BJSW Advance Access originally published online on February 7, 2007
British Journal of Social Work 2008 38(7):1302-1319; doi:10.1093/bjsw/bcl394
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Child Risk and Parental Resistance: Can Motivational Interviewing Improve the Practice of Child and Family Social Workers in Working with Parental Alcohol Misuse?
Donald Forrester is a research fellow in social work at Brunel University. Prior to this, he was a child and family social worker for a number of years. His research interests include assessing and working with parental substance misuse, social work communication skills, the use and evaluation of Motivational Interviewing within social work settings and the application of quantitative methodologies in social work research.
Jim McCambridge is a researcher specializing in addiction prevention, individual behaviour change and public health. He has undertaken trials of Motivational Interviewing and brief interventions to reduce alcohol and other drug-related harm targeting at-risk populations directly, as well as having designed adapted interventions targeting practitioners. He has a particular interest in better understanding the needs of young people, and how they may be helped by intervention.
Rhoda Emlyn-Jones has over twenty-five years’ experience in alcohol and drug misuse and child-care services. She is a Social Services Officer managing Substance Misuse Services in Cardiff and in the Vale of Glamorgan. In 2000, Rhoda established ‘Option 2’—an intensive service for families’ in which there are serious child protection concerns and drug and alcohol issues.
Clara Waissbein works part time as a researcher in social work and is a qualified social worker. Her research interests include Motivational Interviewing and effecting change in social work practice.
Stephen Rollnick is Professor of Healthcare Communication in Cardiff University. He worked as an NHS clinical psychologist for many years, and then worked on research on difficult consultations and the training of practitioners in new interventions. He has published widely on the subject of behaviour change and is co-author, with Bill Miller, of Motivational Interviewing: Preparing People for Change.
Correspondence to Donald Forrester, Social Work Section, Department of Health Sciences and Social Care, Mary Seacole Building, Brunel University, Uxbridge, Middlesex UB8 3PH. E-mail: Donald.Forrester{at}brunel.ac.uk
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Abstract |
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Motivational Interviewing (MI) is a client-centred, directive counselling method. This study evaluates the effectiveness of a two-day workshop in MI for forty social workers in changing self-reported practice over a three-month period, the levels of skills achieved, and factors associated with acquired skills, including the impact of post-workshop supervision. The focus of training was alcohol misuse but participants were encouraged to explore the use of MI with other issues. A multi-method pre and post-design was used, utilizing both quantitative and qualitative data and employing an embedded randomized controlled trial of the impact of supervision. The two-day workshop had a modest positive impact on evaluations of simulated practice, on some measures of attitudes to working with problem drinkers and in qualitative accounts of practice. Despite this, three months post-workshop, workers generally had not reached a skilful level of MI practice as measured in ratings of an interview with a simulated client. Offer of post-workshop supervision had little impact on skill, with take-up being low. There was a significant difference between participants in the two workshops, despite identical programmes and trainers. Qualitative data suggested that participants had found the training useful and many reported a positive impact on their practice.
Keywords: alcohol misuse, Motivational Interviewing, child protection, training