Motivational Interviewing Becomes Tenth Approved Service Under Family First Act

A demonstration of Motivational Interviewing. Photo: Saskatchewan Prevention Institute

A process used by social workers and other professionals to inspire the confidence and desire to change in clients has been cleared for federal funding under the Family First Prevention Services Act, which mostly took effect last month.

Motivational Interviewing (MI) was developed in 1983 by clinical psychologists William Miller and Stephen Rollnick, and refined in a procedural guide published in 1991. Interviewers are trained to explore, and then resolve, the ambivalence that prevents them from stopping negative behaviors such as the use of illicit drugs.

The clearinghouse created to review candidates for Family First Act services has rated the model “Well Supported,” the highest of three ratings possible for approved interventions. MI was among the first models screened by the clearinghouse, and is the last one of that first group to receive a rating. It was a bit surprising that it took as long as it did, given that the model has long been among the highest-rated models by the California Evidence-Based Clearinghouse for Child Welfare.

There are another 15 models and programs under consideration right now by the clearinghouse, which recently solicited public input on what its next slate of reviews should include.

The Family First Act was passed in 2018, and its main provisions took effect in October of this year. It permits for the first time the use of  Title IV-E, a child welfare entitlement, to provide certain services aimed at preventing the need for foster care in some child welfare cases. Those services will generally fall in the areas of substance abuse, mental health and parenting, and states can also draw the funds for “kinship navigator” programs that help relatives and family friends temporarily care for kids.

But those funds will not flow for just any model of service. The Family First “prevention services” will be limited to a list of options on a newly established clearinghouse that meet one of three evidentiary tiers: “Promising,” “Supported” or “Well-Supported.” And half of the spending must come in that hardest-to-meet standard of Well-Supported, though a bill is making its way through Congress that would ease off on that rule in the near term.

The other nine services that have been approved thus far by the clearinghouse are listed below.

Well-Supported

Functional Family Therapy

A family intervention model used with households that include an adolescent exhibiting conduct disorder, substance abuse or is acting out violently.

Multisystemic Therapy

Seeks to promote pro-social behavior and curb criminal activity and illicit substance abuse among 12- to 17-year-olds.

Parent-Child Interaction Therapy (PCIT)

A model to serve families with young children who exhibit behavioral or parent relationship problems. PCIT imparts play therapy skills for parents to use with their children.

Parents As Teachers

A home-visiting model that uses trained parent educators to work with new and expectant mothers.

Nurse-Family Partnership

A home-visiting model that pairs new moms with professional nurses before and after pregnancy.

Healthy Families America

A home-visiting model that supports new and expecting parents with biweekly visits before birth and weekly visits for at least six months after birth.

Supported

Families Facing the Future

This model is for parents who have young or adolescent children, and who are receiving methadone treatment. The program includes a family retreat and 32 parenting sessions conducted over a 16-week period (kids attend some of them, others are just parents).

Promising

Methadone Maintenance Therapy, through which patients use methadone to reduce their use of heroin and other opiates.

Trauma-Focused Cognitive Behavioral Therapy (CBT)

This version of CBT is designed to serve children with an established history of trauma who are experiencing sexual behavior problems and post-traumatic stress disorder.


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John Kelly
About John Kelly 1135 Articles
John Kelly is editor-in-chief of The Chronicle of Social Change.