Motivational interviewing is a client centred behavioural therapy for
addictive behaviours. It is an intervention designed to help all addicts,
not just those ready to change. It is therefore suitable for use as an
opportunistic intervention for clients whose main reason for contact may
not be their addiction. A pilot randomized controlled trial of home-based
motivational interviewing by a specially trained midwife to help pregnant
smokers reduce their habit was performed in Glasgow from February 1997 to
January 1998. Did motivational interviewing take place? All 171 counselling
interviews from 48 intervention clients were audio-taped. Forty-nine
interviews from 13 randomly selected clients were transcribed for content
analysis. A rating scale established for feedback to trainee psychologists
was used by three experienced analysts. Thirty-two interviews were scored
independently to validate the rating scale in this setting. More than 75% of
interviews showed satisfactory motivational interviewing. Therapist
utterances were motivational, and client responses included many
self-motivational statements. Few episodes of client resistance were
recorded. Rating took 160 mins per half hour interview. This instrument
provided a valid measure of intervention quality for a randomized
controlled trial. It would not be practical to document process outside
a research environment.