Evidence, fidelity, and organisational rationales: multiple uses of Motivational Interviewing in a social services agency

Björk, Alexander

doi:10.1332/174426415x14358305421172

Cited by 7 publications

(9 citation statements)

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“…Timmermans & Mauck, 2005), and the logic of fluidity with demands on individualisation and responsibilisation (Andersen & Järvinen, 2007;Järvinen & Mik-Meyer, 2012), and with practical feasibility and patient-centred care (Epstein et al, 2010). There is thus one 'desktop product RP' providing political legitimacy, and one 'real life RP' that provides professional legitimacy (for a similar reasoning on Motivational Interviewing, see Björk, 2016). According to Mol and Berg (1994), the coexistence of different logics, often referred to as the difference between principles and practice, is common in medicine and similar disciplines.…”

Section: Discussionmentioning

confidence: 99%

Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment

Ekendahl

Karlsson

2021

Critical Public Health

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This article explores how professionals within Swedish addiction treatment (n = 18) describe and make sense of relapse prevention (RP). RP is known as a self-control programme for maintaining behavioural change, helping people deal with high-risk situations. However, since self-control techniques have been incorporated widely in the addiction treatment field, the specificities of RP have become vague. To grasp what RP 'is', we draw on John Law's and Annemarie Mol's thoughts on how logics enact objects and realities. We thus follow critical scholarship in Science and Technology Studies and view treatment as a local knowledge-making practice that may depart from how it was originally designed. A key question is how RP is potentially transformed and made-to-matter when moved from the controlled settings of theorising and experimental studies to practice. The professionals used a logic of fixity to make RP stable, structured and evidence-based, easily distinguishable from other interventions. They also used a logic of fluidity to explain how and why they tinkered with it and adapted it to the preferences of both staff and attendees. The two logics enacted two different realities of addiction treatment: one in which RP is standardised, temporally demarcated and can solve most addiction problems, and another where interventions must be individualised, continuous and adapted to local settings and needs. It did not appear contradictory to 'make up' RP as both fixed and fluid; the two realities exist side by side, but with different material effects.

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Section: Discussionmentioning

confidence: 99%

Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment

Ekendahl

Karlsson

2021

Critical Public Health

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“…Several researchers have highlighted the importance of organizational support as an explicit facilitator for an intervention's implementation (Mosson et al, 2017;Rojas & Stenström, 2020). Other factors facilitating an intervention's success in an organization would be how well it fits with the routines and practices of the organization (Björk, 2016b) and staff possessing sufficient knowledge to search for evidence or to systematically follow up interventions (Rojas & Stenström, 2020).…”

Section: The Organization Of Social Work and Evidence-based Practicementioning

confidence: 99%

‘Easy ride or born to be wild'? The travelling of evidence-based social work to Sweden

Liedgren

Kullberg

2021

European Journal of Social Work

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The starting point of this article is an interest in understanding what happens when the concept of evidence-based practice (EBP) travel between countries. Understanding knowledge as something constructed between actors who shape and trade ideas and experiences, the aim is to study how EBP has been received, interpreted and practised in Swedish social work in comparison to some of the other Nordic welfare states. This is done through a scoping study literature review of research on evidence-based practice (EBP) in Swedish social work within the Swedish welfare system. The review shows that two research units (CUS and IMS) at the public authority National Board of Health and Welfare have had significant influence on the travelling of EBP to Sweden. Further, the review shows that a guideline-model version of EBP has been given priority in the diffusion process. The results also show that the interest in EBP among managers has increased over the past few years, and that their attitude toward the concept is generally positive. At the same time Swedish social workers rarely make use of research in their work, seldom use evidence-based methods, and seems to be unsure of the meaning of the concept. SAMMANFATTNINGUtgångspunkten för denna artikel är ett intresse i att förstå vad som händer när evidensbaserad praktik (EBP) som begrepp reser mellan länder. Genom att förstå kunskap som något konstruerat mellan olika aktörer som skapar och förhandlar idéer och erfarenheter syftar artikeln att studera hur EBP har blivit mottagen, tolkad och utövad i svenskt socialt arbete i jämförelse med några av de andra nordiska välfärdsstaterna. Detta är genomfört genom en omfångsstudie av publicerad forskning EBP i socialt arbete i Sverige. Översikten visar att två forskningsavdelningar (CUS och IMS) hos den statliga myndigheten Socialstyrelsen har haft stor betydelse i införandet av EBP till Sverige. Dessutom visar översikten att riktlinje-versionen av EBP har getts företräde i spridningen. Resultaten pekar också mot att intresset hos gruppledare och chefer har ökat under de senaste åren, och att deras attityd gentemot EBP, generellt är positiv. Samtidigt använder sällan svenska socialarbetare forskning i sitt arbete eller evidensbaserade metoder och tycks även vara osäker på begreppets betydelse.

