Academic journal article Journal of Mental Health Counseling

Strengthening the Planning Process of Motivational Interviewing Using Goal Attainment Scaling

Academic journal article Journal of Mental Health Counseling

Strengthening the Planning Process of Motivational Interviewing Using Goal Attainment Scaling

Article excerpt

Client-centered, outcomes-based mental health counseling is driving the behavioral health field toward identifying mechanisms to facilitate specific, measurable goal setting and tracking with client?. Motivational interviewing (MI) is an evidence-based, collaborative, goal-oriented style of counseling; however, the fourth process of MI, planning, is not as well defined as the other MI processes, especially related to goal setting. Goal attainment scaling (GAS) is a method for setting measurable goals and assessing clinical progress. The combination of MI and GAS has potential to be a valuable clinical tool to establish client-centered goals, monitor goal attainment, and provide feedback within clinical mental health settings. Therefore, we propose that the MI planning process can be enhanced by incorporating GAS. However, research is needed to substantiate the feasibility of the proposed integration. A brief case study is provided to illustrate key concepts.

Motivational interviewing (MI) has significantly grown in popularity over the past two decades (Burke, 2011; Rosengren, 2009). MI has influenced numerous treatment programs and has been studied in over 200 clinical trials; its effectiveness has been substantiated across a number of presenting clinical problems (Miller & Rollnick, 2013). A noteworthy aspect of MI is helping people increase their internal motivation to accomplish goals related to behavior change. Yet processes within MI lack a formal strategy to set and track goal progress and intermediary outcomes that meet the standards consistent with evidence-based practice. The reality of clinical mental health care is that counselors are increasingly asked to engage in various methods for documenting and monitoring progress and for facilitating effective outcomes (Goodman, McKay, & DePhilippis, 2013; Kilbourne, Keyser, & Pincus, 2010; Lizarondo, Grimmer, & Kumar, 2014; Ottenbacher & Cusick, 1990, 1993). Therefore, the ability to measure incremental progress and improvements in symptoms, behaviors, and functions for a variety of issues in mental health practice is needed (Goodman et al., 2013; Kilbourne et al., 2010), even when utilizing evidence-based protocols such as MI.

In the area of physical medicine, practitioners are held accountable for measuring outcomes in response to treatments for chronic conditions such as diabetes. These outcomes are often measured in absolutes (e.g., reduction of average blood glucose levels in the past 3-6 months), without regard for important incremental changes in client symptoms, behaviors, and functional progress (e.g., increased physical activity and improved dietary habits). Similarly, many popular outcomes-based measures within clinical mental health (e.g., the Outcome Rating Scale [ORS; Miller & Duncan, 2000, as cited in Campbell & Hemsley, 2009], Session Rating Scale [SRS; Duncan et al., 2003], and Outcome Questionnaire-45 [OQ-45; Lambert et al., 1996]) are based on broad outcome markers such as the strength of the alliance and individual, relational, and social functioning. A concern with some outcome measures is the time it takes to complete them within a session. This concern is minimized with ultrabrief measures such as the ORS and SRS (Shaw & Murray, 2014); however, other measures such as the OQ-45, despite strong psychometric properties, are considered time-consuming and impractical, leading to problems with clinician follow-through (Campbell & Hemsley, 2009). In addition, established outcome measures are not based on collaborative goal setting nor designed to assess incremental movement toward attainment of a specific counseling goal. Measures that rely solely on outcomes allow counselors to predict functioning, but not to assess specific goal attainment or assess progress toward a goal or goals.

MI's evidence-based clinical approach may be driving its popularity; however, an objective mechanism for monitoring progress toward clinical goals does not currently exist. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.