This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cachildwelfareclearinghouse.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cachildwelfareclearinghouse.org/
Child Welfare Outcomes: Safety.
Type of Maltreatment: Not specified
Target Population: Caregivers of children referred to the child welfare system.
Brief Description:
Motivational Interviewing (MI) has been rated by the CEBC in the area of Substance Abuse (Parental). MI is a client-centered, directive method designed to enhance client motivation for behavior change. It focuses on exploring and resolving ambivalence by increasing intrinsic motivation to change. MI has been shown to be effective in improving substance abuse outcomes by itself, as well as in combination with other treatments.
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The overarching goals of MI are:
MI emphasizes two essential dimensions related to an individual's ambivalence to change:
MI includes a number of open-ended questions encouraging the client to talk about circumstances surrounding his or her referral for evaluation as opposed to the standard substance abuse evaluation that includes administering a number of structured interviews asking closed-ended questions. Examples of the types of open-ended questions that might be used are as follows:
Motivational Interviewing (MI) was designed to be conducted in a group.
Motivational Interviewing (MI) has been tested for use in a group setting.
Testing references:
1) Van Horn, D.H. & Bux, D.A. (2001). A pilot test of motivational interviewing groups for dually diagnosed inpatients. Journal of Substance Abuse Treatment, 20, 191-195.
2) Bailey, K. A., Baker, A. L., Webster, R. A., & Lewin, T. J. (2004). Pilot randomized controlled trial of a brief alcohol intervention group for adolescents. Drug and Alcohol Review, 23(2), 157-166.
3) John, U., Veltrup, C., Driessen, M., Wetterling, T., & Dilling, H. (2003). Motivational intervention: An individual counseling vs. a group treatment approach for alcohol-dependent in-patients. Alcohol and Alcoholism, 38, 263-269.
The recommended group size is: 5-7 participants
Recommended intensity: Usually 1-3 individual sessions. There is some evidence that 2-3 sessions are more effective than a single session. Less is known about the optimal intensity when delivered in a group format.
Recommended duration: 30-50 minutes each session.
Motivational Interviewing (MI) does not include a homework component.
Motivational Interviewing (MI) is typically conducted in a(n): Community Agency, Hospital, Outpatient Clinic, and Residential Care Facility.
Motivational Interviewing (MI) was designed with a Parent Component.
Motivational Interviewing (MI) addresses the following presenting problems and symptoms: Substance abuse or dependence and other health/lifestyle behavior change issues.
Motivational Interviewing (MI) was not designed with a Child Component.
Motivational Interviewing (MI) was not developed for children with developmental delays.
Motivational Interviewing (MI) has not been tested for children with developmental delays.
Motivational Interviewing (MI) was not designed for specific racial/ethnic/cultural groups.
Motivational Interviewing (MI) was tested in specific racial/ethnic/cultural groups.
Relevant research studies:
MI appears to produce higher effect sizes when used with minority populations. It has been particularly tested with African-American, Hispanic and Native American populations. See meta-analysis: Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91-111.
There is a manual that describes how to implement this program.
There is training available for Motivational Interviewing (MI).
Training contact: The website, www.motivationalinterview.org, contains a list of trainers and Dr. Theresa Moyers at the University of New Mexico, email: tmoyers@unm.edu.
Number of days/hours: Training can be provided on-site. Follow-up feedback and coaching can be delivered effectively by telephone.
Training is obtained: Training can be provided on-site. Follow-up feedback and coaching can be delivered effectively by telephone.
There currently are additional qualified resources for training.
List of additional qualified resources: Mike Clark trains CPS staff in Motivational Interviewing Assetbuilding@aol.com, www.motivationalinterview.org
The typical resources for implementing Motivational Interviewing (MI) are: A room to conduct the session.
None. Efficacy does not appear to be related to the level of practitioner degree.
Carroll, K., Libby, B., Sheehan, J., & Hyland, N. (2001). Motivational interviewing to enhance treatment initiation in substance abusers: An effectiveness study. The American Journal of Addictions, 10, 335-339.
Carroll and colleagues used a single MI assessment at treatment intake and showed a large and significant increase in entry into at least one session of regular treatment (59% versus 29%) even with only 60 clients randomized. Once regular treatment began and no further MI was implemented, both groups disengaged from treatment at similar rates.
Mullins, S., Suarez, M., Ondersma, S., & Page, M. (2004). The impact of motivational interviewing on substance abuse treatment retention: A randomized control trial of women involved with child welfare. Journal of Substance Abuse Treatment, 27, 51-58.
Another study randomized 71 subjects to MI implemented by the substance abuse treatment provider; no significant differences were shown in treatment outcomes in eight weeks. Several reasons were posited for the lack of positive finding, including a small sample and an active control condition (education and home visit).
Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91-111
This article contains a meta-analysis of over 70 controlled trials of motivational interviewing. The review shows particularly strong evidence for the efficacy of MI with alcohol/drug abuse.
Chanut, F., Brown, T., & Dongier, M. (2005). Motivational interviewing and clinical psychiatry. Canadian Journal of Psychiatry, 50(9), 548-554.
Moyers, T., Martin, T., Manuel, J., Hendrickson, S. M. L., & Miller, W. R. (2005). Assessing competence in the use of motivational interviewing. Journal of Substance Abuse Treatment, 28, 19-26.
Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23, 325-334.
Contact name: William R. Miller, Ph.D.
Email: WRMiller@unm.edu
Phone: 505-925-2378
Fax: 505-925-2379
Website: http://www.motivationalinterview.org