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In both individual and relational psychotherapy contexts, it has been argued that the effectiveness of psychotherapy practice is associated with common factors cutting across the models including client factors, therapist factors, hope/expectancy of the clients, allegiance of the therapists, the quality of therapeutic relationship, and the basic counseling skills rather than model specific factors (Davis and Piercy, 2007a, 2007b; Lambert, 1992; Hubble, Duncan, and Miller, 1999; Sprenkle, Davis, and LeBow, 2009; Sprenkle, Davis, and LeBow, 2009; Wampold, 2001, 2008, 2015). However, the common factors perspective has been criticized for not having a theoretical framework, operationalization of its elements, and research support (Sexton, Ridley, and Kleiner, 2004). Despite gradually increasing interest in the literature, the research exploring the common factors of effective psychotherapy practice is still in its baby steps in the context of relational psychotherapy. In this study, motivational interviewing (MI) is presented as a theoretical framework and a practical research tool for exploring common factors in the context of relational psychotherapy. The research questions of to what extent motivational interviewing elements are implemented in the context of relational psychotherapy and to what extent therapist behaviors are associated with client change behaviors were explored by using task analysis and sequential analysis methodologies. Using the AAMFT Masters Series Tapes of MFT Model developers, including Boszmormenyi-Nagy, Minuchin, Satir, Whitaker, and White, the exemplary demonstrations of relational psychotherapy were rated on the Motivational Interviewing Treatment Integrity Scale (MITI 4.2.1., Moyers et al., 2014) for therapist behaviors and on the Motivational Interviewing Skills Code-Client Behaviors Scale (MISC; Miller, Moyers, Ernst, and Amrhein, 2003) and the Experiencing Scale (EX; Klein, Mathieu, Kiesler, and Gendlin, 1969) for the client change behaviors. The results are discussed in terms of a common factors perspective. / Ph. D. / Since the beginning of psychotherapy as a method of treatment, the answers to the age-old question of how psychotherapy helps people to change has become more sophisticated, elaborated, and diversified. Recent literature focusing on individual psychotherapy processes shows that it might be the common factors cutting across the models including the quality of therapeutic relationship, and the basic counseling skills rather than model specific factors are responsible for change in psychotherapy process. However, there are few studies exploring these factors in the context of relational psychotherapy. By means of in depth analyses of the relational psychotherapy training videos, this study contributes to the understanding of common factors of effective practice in relational psychotherapy. Thanks to this study, the clinicians and researchers can have a better understanding of the effective relational psychotherapy practice. This understanding will allow the clinicians, researchers, and health care providers and educators to provide better clinical service and develop more effective psychotherapy practices.

School counselors have potential to make significant gains in closing the achievement gap for all students as advocated for by the American School Counseling Association. School counseling is moving away from the no-model model of services delivery that places counselors at the whim of principals, parents and teachers who traditionally define counseling duties according to their needs. Instead, it is moving toward a school counseling framework advocated for by national and state organizations. A core concept of these frameworks is the use of evidence-based practices to meet the needs of all learners. Motivational Interviewing (MI) is an evidence-based counseling practice developed to assist with resolution of ambivalence and behavior change. Researched throughout the world in a variety of settings from the health professions to prisons, the results show promise in MI for assisting with behavior change in both adult and adolescent populations. MI training is currently available to school counselors at conferences, school district trainings and through self-study. There is little research on the efficacy of MI and school counseling training and implementation. The purpose of this dissertation is to produce two manuscripts related to school counseling and MI. Using a concurrent multiple baseline design, this study focused on the impact of MI feedback and coaching supervision of school counseling graduate students (N=3) with previous beginning MI training in a two day workshop. The hypothesis stated that subsequent feedback and coaching supervision improved school counseling graduate the percentage of MI adherent behavior on the Motivational Interviewing Treatment Integrity (MITI 3.1). The global rating scores increased with feedback and coaching supervision and the participants moved from levels of beginning MI competency to proficiency in their mean scores. Participants did not, however, increase the percentage of MI adherent behavior. These score began high and remained high throughout the 10 week duration of the research. Implications for this study include highlighting the importance of feedback and coaching supervision for school counseling graduate students wanting to increase beginning MI skills, and it marks the beginning of research on training and implementing MI in school counseling programs. / Graduation date: 2013

