Virga and the future of motivational interviewing: Issues in training counseling skills.

Miller, William R · Patient Educ Couns · 2026

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Abstract

Online and in-person workshops are most common in continuing professional education, but research shows that such didactic training alone is unlikely to increase clinical skill in motivational interviewing (MI) enough to benefit clients, though it can instill false confidence. If training continues to rely primarily on didactic education, the popularity and dissemination of MI may peak without improving clinical outcomes when those interested in learning MI believe they have done so. This risk is not unique to MI but may apply more generally with behavioral health interventions. What actually improves proficiency is akin to healthcare training in which learners receive expert feedback and coaching through observed practice until reaching a standard of competence. This article discusses three important issues in training complex behavioral interventions: (1) proprietary control, (2) quality assurance, and (3) training modalities. Implications and recommendations for future training are discussed.