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“…However, systematic reviews have shown that many studies lack fidelity measures or are otherwise of low quality, making it difficult to assess MI efficacy in relation to specific mediators of change (Apodaca & Longabaugh, 2009;Copeland, McNamara, Kelson, & Simpson, 2015). Nevertheless, there is a tendency to linkages between specific MI practice behavior (including MI spirit), client change talk, and outcomes-which in turn is dependent on MI training as well as systemic changes in the treatment context (Miller & Moyers, 2015, 2016. Still, there is not enough evidence on the association between MITI assessment and MI outcomes (Moyers, Rowell, Manuel, Ernst, & Houck, 2016).…”

Section: Motivational Interviewing: the Development Of A Bfluid^intermentioning

confidence: 99%

“…But even in instances where nurses reported using an MI style approach, not everyone had MI training or scored high enough in MITI evaluation (Östlund, Kristofferzon, Häggström, & Wadensten, 2015). Professionals may also use MI differently depending on their organizational position or use only certain MI techniques and not necessarily in the spirit of MI, due to their perception that it does not fit with the organization's routines and practices (Björk, 2016). Miller and Rollnick (2014) suggest that interventions should comprise proficiency thresholds prior to treating patients, ongoing feedback, and coaching, as well as fidelity levels which need to be obtained throughout delivery.…”

Section: Context Mattersmentioning

confidence: 99%

Motivational Interviewing as Evidence-Based Practice? An Example from Sexual Risk Reduction Interventions Targeting Adolescents and Young Adults

Bahner

Stenqvist

2019

Sex Res Soc Policy

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This paper critically examines sexual risk reduction interventions, more specifically how they are evaluated and the implications that this has for sexual health policy. The focus is on motivational interviewing (MI) interventions which aim to promote protective behaviors related to sexual risk on the part of young people. MI has become increasingly popular, largely due to it being a highly flexible counseling approach that may, with adequate staff training, and fidelity in implementation, be tailored to many different settings (e.g., health care, schools and in community work). Following a scoping review that comprised 34 papers, of which 29 were unique studies, the range and type of existing research were examined. The results show a wide range of study designs and evaluation procedures, MI conceptualizations, modes of MI delivery, and the particular sub-populations of youth and sexual risk behaviors targeted. While this makes it difficult to draw any generalized conclusions about Bwhat works^in prevention, it provides important insights about the complexity of sexual risk behavior as well as complex behavioral treatment approaches like MI. We therefore problematize the political drive to implement evidence-based methods without adequate resource allocation and contextual adaptation.

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Evidence, fidelity, and organisational rationales: multiple uses of Motivational Interviewing in a social services agency

Cited by 7 publications

References 0 publications

Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment

Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment

‘Easy ride or born to be wild'? The travelling of evidence-based social work to Sweden

Motivational Interviewing as Evidence-Based Practice? An Example from Sexual Risk Reduction Interventions Targeting Adolescents and Young Adults

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