Effects of Motivational Interviewing for Enhancing Engagement in Intimate Partner Violence (IPV) Treatment for Men at High Risk of IPV Behaviour

The research conducted at Aviva and SVS. Aviva is a not-for-profit agency dedicated to supporting New Zealand families to become their best, free from violence. SVS provides non-violence programs for men and women since 1983 and for youth since 2008. Primary Objectives The primary objective of the research project was to assess the effects of MI for treatment engagement, as a brief (two sessions) pre-treatment intervention, to enhance treatment engagement in an IPV treatment for men who have been referred to Aviva and SVS to attend the IPV treatment programmes. The research comprised three main studies: a control phase, a training study in which staff at Aviva and SVS were trained in MI in preparation for the third study, which was an evaluation of the implementation of MI for engagement as part of the standard intake procedures occurring at Aviva and SVS. Phase one: Control Group Participants: The study comprised men who have been referred to Aviva and SVS via the different sources of referrals including self-referral, ISR, Police, and referrals from other agencies like the Department of Corrections and Family Court, to attend an IPV Treatment Program at Aviva and SVS. If a client had received MI or IPV treatment previously, they were excluded from the study. This was asked by staff on a client referral before their allocation to MI or Control group. No participant was paid for his involvement with the study. Procedure: The standard engagement procedure was conducted by staff at Aviva and SVS. The recruitment started in July 2017 at Aviva and Oct 2017 at SVS. The control phase was ended in November at both agencies and lasted for 5 months in total for Aviva and 2 months for SVS. The current treatment process at Aviva and SVS is that social workers receive referrals and then they engage with the client for the first time over the phone. Afterward, they have a session called assessment session to engage with the client in more detail and get to know them. After the assessment sessions (usually two assessment sessions or sometimes more depending on the needs of the clients) they will initiate the IPV treatment program. Measure: The mean number of IPV treatment sessions attended were the primary outcome measures. The number of the sessions attended was recorded and reported by staff at Aviva and SVS. Secondary measures include: self-ratings: on the Change Questionnaire, in which participants have been asked to rate the importance, commitment, and ability to change their violent behaviour on a scale of 0-10 (0=definitely not,10=definitely); the Readiness Ruler which determined the participants’ readiness to change on a scale of 0 to 10 in which the lower numbers indicate less readiness, and the higher numbers indicate greater readiness for change. These questionnaires administrated before and after the assessment session, before initiating the IPV treatment program. The outcome was reported as within group changes. The validity and reliability of these questionnaires are confirmed. Recruitment and randomization: Participants were recruited between July 2017 and July 2018 through family violence services centres (Aviva and SVS) in the Canterbury, Christchurch. Recruitment occurred from several sources including self-referrals, ministry of justice, department of correction, ISR pilot study, and police. Phase two: Staff Training Participants: Clinicians at Aviva and SVS who provide the initial contact with men referred via the ISR pilot or other sources of referrals for IPV treatment were recruited into the study. Measures: Pre and post-training the Aviva and SVS staff were administered the Video Assessment of Simulated Encounters Revised New Zealand version (VASE-R NZ), a test of MI skill attainment. Studies indicate that VASE-R can be useful in assessing respondent skills and providing a preliminary, but data-based method to evaluate their scores. The findings also show that subscales could help researchers to discriminate between areas of skill and areas in need of further work. Furthermore, VASE-R can be employed in group, while there is no need for complex technology, and as a result it could be administrated easily. Finally, the VASE-R is helpful for researchers to determine individual skill levels and to ascertain if a priori skill targets are met before permitting a MI clinician to begin a trial. Additionally, the MI sessions were audio-recorded and coded using the Motivational Interviewing Treatment Integrity (MITI 4.2.1) scale by the MINT members as a measure of treatment integrity. The VASE-R NZ and MI integrity served as the primary outcome measures for this part of the study. Also, a focus group with Aviva and SVS staff will be conducted in July to explore their experiences of MI after they have been trained in MI and had the opportunity to utilize it with clients. Phase three: MI Implementation for Engagement Procedure: Men referred to for IPV treatment at Aviva and SVS received two MI for engagement sessions. There was one session of MI for engagement, followed by the assessment session, and then the second session of MI for engagement. The duration of each MI session was 20-40 minute. None of the participants were formally engaged in MI intervention at the time of their consent in the study. No participant was paid for his or her involvement with the study. Measures: The mean number of IPV treatment sessions attended were the primary outcome measures. Treatment attendance data for these men who received MI was compared with attendance data of matched clients who received the standard treatment (group 1). Also, the attendance data was compared with another matched group of clients that had been referred to Aviva and SVS (group 3) 12 months earlier. Secondary measures were same as in phase1 and they were administrated before the first MI session and after the second MI session.