Program Profile: Brief Motivational Interviewing for Alcohol Use (Incarcerated Women)

This program was designed to provide an alcohol intervention to incarcerated women with hazardous drinking habits who were being released from prison. The program is rated Ineffective. There were no statistically significant differences between the treatment and comparison groups on the number of days abstinent from alcohol consumption at the 6-month follow up.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals

Brief Motivational Interviewing for Alcohol Use (BMI-AU) aimed to reduce alcohol consumption among incarcerated women with hazardous drinking habits who were being released from prison and were returning to the community.

Target Population/Eligibility

Women were eligible for the intervention if they 1) engaged in hazardous alcohol consumption (consumed four or more drinks at a time on at least 3 separate days in the previous 3 months or received a score of 8 or above on the Alcohol Use Disorders Identification Test); and 2) engaged in risky sexual behavior (had unprotected sex on at least 3 separate days in the 3 months prior to incarceration).

Program Components

The intervention consisted of two, one-on-one motivational interviewing (MI) sessions that lasted 30 to 45 minutes each. The initial MI, which occurred while the women were still incarcerated, established goals regarding making changes in alcohol use behavior and exploring strategies to deal with barriers and obstacles to achieving those goals. Specifically, in the first session, the participants and interventionists discussed 1) the participant’s values and goals, 2) the pros and cons of alcohol use, 3) thoughts about alcohol use and cutting back/quitting, 4) rational facts about alcohol (cost of alcohol, reasons for drinking, negative consequences), 5) thoughts about the usefulness of alcohol, and 6) readiness to change alcohol use and generation of a change plan.

The second MI session was intended to be held at a hospital-based site in the community within 1 month of release from incarceration. This session was based on the initial MI session goals and change plan, focusing on progress, assessment of barriers, and developing concrete strategies for meeting new goals. Additionally, recovery strategies were also discussed, with an emphasis on identifying high-risk situations for release and effective coping strategies in high-risk situations.

In the cases where non-alcohol-related goals were set in the first MI session, the second session focused on developing strategies to achieve those goals and overcoming barriers. The interventionist and participant then evaluated the potential for setting an alcohol-related goal and interim steps to ultimately consider setting an abstinence goal.

Study

Stein and colleagues (2010) conducted a randomized clinical trial to test the impact of Brief Motivational Interviewing–Alcohol Use (BMI-AU) on participants’ alcohol use in the past 90 days. Participants included all women who were detained at the Rhode Island Department of Correction facility between February 2004 and June 2007, and who had engaged in hazardous alcohol consumption and risky sexual behavior during the 3 months prior to incarceration. 

The treatment group (n = 125) received two motivational interviewing sessions: one while they were still incarcerated and a second within 1 month of release at a hospital-based research setting in the community. The control group (n =120) received assessment only. Both groups received information about community-based substance abuse treatment. At the initial screening, members of both groups were also asked to recall and report their alcohol use behaviors during the 90 days prior to incarceration for use as baseline measures. 

The treatment group was on average 33 years old, with 10 years of education. They also self-reported alcohol use on 54 percent of the 90 days prior to incarceration. The racial breakdown was 71 percent white, 21 percent African American, 6 percent Hispanic, and 2 percent other racial or ethnic groups. The comparison group was on average 35 years old, with 10 years of education. They also reported alcohol use on 49 percent of the 90 days prior to incarceration. The comparison group racial breakdown was 72 percent white, 18 percent African American, 8 percent Hispanic, and 3 percent other racial or ethnic groups. Seven demographic characteristics and baseline alcohol use behaviors of both groups were examined, and no statistically significant differences between the groups were found.  

Follow-up assessments were conducted with both groups at 1, 3, and 6 months after the initial assessment. Rates of attrition were not significantly different between groups. The final sample size used in the 6-month analysis was 193 (78.8 percent of the original sample; n = 99 for the treatment group and n = 94 for the comparison group).   

To estimate the intervention’s effects on abstinence from alcohol and the number of drinks consumed per drinking day at the 1-, 3-, and 6-month follow-up points, a zero-inflated negative binomial model was used. This model estimated the differences between the treatment and control groups in terms of changes in alcohol use behavior from the baseline period to the follow-up period.

The Brief Motivational Interviewing–Alcohol Use intervention included a quality assurance measure, the Motivational Interviewing Integrity Code version 2.0, which was used to train the therapists who provided the motivational interviewing (MI) sessions, assess their competence, and monitor their skills. Training consisted of reviewing the five basic principles of MI: expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, and support self-efficacy (Stein et al. 2010).

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Clarke, Jennifer, Bradley Anderson, and Michael Stein. 2011. “Hazardously Drinking Women Leaving Jail: Time to First Drink.” Journal of Correctional Health Care, 17(1):61–8.