Academic journal article Violence and Victims

Motivational Interviewing as a Pregroup Intervention for Partner-Violent Men

Academic journal article Violence and Victims

Motivational Interviewing as a Pregroup Intervention for Partner-Violent Men

Article excerpt

This study investigated the effects of a pregroup motivational intervention for domestic abuse perpetrators. Men presenting for treatment at a community domestic violence agency ( N = 108) were assigned to receive either a two-session intake using the techniques of motivational interviewing (MI) or a structured intake (SI) control. All participants were then referred to a cognitive behavioral treatment (CBT) program in groups homogeneous with respect to intake condition. The motivational intake led to more constructive insession behavior during the early phase of group CBT, greater compliance with group CBT homework assignments, higher late session therapist ratings of the working alliance, and more help seeking outside of the domestic violence program. No significant effects of intake condition were found on session attendance, self-reports of readiness to change abusive behavior, or client reports of the working alliance. Partner reports of abusive behavior outcomes during the 6 months after group CBT revealed a marginal effect favoring the MI condition on physical assault. The findings suggest that motivational interviewing can increase receptivity to partner violence interventions.

Keywords: partner violence; abuse; motivation; change; outcome

The efficacy of standard group interventions in reducing partner-violent behavior remains in question. One recent meta-analysis uncovered very small average effects of counseling relative to minimal treatment or probation controls (Babcock, Green, & Robie, 2004). A number of factors may account for the limited program effects, most notably high rates of session nonattendance and treatment dropout (e.g., Brown, O'Leary, & Feldbau, 1997; Cadsky, Hanson, Crawford, & Lalonde, 1996; Chen, Bersani, Myers, & Denton, 1989; Gondolf & Foster, 1991; Hamberger & Hastings, 1989), low motivational readiness to change (Eckhardt et al., in press), problems in the establishment of a therapeutic alliance (Taft, Murphy, Musser, & Remington, 2003), and limited engagement in treatment activities such as homework assignments (Taft, Murphy, King, Musser, & DeDeyn, 2003). Thus, treatment innovations are needed to enhance motivational readiness to change, treatment involvement, and session attendance.

Motivation to change has been defined as the probability that a person will enter into, continue, and adhere to a specific change strategy (Miller & Rollnick, 1991). Many counseling programs for partner-violent men emphasize active change techniques that are most appropriate for individuals who are ready and willing to change. Yet, the vast majority of abusive clients appear to be in preaction stages of change (precontemplation or contemplation; Prochaska & DiClemente, 1984), when they present for services (Alexander & Morris, 2008; Eckhardt et al., in press; Levesque, Gelles & Velicer, 2000). In addition, some abuser counseling programs promote direct confrontation of denial and excuses in a fashion that may inadvertently enhance defensiveness or impede the establishment of a collaborative working alliance (Murphy & Baxter, 1997). Based on an extensive review of motivation for treatment, Miller (1985) concluded that therapists expressing high levels of empathy have more success than confrontational therapists in helping clients to enter, continue, comply with, and succeed in treatment. Despite this extensive research in other areas of behavior change, supportive, alliance-building strategies are rarely discussed in the clinical literature on partner violence interventions.

Two prior controlled studies have examined supportive pregroup preparation strategies for partner-violent men. One involved an intensive 12-hour workshop conducted over 2 days (Tolman & Bhosley, 1990), and the other involved a 20-minute dramatic video portraying an individual who overcomes his initial resistance to partner violence treatment, followed by a structured group discussion of the video and its effects (Stosny, 1994). …

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