Promoting Engagement and Satisfaction Among Child Protective Service Recipients: Combining Motivational Interviewing and Deliberate Practice

Background. Engaging families in child protective services is critical yet challenging to accomplish. Children’s safety and the family’s integrity are at stake. Motivational Interviewing (MI) is a counseling approach designed to promote client engagement and motivation for taking action while simultaneously reducing “resistance” (Miller & Rollnick, 2014). Learning to work with a family’s motivation in the high pressure setting of child protection is a complex, demanding skill which requires more than simple presentation of knowledge. Deliberate practice (Ericsson, Krampe, & Tesch-Romer, 1993) provides an empirically based learning structure for reliably acquiring complex skills. In this study we trained Child Protection Service (CPS) Workers in MI using a Deliberate Practice (DP) informed training structure. Our hypothesis specified CPS workers who participated in the MI/DP training would have better alliances with families compared to those who did not.

Methods. A two-group design was utilized, with the experimental group receiving specialized training and supervision. Randomization was not possible given the nature of CPS work. The comparison and experimental group shared a geographical boundary and are roughly equal demographically. Outcome data was gathered from CPS families as their cases naturally closed around the time training completed. A modified, 7-item version of the Working Alliance Inventory-Short Revised (WAI-SR, Hatcher & Gillaspy, 2006) gathered information about recipients’ experience with their caseworker. Three subscales were derived: agreed upon goals, agreed upon tasks, and relationship quality. For the experimental group, supervisors received 40 hours of training and frontline workers received 20. Supervisors were also coached on how to promote MI implementation consistent with DP guidelines. MI was operationalized into 16 skills with specific adherence guidelines that guided practice and supervision efforts post training.

Results. 166 recipient parents responded to the survey request (11% response rate which was equal across groups), 79 of whom were in the experimental condition. Across all questions, there was a statistically significant positive outcome in favor of the MI/DP training group, t = 1.74 (df = 160), p < .05, Cohen’s d = 0.28. For the agreed upon goal factor, there was also an advantage for the MI/DP training group, t = 1.95 (159), d = .31. The MI/DP training group also enjoyed a statically significant advantage in the quality of relationship factor, t = 1.65 (159), d = .26. The agreed upon task factor showed no reliable difference, t = 1.22 (158), d = .19. Effect sizes for all of the analyses were in the statistically significant but small range.

Implications. CPS service recipients found increased value in working with caseworkers in terms of relationship quality and securing agreed upon goals after their workers received training in MI using a DP informed training structure. These data suggest training to supervisors and caseworkers can reach actual clients in a meaningful manner thereby promoting healthy outcomes for children and families. The increased investment of resources to train to competency seems beneficial and worth further study.