help trainers and trainees get the most out of training are also provided.

Jennifer K. Manuel, PhD, is deputy director of psychology at the San Francisco Veterans Affairs Health Care System and anassociate professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco. She has been a member of the Motivational Interviewing Network of Trainers (MINT) since 2005. She conducts MI training and coding workshops throughout the world. She has coauthored multiple MI behavioral coding systems including the widely used Motivational Interviewing Treatment Integrity (MITI) coding manual. Dr. Manuel’s research expertise is in the implementation and evaluation of MI in front-line clinical settings.

 

Denise Ernst, PhD, is an adjunct professor at the School of Social Work, Portland State University. She has been a motivational interviewing (MI) consultant for over 25 years, providing training, evaluation, research and implementation support, and private coaching internationally. Dr. Ernst has helped develop and refine MI coding instruments, including the Motivational Interviewing Skill Code (MISC) and the Motivational Interviewing Treatment Integrity (MITI) coding system. She participated in research efforts to enhance training effects, providing structured feedback and coaching for many professions. Dr. Ernst has been a member of the Motivational Interviewing Network of Trainers (MINT) since 1997.



Alexandre Vaz, PhD, is chief academic officer of Sentio University marriage and family therapy (MFT) program in California. This innovative online/hybrid California MFT degree was the first approved by the California Board of Behavioral Science for MFT licensure to fully integrate deliberate practice into its curriculum to ensure superior clinical outcomes. He is also director of clinical training for the Sentio Counseling Center, which is Sentio MFT program’s guaranteed practicum site where students provide low-cost online couples therapy in California. Dr. Vaz is the author/coeditor of many books on deliberate practice and psychotherapy training.

Tony Rousmaniere, PsyD, is president of Sentio University marriage and family therapy (MFT) program in California. He led the development of the online/hybrid MFT program, which is the first MFT therapist training program approved by the California Board of Behavioral Science for MFT licensure that fully integrates deliberate practice. Dr. Rousmaniere is the author/coeditor of many books on psychotherapy training. He is also the executive director of the Sentio Counseling Center, which is Sentio MFT program’s guaranteed practicum site where students provide sliding-scale online therapy in California, and past president of the American Psychological Association’s Division 29.