offending and thus group differences are not evident due to floor effects (Kistenmacher, 2000; Marques et al. , 1999; Woodall et al. , 2007). One concern is that, although MI can effect change, the effects may not always be sustained in the longer term, and if it does persistence of change may be attributable to other influences, such as community support (Miles et al. , 2007). Follow-up times in the studies reported here were mostly short. Additionally, because MI is often combined with other treatment components, its unique effects are hard to tease out. Where to now with MI for offenders? There are a number of issues that require attention if MI is to be satisfactorily developed within the repertoire of evidence-based offender interventions. These are theory, integrity, and research. First, as for MI in general, a sound theoretical base needs to be articulated as a foundation for the development of testable hypotheses that will facilitate clinical discovery (Allsop, 2007). Recently, MI has been framed within Deci and Ryan’s (2000) self-determination theory (Markland, Ryan, Tobin, & Rollnick, 2005; Vansteenkiste & Sheldon, 2006). The self-determined behaviour is intrinsically reinforced by satisfaction of innate needs for autonomy, competence, and relatedness. MI fits well with this, given its spirit of encouraging the client to argue for change rather than the professional foisting change upon the client. MI may have the power to move people along a continuum from extrinsic motivation, i.e. where behaviour is controlled by external contingencies, to intrinsic motivation, i.e. where behaviour is self-determined (Deci & Ryan, 2000). Clarification of a theory will help identify the processes that underpin motivation to change and so facilitate clinical development of MI. The integrity of delivery of MI, as other therapies, is crucial. The practitioners must know what they are aiming to do through MI, e.g. motivate offenders for treatment or effect behaviour change or both. They must also know how this is to be done. Training courses in MI have flourished, but training does not always lead to tangible changes in practitioners’ behaviour. Miller and Mount (2001) found that professionals trained in MI showed their learning well on paper-and-pencil tests, but observations of their practice in the clinical setting did not show them to be as proficient as they claimed. In fact, the professionals’ confidence outstripped their skills, inoculating them against further learning. Much work has been done to develop ways of assessing the fidelity of MI in practice, including clinical session rating protocols, skills assessments, and a treatment integrity scale (see review by Madson & Campbell, 2006). Training, support and practice monitoring all need to be researched to identify how best to teach 96 Mary McMurran
Copyright © The British Psychological Society Reproduction in any form (including the internet) is prohibited without prior permission from the Society MI, who can learn MI, and how MI can be implemented with integrity. This is true in correctional settings as in other settings.
- Winter '18
- Sociology, Randomized controlled trial, Evidence-based medicine, British Psychological Society