Effects of Motivational Interviewing in Prison

Motivational Interviewing Delivered by Existing Prison Staff: A Randomized Controlled Study of Effectiveness on Substance Use After Release

Motivational Interviewing (MI) is a communication style demonstrated to decrease drug and alcohol use. A five session MI intervention (BSF) was implemented in the Swedish correctional system. The intervention was delivered by counsellors with workshop only MI training (BSF) or by counsellors with workshop MI training followed by peer group supervision based on audio taped feedback (BSF+).

Aim was to examine whether BSF in prisons reduces drug and alcohol use more effectively than interviews conducted according to the usual planning interview routine (UPI).

Study Overview

• Status: Completed
• Conditions: Alcohol Abuse
• Intervention / Treatment: Behavioral: Motivational Interviewing; MI

• Study Type: Interventional
• Enrollment (Actual): 296
• Phase: Phase 3

Contacts and Locations

Study Locations

• Sweden
  • Stockholm, Sweden, S-171 76
    • Karolinska Institutet, Dep Clin Neuroscience

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Born between 01-01-1954 and 31-12-1984;
• Conditional release no later than 30-06-2005 (this was extended to 19-09-2005 and again to 31-03-2006);
• Swedish or Norwegian speaker;
• Not having previously received BSF in remand or any other prison;
• Heavy use of alcohol or drugs, measured by the standard prison and probation system: 1= occasional use; 2= heavy use;
• ASI interview at intake;
• No order for deportation after release from prison

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: (BSF) MI sessions; 5 semi-structured manualised MI sessions was conducted by existing prison staff having undergone 3 days of Motivational Interviewing workshop training and 2 days of training with the BSF manual.	Behavioral: Motivational Interviewing; MI; MI is a communication style defined as a collaborative, person-centred form of guiding to elicit and strengthen motivation to change. The method is based on four principles: showing empathy; developing discrepancy between the subject's current behaviour and an alternate, more desired, behaviour; reinforcing self-efficacy; and "rolling" with resistance to change. Client arguments for change are elicited and reinforced in an atmosphere that is empathic, collaborative and supportive of autonomy. The choice to change and the responsibility for change remain with the client.
Active Comparator: (BSF+) MI sessions with supervision; 5 semi-structured manualised MI sessions was conducted by ordinary prison staff having undergone 3 days of Motivational Interviewing workshop training and 2 days of training with the BSF manual, followed by ongoing Motivational Interviewing training with feedback based on audio taped sessions in peer supervision groups.	Behavioral: Motivational Interviewing; MI; MI is a communication style defined as a collaborative, person-centred form of guiding to elicit and strengthen motivation to change. The method is based on four principles: showing empathy; developing discrepancy between the subject's current behaviour and an alternate, more desired, behaviour; reinforcing self-efficacy; and "rolling" with resistance to change. Client arguments for change are elicited and reinforced in an atmosphere that is empathic, collaborative and supportive of autonomy. The choice to change and the responsibility for change remain with the client.
Active Comparator: (UPI) Usual Planning Interview; 5 sessions was conducted by prison staff according to usual working practices, with the exception that content was structured into 5 sessions and audio recorded. The provision of a government decree served as a basis for the intervention, covering planning of prison activities and post release arrangements including strategies for drug use cessation.	Behavioral: Motivational Interviewing; MI; MI is a communication style defined as a collaborative, person-centred form of guiding to elicit and strengthen motivation to change. The method is based on four principles: showing empathy; developing discrepancy between the subject's current behaviour and an alternate, more desired, behaviour; reinforcing self-efficacy; and "rolling" with resistance to change. Client arguments for change are elicited and reinforced in an atmosphere that is empathic, collaborative and supportive of autonomy. The choice to change and the responsibility for change remain with the client.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
number of days with substance use	alcohol- or drug use as measured by the Addiction Severity Index (ASI) at intake and at 10 months after release	of the last 30 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
reported days of illegal activity	as measured by Addiction Severity Index at intake and 10 months after release	during the preceding 30 days
number of days working	as measured by the Addiction Severity Index at intake and 10 months after release	during the last 30 days

Collaborators and Investigators

• Sponsor: Karolinska Institutet
• Collaborators: the research committee of the National Prison and Probation Administration
• Investigators: Principal Investigator: Lars G Forsberg, Ph D, Karolinska Institutet

Study record dates

Study Major Dates

• Study Start: April 1, 2004
• Primary Completion (Actual): March 1, 2007
• Study Completion (Actual): July 1, 2008

Study Registration Dates

• First Submitted: August 18, 2010
• First Submitted That Met QC Criteria: August 18, 2010
• First Posted (Estimate): August 19, 2010

Study Record Updates

• Last Update Posted (Estimate): August 19, 2010
• Last Update Submitted That Met QC Criteria: August 18, 2010
• Last Verified: October 1, 2003

More Information

Terms related to this study

• Keywords: Inmates with heavy use of alcohol or drugs
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Alcohol-Related Disorders; Substance-Related Disorders; Alcoholism
• Other Study ID Numbers: 30225613