Motivational interviewing in Child, Youth and Family residences : case leaders' experiences, appraisal and skill level, and the barriers to implementation.

Abstract

Motivational Interviewing (MI) is “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller & Rollnick, 2012, p.12). Utilised as a preparation tool to increase engagement in treatment, as an adjunct to another therapeutic intervention, or as a stand-alone intervention in its own right, MI promotes and strengthens an individual’s motivation to change by helping to explore and overcome ambivalence (Miller & Rollnick, 2012). This study aimed to investigate Child, Youth and Family (CYF) case leaders’ experiences of practising MI and its implementation within the context of CYF residential units throughout New Zealand. A mixed-methods exploratory sequential design was employed to address the research aims, which sought to capture CYF case leaders’ experiences and appraisal of MI, and to assess their level of skill in applying MI post-workshop training. In addition, this research aimed to identify potential barriers to MI implementation, in order to inform future training and intervention efforts. Data was collected through an online survey, focus groups and audio recordings of participant MI interactions submitted post-training. Qualitative and quantitative analyses identified that the case leaders’ perceived and externally assessed low level of MI skilfulness, as well as a lack of time and resources (e.g., quiet space), were major factors influencing the infrequent use of MI in residences post-training. Furthermore, the results highlight the complexity of implementing Evidence Based Practices (EBP)’s, such as MI, within government organisations, and the need for systematic ongoing training, feedback and organisational support for this to be successfully achieved.