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Motivational interviewing (MI) is gaining traction in veterinary medicine as an evidence-based approach for engaging clients in conversations that strengthen their intrinsic motivation to change behaviours that affect the welfare of animals in their care. While MI has a substantial and well-established evidence base across human healthcare and related fields, the veterinary evidence base remains small and is currently limited by study design challenges, inconsistent fidelity measurement, and outcome measures that rarely extend beyond short-term changes in communication behaviour. Existing methodological guidance addresses treatment integrity and theoretical mechanisms but does not provide an integrated framework for designing robust studies across the range of questions relevant to veterinary practice. This paper addresses that gap by providing practical methodological guidance for researchers designing MI studies in veterinary clinical settings. A novel conceptual model of the MI implementation pathway, mapping the journey from practitioner awareness through training and delivery to client outcomes, is used to organise key research questions that need to be answered in veterinary contexts. Guidance is then provided on selecting appropriate study designs, measuring fidelity and outcomes, estimating sample size, and managing the practical and ethical challenges specific to veterinary clinical settings, alongside minimum reporting standards to support more rigorous and reproducible MI research.

Background/purpose: Rural adults and children are at higher risk for overweight and obesity. However, there are relatively few lifestyle modification programs available for these high-risk families, mainly because of the difficulty in reaching them. This mindfulness-based motivational interviewing (MM-based-MI) pilot aimed to improve parents’ healthy eating index (HEI), collective family efficacy, family satisfaction, perceived stress, and depressive symptoms as well as parent–child dyads’ eating patterns, physical activity (PA), and body mass index (BMI).Methods: This randomized controlled trial (RCT) was conducted in the Midwestern US to examine the feasibility (enrollment, attendance, and attrition), acceptability, and preliminary effects of an MM-based-MI intervention that contained nine sessions of health coaching (1-on-1), while the active-control included nine emailed health handouts sent over an 18-week period.Results: A total of 46 parents (29 intervention, 17 control; Mage = 38.5 years, 85% female) participated. The enrollment rate, intervention attendance rate, and attrition rate were 12.6%, 79.8%, and 23.9% respectively. Although not statistically significant, compared to the control, the MM-based-MI intervention showed positive effects on improving parents’ HEI in terms of increasing total HEI score (Cohen’s d = 0.43), vegetable intake (d = 0.41), greens/beans (d = 0.59), protein food (d = 0.82), and self-efficacy in exercise (d = 0.21), as well as decreasing total calories (Kcal, d = −0.58), added sugar (d = −0.50), and depressive symptoms (d = −0.42), while controlling for marital status. Controlling for age, sex, and marital status, intervention children had greater improvement in increasing fiber (d = 0.75) and protein (d = 0.72) intake compared to the active-control group. Moreover, parents in both groups reported improvement (small to large effects) in ↑mindful eating, ↑collective family efficacy, ↑family satisfaction, and ↓perceived stress over time.Conclusions: Despite some limitations (small sample size, virtual at home measurement), our results support the feasibility, acceptability, and preliminary effects of this Mindful Healthy Family program on potentially mitigating some obesogenic behaviors among rural parent–child dyads.Trial registration: ClinicalTrials.gov identifier: NCT05324969.

Motivational interviewing (MI) is an evidence-supported style of communication used across many fields of human services, including addiction treatment, social work, healthcare, education, and criminal justice. MI can be utilized by a variety of human service professionals and requires no special licensure or educational degree. In 2016, our Human Services program at LaGuardia Community College, CUNY began to implement MI training as a core part of our curriculum to provide students with this micro-credential to increase their career readiness. This paper outlines our ongoing approach for implementing MI in a community college human services program, including the training model we used for preparing faculty and staff to implement this approach, as well as some reflections from graduates.

INTRODUCTION: Chronic pain is common among Veterans, some of whom use cannabis for pain. We conducted a feasibility pilot study of a novel coaching intervention to help Veterans optimize use of medical cannabis products for pain management (NCT06320470). METHODS: The intervention drew from scientific literature, consultation with cannabis experts, Veteran input via a Community Advisory Board, and tenets of motivational interviewing. Participants were Veterans with chronic pain who endorsed current use or interest in using cannabis for pain management. Participants received up to 4 individual coaching sessions via videoconference, spaced approximately 2 weeks apart. We assessed feasibility (adherence, satisfaction, acceptability) and preliminary effects on pain symptoms 14 weeks after baseline. The primary outcome was the Patient Global Impression of Change (PGIC), and exploratory outcomes included domains from the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. RESULTS: Of 22 enrolled participants, 17 attended 4 coaching sessions, 2 attended 3 sessions, and 2 attended 2 sessions. Among those who completed end of intervention surveys (16/21), 87.5% were very or completely satisfied with the intervention and 81.3% rated coaching as very or extremely helpful. All participants reported improvement on the PGIC, with 63% reporting much or very much improvement. Participants reported statistically significant decreased pain intensity (7.1/10 vs. 5.7/10) and pain interference (T-score 66.3 vs. 61.8), and increased social satisfaction (T-score 41.4 vs. 44.3). Participants noted helpful intervention factors, including co-developing a personalized plan, discussing questions/concerns, and trying different approaches to cannabis-based treatment. CONCLUSIONS: In this feasibility pilot study of coaching on cannabis use for chronic pain among Veterans, participants were satisfied with the intervention and reported clinically significant improvements in pain symptoms. Our results support evaluating this intervention in a larger, efficacy trial.

