The MITI and Motivational Interviewing Fidelity
August 12, 2026 2026-09-22 22:49The MITI and Motivational Interviewing Fidelity
The MITI and Motivational Interviewing Fidelity
How do we know whether a conversation intended to use Motivational Interviewing actually resembles MI in practice? Fidelity measures provide structured ways of looking at observable practitioner behaviour.
Looking beyond intention
What is the MITI?
The Motivational Interviewing Treatment Integrity code, usually called the MITI, is a behavioural coding system developed to assess MI fidelity. It can be used in research, quality assurance and practitioner development.
The University of New Mexico describes the MITI as a one-pass coding system designed to measure MI treatment fidelity and notes its use for clinician training as well as clinical-trial quality checks.
The MITI does not ask whether a practitioner meant to use MI. It examines features of what occurred in the conversation.
What coding can show
Global ratings and observable behaviours
MITI coding combines global judgements about aspects of the practitioner’s MI practice with counts of particular conversational behaviours. MITI 4 strengthened attention to client language, autonomy and the way information and advice are offered.
A learning tool, not a verdict
A learning tool, not a verdict
Using fidelity feedback developmentally
A numerical score can easily feel like a judgement of the practitioner. Used well, coding serves a different purpose: it provides information that can help identify a manageable next learning step.
Notice patterns
What conversational behaviours appear repeatedly?
Identify strengths
What is already supporting engagement and MI-consistent practice?
What the MITI cannot tell us
What one change might make the next conversation more skilful?
Practise again
Continue developing
What the MITI cannot tell us
Fidelity is not the whole conversation
No coding system captures everything that matters in helping relationships. Context, culture, professional responsibilities, the client’s experience and what happens beyond the coded segment also matter.
The MITI is therefore best understood as one useful lens. It can tell us something important about MI fidelity without becoming the only way we judge the quality or value of a practitioner’s work.
Continue developing
Turn feedback into learning
For further MI resources, visit the Motivational Interviewing Network of Trainers (MINT).
