Online training improves motivational counseling in health insurance practitioners: a pre-post analysis of return-to-work conversations.

Abstract

Health insurance practitioners need to evaluate sick-listed workers, motivate them for return-to-work (RTW), and guide them in doing so. This study evaluates the effectiveness of a 10-h, online and interactive training in "motivational counseling," on practitioners' communication behaviors. The training is based on Motivational Interviewing (MI) and Self-Determination Theory (SDT)'s basic psychological need support for autonomy, relatedness, and competence. We observed and rated video recordings of online patient encounters, simulated by experienced actors enacting fictive scenarios. Two-tailed Wilcoxon signed-rank tests compared pre- and post-training outcomes of 31 practitioners using observational instruments based on MI and SDT. After training, the practitioners showed significantly more technical (e.g., using reflections) and relational (i.e., seeking collaboration and taking perspective) MI behaviors. Autonomy- and competence-supportive behaviors increased (e.g., providing rationales or feedback) while autonomy-thwarting behaviors decreased (e.g., using controlling language). The training in motivational counseling effectively promoted motivating communication behaviors among health insurance practitioners, in line with SDT and MI. The online format makes the training practically more feasible for RTW stakeholders operating in time-restrained contexts. More research is needed on training transfer and implementation barriers, as on the impact on sick-listed workers' motivational processes and RTW trajectories.