Motivational interview vs. standard interview with people screening to enter the homeless veterans rehabilitation program: Effect on rate of entry, self-efficacy and readiness to change

Motivational interviewing (MI) is a client-centered, directive, usually brief approach that has been used to facilitate entry into, and adherence with, drug and alcohol treatment programs, as well as to improve length of stay and other long term outcomes, such as decreased alcohol consumption. Very little research has been done to determine whether MI is an effective intervention with extremely distressed populations, yet, due to its cost-effectiveness, it would be useful to know whether it is. People being screened to enter the Homeless Veterans Rehabilitation Program (HVRP) are such a population; they are homeless, unemployed and substance dependent. After being screened for the program, eligible applicants are placed on a wait-list, during which time they must call in each day to see if there is a bed for them and they must obtain a TB test and a medical clearance, provide recent medical records, agree that they have no outstanding warrants or pending court dates, obtain VA clearance, and remain clean and sober for at least 72 hours prior to entry. The wait list period and procedures are challenging for this population and 45% of those screened do not make it through the wait-list procedures to enter the program. In this study, 66 people being screened to enter HVRP were given either a single, brief MI or a standard intake interview as a control. Before and after the interviews, participants completed questionnaires to assess readiness to change and self-efficacy. Ninety-five percent of those who received the MI interview made it through the wait-list period to be admitted to the program. No differences were found pre- to post-interview in readiness scores, but trends toward an increase in self-efficacy scores and length of stay are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)