Table 3.
Assessment of Fidelity to MI: summary scores for five randomly selected interviews.
| MITI -4 outcome measure for determining competence in MI | MITI -4 basic competence (fair) Threshold Score |
MITI -4 proficiency (good) Threshold Score |
Researcher range scores | Researcher Average Score |
|---|---|---|---|---|
| Global Clinician Rating –technical (cultivating + sustaining/2) | Average of 3 | Average of 4 | (3–4) | 3.2 (fair to good) |
| Global Clinician Rating – Relational (partnership + empathy/2) | Average of 3.5 | Average of 4 | (3–4) | 4.2 (good) |
| Reflection to Question Ratio (total reflection/total questions) | 1:1 | 2:1 | 2.75:1 (good) | |
| Percent Complex Reflections (CR/(SR + CR) | 40% | 50% | 48.5% (fair to good) | |
| Total MI-Adherent (SC + A + EA) | NA | NA | 10–19 | 15.4 |
| Total MI – non adherent (confront + persuade) | NA | NA | 0–3 | 1.4 |
Complex reflections (CR) typically add substantial meaning or emphasis to what client has said.
Simple Reflections (SR) convey understanding or facilitate client-clinician exchange.
Seeking Collaboration (SC) clinician explicitly attempts to share power or acknowledge expertise of client.
Affirmation (A) clinican utterance that accentuates something positive about the client.
Emphasising Autonomy (EA) utterances that clearly focus the responsibility with the client for decisions about change.