Motivational Interviewing for Substance Use Counseling in the Juvenile Justice Setting: A Nursing Staff Quality Improvement Project

The majority of youth in juvenile justice facilities have substance use disorders. Motivational interviewing (MI) has been found to be an effective counseling style for substance use among adolescents. The purpose of this study was to evaluate the effectiveness of a brief MI training for nurses and nurse practitioners in the context of substance use counseling in the juvenile justice setting. Ten juvenile justice nurses and nurse practitioners completed a 3-hour online training module followed by a 1-hour in-person training session. Participants took a pre- and post-training survey to measure their knowledge of MI concepts, confidence in applying the MI style, and intention to use MI in practice. Participant's knowledge of MI improved significantly (p=0.007). Their self-reported confidence in using MI improved, although not significantly (p=0.066). After completing the training, all participants planned to use the MI style with their patients. A chart audit showed that the percent of youth receiving substance use counseling increased from 6% to 57% after the MI training. The results of this study show that a 4-hour hybrid MI training (online and in-person) effectively increases knowledge of MI for nurses and nurse practitioners. Limitations include small sample size, lack of study of the youth being counseled, and no long-term follow-up with training participants. While the knowledge of MI significantly increased among nursing staff, the ultimate unmeasured effect was with the youth receiving such counseling. Incorporating MI training into nursing programs and staff meetings can improve patient care and potentially save lives.