Motivational Interviewing and Batterer Treatment: A Scoping Review

Purpose: The confrontational style of many Batterer Intervention Programs (BIP’s)may provoke clients to justify and defend their aggressive behaviors (Crane & Eckhardt, 2013), despite the fact that available research suggests that confrontational, hostile, and critical therapist behaviors limit treatment effectiveness (Murphy & Baxter, 1997). Conversely, motivational interviewing (MI) emphasizes therapeutic collaboration and autonomy, but is not typically included within BIP’s. This scoping review takes stock of what is known and unknown, while evaluating the methods investigators have used for understanding the impact of motivational interviewing on perpetrators of intimate partner violence (IPV). This work inspected the status of scholarship by examining two research questions:

1. What is the extent, nature, and range of research activity related to MI and treatment for perpetrators of IPV?

2.  What are the gaps in existing literature regarding MI and treatment for perpetrators of IPV?

Methods: The methods used for this review were adopted from the methodological framework for scoping studies published by Arksey & O’Malley (2005). First, research questions were identified and definitions operationalized. Second, in order to identify relevant studies, 10 electronic databases were searched using appropriate terms. Hand searching was used to locate potential studies or actual pdf documents when only titles or abstracts were accessible through databases. Studies were included from January 1975 to May 2014.  Third, studies were included if they met the following criteria: 1) included participants who were perpetrators of intimate partner violence; 2) implemented a form of motivational interviewing during the study timerme 3) published in the English language. Fourth, general information about the study, specific information related to the study population, research setting, type of intervention, outcome measures, important findings, study design, and suggestions for future research, amongst other data was selected for charting. Finally, the data was charted, a technique for synthesizing and interpreting qualitative data by organizing material according to key issues and themes.

Results: Six studies met the inclusion criteria for this review. The goal of the sessions across studies were to provide a collaborative, nonjudgmental environment in which the therapist could invite the client to make their own arguments for change and eventually experience increased motivation for reducing or ending battering behavior. Typically focused on improving outcomes related to physical violence, each of the studies found that MI significantly improved at least one of the outcomes being measured. Themes within future research discussions focused on expanding outcome measures, inclusion of marginalized populations, and methodological improvement.

Implications: Adopting a motivational approach is not without controversy, even though the literature supports its use. The field of batterer intervention continues to debate the appropriate balance of judicial sanction, protection of victim safety and promotion of change as goals of batterer intervention. Actual broad inclusion of MI techniques into treatment for batterers may require more evidence before policy and broad scale treatment changes can be made, especially since doing so would likely increase costs (i.e. training, therapists time for individual sessions). The results of this review indicate that more research needs to be done.