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Coding
What is coding?
Coding means that statements in a conversation are assessed according to a reliable, standardized manual. The coding of the counselor's statements in a conversation is done according to the Motivational Interviewing Treatment Integrity Manual (MITI 4.2.1) and answers the question: 'To what extent is MI used during the conversation?'
what is coding?how coding is donehow coders are trainedQuality assurance of operationsIMPORTANT TO CONSIDERtnt-applicationConversations with actorsConfidentiality
What is coding?
Coding means that the counselor's statements are reliably assessed according to a standardized manual.
Coding means that statements in a conversation are assessed according to a reliable, standardized manual. The coding of the counselor's statements in a conversation is done according to the Motivational Interviewing Treatment Integrity Manual (MITI 4.2.1) and answers the question: 'To what extent is MI used during the conversation?' The coding of the client's statements in a conversation is done according to Client Language EAsy Rating (CLEAR) and answers what client statements are neutral and are not assessed to influence the client's future change as well as which constitute change talk (for a change) and which constitute sustain talk (against a change).
How coding is done
Coding is conducted using coding manuals. Counselor statements are coded according to the 'Motivational Interviewing Treatment Integrity Coding Manual 4.2.1' (MITI). Client statements are coded according to the CLEAR manual. The client's degree of self-disclosure can also be coded on a 7-point scale.
SELF-DISCLOSURE
The client's self-disclosure during conversations is assessed on a 7-point Likert scale. The client's coded degree of self-disclosure has been correlated in research with the client's future change.
Self-Disclosure/ Self-Exploration
CLEAR
With CLEAR ('Client Language EAsy Rating'), two variables are coded, each with seven subcategories. The two types of client statements are those that indicate that the client is likely to change (Change Talk) and those that indicate that the client is unlikely to change (Sustain Talk). Statements for and against change are defined in six subcategories and coded as frequency counts. The coding is summarized in the percentage of change talk (frequency of change talk / frequency of change talk + frequency of sustain talk).
Manual for coding client talkEmpty CLEAR protocol
MITI
With MITI, 14 variables are coded, which define the statements in the counselor's conversation and the overall performance of the conversation. The four overarching variables are summarized into two components: the relational variable - responsiveness (Empathy and Partnership) and the technical variable – change-driving (Promote Change Talk and Dampen Sustain Talk). Ten types of conversation statements are defined and counted (Information, Persuasion, Permission-Based Persuasion, Question, Simple Reflection, Complex Reflection, Affirmation, Seeking Collaboration, Emphasizing Autonomy, Confrontation). The first version of the 'Motivational Interviewing Treatment Integrity Coding Manual' was published in 2003 (MITI 2.0). It was updated with support from new research to the versions, MITI 3.0 and MITI 3.1. MIC Lab published the latest update in 2015 (MITI 4.2.1) in Swedish.
Manuals and protocols
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How coders are trained
Coding at MIC Lab is done in the same way as in scientific testing of MI. Regardless of who is coding at MIC Lab, the same assessment should be made and the assessment should not vary from year to year. To work as a professional coder at MIC Lab requires continuous training and reliability testing.
Training of coders
Coding at MIC Lab is done in the same way as in scientific testing of MI. Regardless of who is coding at MIC Lab, the same assessment should be made. The assessment should not vary from year to year. To work as a professional coder at MIC Lab requires continuous training and reliability testing.
Training history
To train as a professional MITI coder at MIC Lab requires a basic education that is assessed with a reliability check. Thereafter, continuous training is required. At the establishment of MIC Lab in 2005, as a research group at Karolinska Institute, the first coders were trained at the University of New Mexico, USA by Dr. Theresa Moyers, who, along with colleagues, developed MITI. In 2005, Dr. Moyers and Dr. Ernst trained the coders at MIC Lab. In 2006, training was provided by Dr. Denise Ernst and Dr. Carolina Yahne, and in 2007, MIC Lab coders were trained in MITI and in CLAMI (the predecessor of CLEAR) by Dr. Ernst. In 2015, Dr. Ernst trained the MIC Lab coders in MITI 4.2.1.
Training meetings
The coders at MIC Lab train together for 2 hours each week. During the meetings, the same conversation is coded together and independently of each other. Difficulties in coding are discussed. In the case of difficult assessments that are not covered by the MITI manual, additions are formulated as a complement to the manual. During training meetings, the pedagogy of feedback on coding results to the person who has conversations coded is developed and improved.
Inter-rater reliability
A measure of reliability for each of the coders is obtained each year by randomly selecting conversations that come into MIC Lab for coding. The reliability between coders in each variable in MITI has been found to range from 'good' to 'excellent' according to the statistical rules of thumb provided by Cicchetti (1994).
Quality assurance of operations
Various organizations such as institutions, treatment centers, health centers, and municipal environmental offices can have their MI practice quality assured. Quality assurance is conducted on two different levels: 'Scientific assessment of MI competence' and 'Monitoring of MI competence'. Please contact MIC Lab for more information on quality assurance of operations. contact@miclab.se
Scientific assessment of MI competence
In 'Scientific assessment of MI competence', the same procedures are required as in scientific testing of MI. This type of quality assurance is used to demonstrate that the MI being conducted is evidence-based. The organization records all conversations in which MI is used over a certain period. Three randomly selected conversations per quarter and counselor are then coded by MIC Lab. After the quality assurance is completed, a certificate is issued and MIC Lab compiles a short report where the coding results are anonymized and compiled so that no individual provider can be identified. The demonstrated MI competence of the counseling group is reported and related to recommended levels of competence for basic competency and proficiency in MI according to MITI. The quality assurance can be combined with feedback on performance either by the organization organizing supervision where coding protocols are used as a basis or by MIC Lab providing counselors with feedback by phone on one or more conversations that have been coded. The counselor is given the opportunity to discuss the conversation and coding directly with the coder.
Monitoring of MI competence
In 'Monitoring of MI competence', one conversation per counselor and quarter is used for coding. The counselor or organization selects which conversation should be sent to MIC Lab. After the quality assurance is completed, MIC Lab issues a certificate that the organization continuously receives independent feedback on its MI practice. Monitoring of MI can be combined with feedback on performance either by the organization organizing supervision where coding protocols are used as a basis or by MIC Lab providing counselors with feedback by phone on one or more conversations that have been coded. The counselor is given the opportunity to discuss the conversation and coding directly with the coder.