Motivational Interviewing (MI) Treatment Integrity Code
Code CategoriesComponentsDefinitionExamplesRating Scheme
MI-adherent statementsAffirm, emphasize autonomy, ask before giving advice, supportIt takes courage to come in and talk about depression. (Affirm)
May I share some information about antidepressant medications? (Ask permission)
Simple reflectionsReflect basic understanding of what patient has saidYou are determined to start an antidepressant medication.
Complex reflectionsAdd substantial meaning to what patient has saidOn the one hand you perceive potential benefit from the medicine, and on the other hand you are terrified of getting addicted.
MI-consistent languageMI-adherent statements + reflections + open questions
MI spiritAverage of global scores of evocation, collaboration, and autonomy/support
EmpathyGlobal score: the extent to which the clinician understands or makes an effort to grasp the client's perspective and feelings. Reflective listening is an important part of this characteristic, but this global rating is intended to capture all efforts that the clinician makes to understand the client's perspective and convey that understanding to the client.Empathy is evident when providers show an active interest in understanding what the client is saying. It can also be apparent when the clinician accurately follows or perceives a complex story or statement by the client or probes gently to gain clarity.
Clinicians with low empathy show little effort to gain a deeper understanding of complex events and emotions, and questions asked reflect shallowness or impatience.
MI nonadherent statementsAdvising, directing, confrontingI would strongly recommend that you start the antidepressant medication now. (Advise)
You're letting your family down if you don't take the antidepressant. (Confront)