How do you balance directive and supportive feedback in MI supervision?

1 The importance of feedback

Feedback is essential for MI supervision, as it helps your supervisees identify their strengths and areas for improvement, monitor their progress, and adjust their practice accordingly. Feedback also reinforces the MI spirit of partnership, acceptance, compassion, and evocation, as you show interest, respect, empathy, and curiosity towards your supervisees. However, feedback can also be challenging, as it may trigger defensiveness, anxiety, or resistance, especially if it is perceived as negative, critical, or inconsistent. Therefore, you need to be mindful of how, when, and what feedback you give to your supervisees.

2 The balance of directive and supportive feedback

Directive feedback is feedback that provides specific and concrete suggestions, recommendations, or corrections for your supervisees to improve their MI skills and fidelity. Supportive feedback is feedback that acknowledges, validates, or praises your supervisees for their efforts, achievements, or competencies in MI. Both types of feedback are important and complementary, as they address different needs and goals of your supervisees. However, the balance of directive and supportive feedback may vary depending on the context, the supervisee's level of experience, and the supervisor's style. Generally, you want to use more supportive feedback at the beginning of the supervision process, to build rapport and confidence, and more directive feedback as the supervisee progresses and seeks more guidance and feedback.

3 The principles of effective feedback

To balance directive and supportive feedback in MI supervision, you can follow some general principles of effective feedback. Timeliness is key - give feedback as soon as possible after observing or reviewing your supervisee's work, so that they can recall and reflect on their performance and apply your feedback to their next practice. Additionally, be specific with your feedback - make sure it is clear, precise, and relevant to the supervisee's goals and objectives. Use a respectful and appreciative tone that conveys your support and encouragement when giving positive feedback that emphasizes the supervisee's strengths and potential. Constructive feedback should identify areas for improvement and offer concrete suggestions for how they can enhance their MI skills and fidelity. Lastly, be collaborative - invite the supervisee's input and perspective, use open-ended questions, reflections, and summaries to elicit and affirm their thoughts and feelings about their work.

4 The methods of feedback delivery

Different methods of feedback delivery can be used in MI supervision, depending on the availability of resources, the format of supervision, and the preference of your supervisees. Live observation is one method, which allows you to provide direct and specific feedback and to intervene or model if needed. However, it may be intrusive, disruptive, or intimidating for your supervisee, so you need to establish clear expectations and boundaries, and use supportive feedback to reduce their anxiety and enhance their autonomy. Audio or video recording is another method that allows you to provide more comprehensive and detailed feedback. But it may be time-consuming, tedious, or embarrassing for your supervisee, so you need to ensure their consent and confidentiality, as well as use positive feedback to increase their motivation and engagement. Finally, self-report is a method that allows you to provide more collaborative and evocative feedback. Nevertheless, this method may be inaccurate, incomplete, or biased by your supervisee's self-perception; therefore, you need to verify and supplement their report with other sources of information, while using directive feedback to challenge and guide them.

5 The tools of feedback measurement

There are various tools of feedback measurement that you can use in MI supervision, depending on the purpose, frequency, and criteria of your feedback. Examples of such tools include MI fidelity scales such as the Motivational Interviewing Treatment Integrity (MITI) code, the Motivational Interviewing Skill Code (MISC), and the Behavior Change Counseling Index (BECCI). These instruments measure the quality and quantity of your supervisee's MI skills and behaviors, allowing you to provide objective and consistent feedback. However, they may also be complex, costly, or rigid so you need to select and use them appropriately. Additionally, MI feedback forms such as the Motivational Interviewing Supervision and Training Scale (MISTS), the Motivational Interviewing Feedback Checklist (MIFC), and the Motivational Interviewing Feedback Form (MIFF) can be used to capture specific aspects of your supervisee's MI practice. These tools allow you to provide tailored and flexible feedback; however, they may also be subjective, inconsistent, or incomplete so you need to design and use them carefully. Ultimately, it is important to validate and balance any findings with other sources of feedback.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?