The Significant Impact of Brief Motivational Interviewing Intervention

» Posted by on Jun 22, 2014 in Alpha Blog | 0 comments

by Steven Bengis, David S. Prescott, and Joan Tabachnick

The Question
Does an offender’s motivation to change reduce their risk of reoffending?

The Research
Brendan Anstiss, Devon Polaschek and Marc Wilson evaluated the effects of a brief Motivational Interviewing (MI) intervention on the reconviction in adult male prisoners convicted of a diverse set of crimes. Even though the population is an adult population (and we typically review articles addressing youth), the men were all considered high risk, and the crimes they committed were more diverse than sexual offenses, we believe that the findings here may be of interest to those working with adolescents who have sexually abused. The intervention is based upon research which shows that a lack of motivation to change behavior is a primary obstacle in safely returning offenders back into the community. The objectives are to increase the client’s acceptance and recognition of the crime, address any ambivalence they may have, highlight the benefits of change, and help the client make a commitment to changing their behaviors. The client’s motivation is often measured through Prochaska and DiClemente’s classic stages of change model. In this model people pass through five distinct stages of change to prevent a return to a previous criminal behavior: Precontemplation, Contemplation, Preparation, Action, and Maintenance (Prochaska & DiClemente, 1994).

Overall, the authors found that men who entered the MI program were significantly less likely to be reconvicted than those who did not. With just one four-hour intervention, men who took part in an MI intervention increased their stage of change scores by one full stage while the stage of change scores of the men who did not participate, remained unchanged. The researchers also found that the prisoners who participated in the program had a 21% lower reconviction and a 17% lower re-imprison rate than those who did not participate. Finally, the researchers found that whether or not the men participated in the MI program, a shift in their “stage of change” predicted reconviction. The authors suggest that the MI interventions may generate change by helping the men develop a strong sense of their own agency, competence, and sense of responsibility. This then raises the question about whether this sense of agency can be equally as important as learning the necessary lifestyle management skills, typically taught in treatment.

Implications for Professionals
While this article focuses upon high risk adults who commit a variety of crimes, the authors’ findings about the importance of motivation are intriguing and likely applicable to those working with children and youth. Other research that this newsletter has previously quoted indicates that therapist qualities contribute more to change than the techniques they use. MI requires a collaborative, supportive and engaged therapeutic alliance to be successful. It is an optimistic approach based on a strong belief in the essential capacity of a client to be different and to alter his/her life. To be effective, it has to be delivered with compassion and understanding, particularly with youth, who feel shame about their behaviors, have significant trauma histories along with learning disabilities and other mental health problems. For these youth, MI can easily resonate with their reality. It is an invaluable addition to the toolkit of a therapist seeking to attune with his/her clients. Although the present article does not discuss it, MI can also be an extremely helpful approach to use with the families of adolescents who have sexually abused; properly used, it can support the autonomy of individuals and families alike.

Implications for the Field
There is a major shift taking place in our field as we continue to distance ourselves from adult practice and move towards a developmental and healing approach that recognizes both the low recidivism and the greater complexities of younger clients. While always acknowledging the small percentage of older, dangerous, and perhaps, violent adolescents for whom adult practices are applicable, the vast majority of our work is shifting to a youth who profiles very differently. The field is embracing healing rather than management, risk management rather than risk prediction, attunement rather than confrontation, and therapeutic alliance rather than manualized approaches. MI is one more important component of this welcomed shift. We have little doubt that outcome research will continue to support this evolution.

Citation
Anstiss, B; Devon, L.L.: Polaschek; and Wilson, M. (2011). A brief motivational interviewing intervention with prisoners: when you lead a horse to water, can it drink for itself? Psychology Crime and Law, 17, 689-710. Retrieved May 4, 2014 from www.tandfonline.com/doi/pdf/10.1080/10683160903524325.

Abstract
See www.tandfonline.com/doi/pdf/10.1080/10683160903524325.