Motivational Interviewing via Co-active Life Coaching (MI-via-CALC)

About the program

MI-via-CALC is a brief coaching intervention to support and encourage client autonomy to quit smoking delivered via phone or video chat. The overarching goal of program is to reduce smoking behaviours by improving participants’ sense of personal competency and perceptions of self-identity. MI-via-CALC is foundationally about supporting and encouraging autonomy.

Who does it work for?

MI-via-CALC is designed for 19–29-year-old youth.  MI-via-CALC has only been evaluated in the USA. A pilot randomized control trial (Mantler et al. 2015) was conducted with 40 people (20 in the intervention group and 20 in the control group). Study participants were an average of 23 years old, and the majority were male (65%) with some level of university education (55%). Participants smoked an average of 11.5 cigarettes per day and most started smoking at 15 years old.

MI-via-CALC has not been evaluated in Australia or with Aboriginal Australians.

What outcomes does it contribute to?

Positive outcomes:

• MI-via-CALC participants had improved internal self-efficacy towards smoking (the temptation to smoke based on emotional states)
• MI-via-CALC participants had improved external self-efficacy towards smoking (the temptation to smoke based on environmental situations)

No effect:

• The program had no effect on participants’ self esteem

How effective is it?

Overall, MI-via-CALC had missed effects on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT)/quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects.

How is it implemented?

MI-via-CALC is delivered via phone or video chat over the course of 3 months. During this time, participants completed 8-10 thirty-minute sessions with a facilitator. For each session participants were asked to initiate both contact with the coach at a pre-arranged time and have a specific focus for the session although the focus did not have to be smoking or cessation related.

The CALC model uses mainly open-ended questions to promote insight and help the participant access his/her own answers. Although specific content of the sessions remained confidential between the coach and participant pairs, typical CALC techniques include:

• Designing an alliance (i.e., how the coach/ participant relationship would work)
• Asking thought provoking, open-ended questions
• Being genuinely curious about the participant
• Championing and acknowledging the participant’s actions
• Challenging and holding the participant accountable to set, work towards and attain goals
• Holding the participant’s agenda.

How much does it cost?

The costs for MI-via-CALC were not reported in the study.

What else should I consider?

Program participants must have been willing to set a quit date within the next 4 weeks to be eligible to complete the program.

MI-via-CALC is foundationally about supporting and encouraging autonomy. This premise resulted in several participants deciding, during their MI sessions, to incorporate additional supports as part of their cessation strategy, specifically, the use of nicotine replacement therapy.

Program coaches ranged in experience; however, all were certified CALC coaches and utilized only CALC tools during the sessions.

Where does the evidence come from?

1 RCT conducted in the USA with a sample of 40 people (Mantler et al., 2015)

Further resources

Mantler, T, Irwin, JD, Morrow, D, Hall, C, & Mandich, A 2015, ‘Assessing motivational interviewing via co-active life coaching on selected smoking cessation outcomes’, Addiction Research & Theory, vol. 23, pp. 131-142, DOI 10.3109/16066359.2014.946410.

The following studies are particularly relevant to the program:

Mantler, T, Irwin, JD, & Morrow, D 2010, ‘Assessing motivational interviewing through co-active life coaching tools as a smoking cessation intervention: A demonstration study’, International Journal of Evidence-Based Coaching and Mentoring, vol. 8, no. 2, pp. 49–63, https://radar.brookes.ac.uk/radar/items/5f5c2e37-0221-4654-9a88-09ede11e2281/1/

Newnham-Kanas, C., Morrow, D., & Irwin, J.D. (2010). Motivational coaching: A functional juxtaposition of three methods for health beahviour change: Motivational interviewing, coaching, and skilled helping. The International Journal of Evidence Based Coaching and Mentoring, vol. 8, no. 2, pp. 27–48, https://radar.brookes.ac.uk/radar/items/95786bfd-83d8-4186-a79d-5d7a8b483791/1.