Motivational Interviewing Delivered by Existing Prison Staff: A Randomized Controlled Study of Effectiveness on Substance Use After Release

Abstract

A sample of 296 drug-using inmates in 14 Swedish prisons was randomized during 2004–2006 into three intervention groups; Motivational Interviewing delivered by counselors with workshop-only training, or by counselors with workshop training followed by peer group supervision, and controls. Drug and alcohol use was measured by the Addiction Severity Index (ASI) at intake and at 10 months after release. Complete data from 114 clients were analyzed by a stepwise regression analysis. All three groups reduced alcohol and drug use. Limitations in the study are discussed and future research is suggested. The study is financed by grants from the Research Committee of the National Prison and Probation Administration.

RÉSUMÉ

Etude aléatoire contrôlée portant sur l'efficacité de l'Entretien Motivationnel délivré par le personnel courant de prison quant à l'usage de substances toxiques après libération.

De 2004 à 2006, un échantillon de 296 détenus, provenant de 14 prisons suédoises différentes et utilisant des substances toxiques, a été réparti aléatoirement en 3 groupes d'intervention: un entretien motivationnel délivré par des conseillers ayant suivi une formation, un autre délivré par des conseillers ayant suivi une formation et ayant été surveillés par leurs pairs, et une intervention de contrôle. Des évaluations de l'indice de gravité de toxicomanie–critère utilisé comme barème d'usage d'alcool et/ou de drogues–ont été réalisées au moment de l'incarcération, ainsi que 10 mois après libération des détenus. Une analyse de régression progressive portant sur les dossiers complets de 114 personnes a révélé que toutes les interventions ont entraîné une réduction quant à l'usage d'alcool et de drogues. Il est également fait état des limitations de l’étude, et une recherche ultérieure est encouragée. L’étude a été financée par le Comité de Recherche du Service National Pénitentiaire Suédois.

RESUMEN

Etude aléatoire contrôlée portant sur l'efficacité de l'Entretien Motivationnel délivré par le personnel courant de prison quant à l'usage de substances toxiques après libération.

Entre los años 2004 y 2006 randomiserades una muestra de 296 convictos con problemas de uso de narcóticos de 14 cárceles suecas. Se utilizaron tres tipos de intervención: sesiones motivacionales realizadas por personal tratante que habían sido entrenados a través de días de seminarios, sesiones motivacionales realizadas por personal tratante que habían sido entrenados a través de días de seminarios agregando además supervisión colegial y un grupo de control. La utilización de las substancias narcóticas y de alcohol se midieron con la ayuda del Indice de Adicción Severa (Addiction Severity Index) a la llegada y 10 meses después de la puesta en libertad. Todos los datos acerca de los 114 clientes se analizaron con la ayuda del análisis de regression gradual. Todas las intervenciones llevaron a la disminución del uso de drogas y de alcohol. Las limitaciones del estudio se discuten y se dan proposiciones para investigaciones futuras. El Comité de Investigación Penitenciario otorgó los fondos para la realización de este estudio.

Keywords :

• motivational interviewing
• substance use
• correction
• prison
• treatment integrity
• existing staff
• multisite
• effectiveness study
• training
• competence level

THE AUTHORS

Lars Georg Forsberg, Ph.D., specializes in clinical psychology, is a licensed Psychotherapist, and is also active as a Senior Researcher with special interest in Motivational Interviewing at the Karolinska Institute, Department of Clinical Neuroscience, Section for Psychotherapy, where he served as a Senior Lecturer in psychotherapy until retirement. He has established the Motivational Interviewing Coding Laboratory (MIC Lab) at KI in service of training practitioners in the field to provide feedback support on MI practice, as well as for monitoring MI fidelity in research, and for analysis of what aspects of MI are important to good client outcomes.

Denise Ernst, Ph.D., serves as a Visiting Researcher at the Karolinska Institute. She has been involved with the development and utilization of Motivational Interviewing (MI) treatment fidelity tools such as the Motivational Interviewing Skill Code (MISC) and the Motivational Interviewing Treatment Integrity (MITI) for 15 years. Her research has focused on using tools in service of training practitioners in the field, for monitoring MI fidelity in both research and in efforts to integrate MI into existing practice, and for analysis of what aspects of MI are important to good client outcomes. She is currently involved in efforts to integrate MI in chronic disease management, mental health treatment, public health prevention efforts, and substance use and abuse programs.

Kristina Sundqvist, an M.A. in psychology and B.A. in social healthcare, is working in Företagshälsovård (Alna), where she assesses employees on assignment from employers with regard to presumed alcohol- and drug issues as well as motivate for change of harmful or risky alcohol- and drug use behaviors. She has been doing research about motivational interviewing at Karolinska Institutet and has before that worked in mental and social healthcare

Carl Åke Farbring, M.A., is with the National Prison and Probation Administration, Research and Development Unit, Stockholm. He is an author of two nationally scientifically accredited programs in the Swedish Prison and Probation Services, as well as books, and articles.

Notes

1 The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.