Exploring the challenges that prevent practitioners from implementing motivational interviewing in their work with clients

Bell, Lenie Debbie (2019-12)

Thesis (MA)--Stellenbosch University, 2019.

Thesis

ENGLISH ABSTRACT: Motivational Interviewing (MI) is an evidence-based counselling technique used by psychologists, doctors, nurses, midwives and social workers aimed at behavioural change. The purpose of this qualitative study was to explore the barriers that prevented practitioners from using MI. Studying the problem was necessary because only a few studies have examined practitioners’ experiences during their MI training and subsequent implementation of MI. I explored practitioner-related factors, client-related factors, training and supervision and workplace related factors that acted as barriers that hindered the implementation of MI. This study was conducted among 15 social and health practitioners living and working in the Western Cape. All participants were trained in MI and found to be competent after the training. Purposive sampling and snowball sampling was used to recruit participants for the study. Thematic analysis was used to analyse the data of the semi-structured interviews. The study drew on a conceptual framework called the Promoting Action on Research Implementation in Health Services (PARiHS) that attempts to explain how to implement evidence-based practice (EBP) effectively. Practitioner-related factors included the difficulty in making a therapeutic paradigm shift, a lack of confidence and negative attitude toward MI. The client-related factors related to the community, lack of family support, cognitive impairment and client resistance. The lack of continued training and supervision was also found as a barrier. Participants with no counselling qualifications reported that they found it challenging to understand the concepts of MI. Another barrier highlighted in this study was that work environments were not conducive to MI as participants reported that they did not have enough time allocated with clients to implement MI and that there was a lack of support from management to implement MI as an intervention. The findings have identified areas in which interventions can take place to support the implementation of MI.

AFRIKAANSE OPSOMMING: Motiverende onderhoudvoering (MO) is 'n bewys-gebaseerde beradings tegniek wat deur sielkundiges, dokters, verpleegsters, vroedvroue en maatskaplike werkers gebruik word gemik op gedragsverandering. Die doel van hierdie kwalitatiewe studie was om die hindernisse te identifiseer wat die praktisyne verhoed om MO te gebruik. Die studie was nodig omdat daar slegs 'n paar studies was wat fokus op die ervaringe van die praktisyne tydens hul MO opleiding en gevolglike implementering van MO. Ek ondersoek die praktisyn verwante faktore, die klient verwante faktore, opleiding en supervisie en die werksplek verwante faktore wat as hindernisse die implementasie van MO verhoed. Hierdie studie is gedoen onder 15 sosiale- en gesondheid praktisyne wat woon en werk in die Wes-Kaap. Alle deelnemers is opgelei in MO en bevoeg bevind met hul opleiding. Doelgerigte steekproeftrekking en sneeubal steekproefneming is gebruik om deelnemers vir die studie te werf. Tematiese analise is gebruik om die data van die semi-gestruktureerde onderhoude te analiseer. Die studie gebruik die konseptuele raamwerk bekend as die Bevordering van Aksie op Navorsing Implementering in Gesondheidsdienste (BANIG) wat poog om te verduidelik hoe om bewysgebaseerde praktyke (BGP) effektief te implementeer. Praktisyne verwante faktore sluit in die uitdaging om ‘n paradiegma skuif te maak en die verandering toe te pas, die gebrek aan self-vertroue en die negatiewe houding van die deelnemers. Die kliënt verwante faktore was die gemeenskap faktore, die gebrek aan familie ondersteuning, kognitiewe uitdagings en kliënt weerstandigheid. Die gebrek aan voortdurende opleiding en toesig was ook as ‘n hindernis geidentifiseer. Deelnemers met geen vorige beradings kwalifikasies het gesukkel met begrip van die konsepte van MO. 'n Gebrek aan ondersteuning van die bestuur om MO te implementeer asook te min tyd om dit toe doen was ook as ‘n hindernis geidentifiseer. Die bevindinge het areas geidentifiseer wat die implementering van MI kan ondersteun in intervensies.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107083
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