Motiverande samtal är en metod som kan användas för att hjälpa individer att finna motivation till förändring. Syftet med föreliggande studie är att undersöka hur skötare inom rättspsykiatrin ser på att använda motiverande samtal inom sitt arbete samt hur de använder sig av metoden. Semistrukturerade intervjuer utfördes med informanter som jobbade aktivt med motiverande samtal på en rättspsykiatrisk klinik. Insamlade data analyserades tematiskt vilket resulterade i fem huvudkategorier med grenade underkategorier. Dessa kategorier visade att informanterna använde sig av både riktade motiverande samtal samt använde metodens förhållningssätt utanför dessa samtal. Majoriteten av informanterna uttryckte sig positivt om metoden, med en vilja att fortsätta lära sig om metoden, samt att de gärna ser att fler medarbetare börjar arbeta med metoden. Personlighet uppfattades vara en faktor som inverkade på uppfattad svårighetsgrad av moment inom motiverande samtal. Inga större brister uppfattades angående motiverande samtal utan det var brister som berodde på arbetsplatsen. De fem huvudkategorierna ansågs ge svar på studiens frågeställningar och dessa svar kan i sin tur hjälpa rättspsykiatrin att utveckla sin verksamhet.

Motiverande samtal är en metod som kan användas för att hjälpa individer att finna motivation till förändring. Syftet med föreliggande studie är att undersöka hur skötare inom rättspsykiatrin ser på att använda motiverande samtal inom sitt arbete samt hur de använder sig av metoden. Semistrukturerade intervjuer utfördes med informanter som jobbade aktivt med motiverande samtal på en rättspsykiatrisk klinik. Insamlade data analyserades tematiskt vilket resulterade i fem huvudkategorier med grenade underkategorier. Dessa kategorier visade att informanterna använde sig av både riktade motiverande samtal samt använde metodens förhållningssätt utanför dessa samtal. Majoriteten av informanterna uttryckte sig positivt om metoden, med en vilja att fortsätta lära sig om metoden, samt att de gärna ser att fler medarbetare börjar arbeta med metoden. Personlighet uppfattades vara en faktor som inverkade på uppfattad svårighetsgrad av moment inom motiverande samtal. Inga större brister uppfattades angående motiverande samtal utan det var brister som berodde på arbetsplatsen. De fem huvudkategorierna ansågs ge svar på studiens frågeställningar och dessa svar kan i sin tur hjälpa rättspsykiatrin att utveckla sin verksamhet.

Purpose: The purpose of this study is to determine if motivational interviewing with written/illustrated infant oral health education provided to caregivers of pediatric dental patients increases caregivers’ oral health literacy compared to verbal only motivational instruction. Methods: This is a cohort study of caregivers and their child receiving oral health anticipatory guidance utilizing motivational interviewing with and without visual aids. Caregivers (N=20) of pediatric dental patients age 0-4 that presented to the Virginia Commonwealth University School of Dentistry for a new patient exam were recruited for the study. Caregivers were randomly assigned into 2 groups: the intervention group (IG), and the control group (CG). Each caregiver took a pre-test to determine their infant oral health literacy. Then the IG received infant oral health education using a flipbook, and the CG received the same information in verbal form. Each caregiver had a brief motivational interviewing session. The caregivers then took the same test (post-test). At the pre-test time period, groups were compared by Fisher’s exact test or a two group t-test, as appropriate. The post-test score of the two groups were compared using an ANCOVA. Results: Currently, 20 patients have been enrolled in the study. There was no significant difference between the CG and the IG in the pre-test scores (P= 0.3913) or the post-test scores (P=0.3022). The intervention group had a nominally higher score after the education. Conclusions: This study was only a pilot study with N=20 caregivers. This study may be used to estimate the number of subjects needed to demonstrate a significant difference.