BACKGROUND: Preventing progression to moderate or severe opioid use disorder (OUD) among people who exhibit risky opioid use behavior that does not meet criteria for treatment with opioid agonists or antagonists (subthreshold OUD) is poorly understood. The Subthreshold Opioid Use Disorder Prevention (STOP) Trial is designed to study the efficacy of a collaborative care intervention to reduce risky opioid use and to prevent progression to moderate or severe OUD in adult primary care patients with subthreshold OUD. METHODS: The STOP trial is a cluster randomized controlled trial, randomized at the PCP level, conducted in 5 distinct geographic sites. STOP tests the efficacy of the STOP intervention in comparison to enhanced usual care (EUC) in adult primary care patients with risky opioid use that does not meet criteria for moderate-severe OUD. The STOP intervention consists of (1) a practice-embedded nurse care manager (NCM) who provides patient participant education and supports primary care providers (PCPs) in engaging and monitoring patient-participants; (2) brief advice, delivered to patient participants by their PCP and/or prerecorded video message, about health risks of opioid misuse; and (3) up to 6 sessions of telephone health coaching to motivate and support behavior change. EUC consists of primary care treatment as usual, plus printed overdose prevention educational materials and an educational video on cancer screening. The primary outcome measure is self-reported number of days of risky (illicit or nonmedical) opioid use over 180 days, assessed monthly via text message using items from the Addiction Severity Index and the Current Opioid Misuse Measure. Secondary outcomes assess other substance use, mental health, quality of life, and healthcare utilization as well as PCP prescribing and monitoring behaviors. A mixed effects negative binomial model with a log link will be fit to estimate the difference in means between treatment and control groups using an intent-to-treat population. DISCUSSION: Given a growing interest in interventions for the management of patients with risky opioid use, and the need for primary care-based interventions, this study potentially offers a blueprint for a feasible and effective approach to improving outcomes in this population. TRIAL REGISTRATION: Clinicaltrials.gov, identifier NCT04218201, January 6, 2020.

Central to the debate over the implementation of empirically supported treatments is whether or not therapist skill in delivering these therapies has a measurable, positive relationship with client outcome. The fidelity and skill with which therapists deliver these treatments have been studied under the constructs of therapist adherence and competence. There has been mixed evidence of the relationship between adherence and competence and client outcomes, that could be due to small sample sizes, potentially inadequate measures for rating therapists' skill, and limited statistical methods. The current study utilized a data set from the Adolescent and Family Treatment (AAFT) project in which 91 therapists provided services to 384 clients at regionally diverse sites. Substance abuse therapists trained to deliver the Adolescent Community Reinforcement Approach (A-CRA) submitted audio-taped therapy sessions to expert raters for review. Measures of adherence and competence derived from these ratings were examined in a Multi-Level Model, for associations with client substance use outcomes at 3, 6 and 12-month follow-up periods. This study found that therapist competence was significantly predictive of decreases in clients' days of substance use. There was a non-significant trend for adherence being associated with decreased days of substance use as well. Client exposure to A-CRA treatment procedures also predicted decreased substance use across follow-ups, as did the cross-level interaction between A-CRA procedure exposure and therapist competence. Post-hoc analyses found that the number of co-morbid disorders of clients as well as client externalizing behaviors were predictive of therapist competence. This study adds to the evidence that treatment fidelity is associated with better treatment outcomes for clients.

The findings from an evaluation of the reclaiming social work project, which was used in 5 local authorities.
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\nReclaiming social work (RSW) is a reform to improve practice in children’s services. The overall aims include:
\n- improving risk assessment and decision-making
\n- providing more effective help
\n- risk management for children and families
\n- keeping families together, where appropriate

This Article critically examines the assumptions underlying the reform movement, and concludes that we should ease the rush to dismantle traditional, deterrence-based civil enforcement. While some of the underlying critiques of traditional enforcement have merit, they do not demonstrate that a wholesale shift to a primarily cooperative-oriented approach will improve compliance with environmental law. In fact, a deterrence based system of enforcement contains many attributes that are equally if not more essential to achieving compliance. Rather than discarding the current enforcement approach, we should move to a system of environmental enforcement that is grounded in deterrence theory but integrates the most constructive features of a cooperative model. Part II of this Article describes the theoretical basis for the traditional approach to enforcing environmental law, and how this approach has evolved in practice. Part Ill assesses the major theoretical critiques of deterrence- based enforcement that underlie the current push for reform. Part IV discusses the positive elements of deterrence-based enforcement and why they should not be abandoned. Part V analyzes the wisdom of the most significant proposed reforms currently being considered or implemented, and suggests a better approach for improving enforcement of our nation's environmental laws.