Effectiveness of Motivational Interviewing with Perpetrators of IPV

Featured Article | Journal of Aggression, Maltreatment & Trauma | 2024, Vol. 33, No. 3, 291 - 310

Effectiveness of the Motivational Interviewing Techniques with Perpetrators of Intimate Partner Violence: A Non-Randomized Clinical Trial

Olga Cunha - Faculty of Psychology, Education and Sports, Universidade Lusofona do Porto, Porto, Portugal

Telma Catarina Almeida - Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal

Rui Abrunhosa Gonçalves - School of Psychology, Universidade do Minho, Psychology Research Centre (CIPsi), Braga, Portugal

Sónia Caridade - School of Psychology, Universidade do Minho, Psychology Research Centre (CIPsi), Braga, Portugal

The effectiveness of perpetrators’ intervention programs (PIPs) remains controversial. Readiness and motivation for change are associated with treatment success among intimate partner violence (IPV) perpetrators. In this study, we aimed to verify whether adding Motivational Interviewing Techniques (MIT) during the intake phase of a standard PIP (SPIP) increases treatment adherence. We also sought to evaluate the effectiveness of the MIT plus SPIP concerning an SPIP alone. In this non-randomized clinical trial, 50 participants were assigned to one of the two conditions SPIP alone or MIT plus SPIP. Data were collected at baseline and the end of the intervention. Proximal outcomes (dropout, intervention dose, motivation, attitudes toward IPV, problem-solving skills) and final outcomes (IPV perpetration, risk of IPV) were assessed. The Reliable Change Index (RCI) was also computed. Results indicated that SPIP plus MIT participants concluded the curriculum in a more advanced stage of change, revealed more readiness to change, evidenced greater clinical improvements, and displayed higher reductions in attitudes toward IPV, IPV perpetration, and recidivism risk than SPIP participants. These findings point to MIT’s ability to promote readiness to change and progression into the stages of change, enhancing intervention efficacy with IPV perpetrators.

Efficacy of Intervention; Intimate partner violence; Motivational interviewing; Perpetrators

Intimate partner violence (IPV), a significant societal concern with profound impacts on victims' health and well-being, prompts a shift in intervention strategies towards perpetrator-focused approaches. In response to this pressing issue, perpetrator intervention programs (PIPs) have emerged as an alternative to traditional approaches focused solely on victims. However, the effectiveness of PIPs remains uncertain, with high dropout rates and resistance to change among participants being common challenges. 

Motivational Interviewing Techniques (MIT), aimed at enhancing motivation and promoting behavioral change, have shown promise in addressing these issues. Studies indicate that incorporating MIT into PIPs increases intervention engagement, reduces dropouts, and improves outcomes, particularly among individuals with low readiness to change. However, more controlled trials are needed to evaluate the effectiveness of MIT in PIPs. Therefore, this study aims to determine whether adding MIT to a standard PIP increases treatment adherence and effectiveness, measured by changes in attitudes, motivation, problem-solving skills, and reductions in dropout rates and IPV perpetration/recidivism risk.

The main goal of this study is to examine the impact of incorporating MIT into PIPs in Portugal. The study utilized a non-randomized clinical trial with 50 participants assigned to either the standard PIP alone or the MIT plus PIP condition. Data were collected at baseline and the end of the intervention, assessing various outcomes, including dropout rates, intervention dose, motivation, attitudes toward intimate partner violence (IPV), problem-solving skills, IPV perpetration, and risk of IPV.

Regarding changing irrational beliefs and attitudes toward IPV, significant reductions were observed in the PIP plus MIT group compared to the PIP alone group post-treatment. This suggests that MIT contributed to more positive changes in attitudes toward IPV, indicating more significant clinical improvements among participants receiving PIP plus MIT. Moreover, individuals in the PIP plus MIT group demonstrated improvements in motivation, readiness to change, completing the intervention, and a reduction in total IPV and psychological violence, abandonment/dropout, and recidivism rates. 

No significant differences were found between the groups regarding problem-solving skills, likely due to both groups reporting adaptive coping skills at intake and post-test. In addition, problem-solving skills were predominantly addressed in the standard PIP, which may have also contributed to similar outcomes in both groups. 

Participants in the PIP plus MIT group reported significantly lower levels of physical and psychological violence, as well as a reduced risk of IPV recidivism compared to the PIP alone group. These findings highlight the effectiveness of incorporating MIT in achieving behavioral changes and reducing IPV perpetration. While both groups showed reductions in violence, the PIP plus MIT group exhibited greater improvements, indicating the value of MIT in enhancing the intervention's efficacy.

This study underscores the importance of efforts to enhance perpetrators' motivation and commitment to intervention, with MIT playing a crucial role in achieving these goals. The findings suggest that MITs are essential for motivating IPV perpetrators to engage in and complete interventions, ultimately reducing dropout and recidivism rates and improving intervention effectiveness.

I​​ncorporate Motivational Interviewing (MI) Techniques: Integrating Motivational Interviewing (MI) techniques into interventions with IPV perpetrators can increase participants' motivation for change and readiness to engage in intervention programs. By employing MI strategies, a collaborative and non-confrontational atmosphere can develop where individuals feel empowered to explore their motivations, values, and goals related to behavior change. 

Tailor Interventions to Individual Needs: It is important to recognize that participants may vary in their level of motivation and readiness for change. This may involve employing different intervention techniques based on the participant's stage of change, addressing specific risk factors or barriers to change, and providing personalized support and guidance throughout the intervention process. 

Focus on Behavioral Changes: Prioritizing behavioral changes can reduce physical and psychological violence among IPV perpetrators. This can be accomplished by working collaboratively with participants to develop concrete strategies for managing conflict, improving communication skills, and promoting healthier relationship dynamics. 

Utilizing PIPs for Problem-Solving Support: Based on the research findings, standard PIPs may already provide sufficient support for developing problem-solving skills. Therefore, MIT interventions may have the opportunity to focus on addressing other critical aspects of treatment, such as motivation enhancement and attitude adjustment toward IPV. By utilizing the existing framework of PIPs to address problem-solving skills, clinicians can allocate resources and attention to areas where MIT techniques may provide greater benefits. 

“In sum, our results have several important practical implications. To the best of our knowledge, this is the first study in Portugal that assesses the addition of MIT during the intake phase of a [standard perpetrators intervention programs]. In addition, this study considers other outcomes than recidivism, which might impact recidivism, focusing on clinical change, which is little considered when assessing the effectiveness of offenders’ intervention. This study reinforces the importance that efforts to improve perpetrators’ motivation should be seen as a requirement for commitment to intervention and motivation to change. Using MIT is fundamental to motivating IPV perpetrators to attend, remain committed to treatment, and complete the intervention, reducing abandonment/dropout and recidivism rates. As in other works, MITs proved to be crucial in improving the main intervention processes (e.g., pro-therapeutic behaviors) in SPIPs, thus increasing their effectiveness” (p. 306 - 307).