Presentation T P11

T P11 (Poster Presentation):
Organizational conditions for implementing Motivational Interviewing in sickness insurance practice

Presented by: Christian Ståhl

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Authors

Ståhl C1,3, Ekberg K1,3, Gustavsson M2,3

  1. National Centre for Work and Rehabilitation, Linköping University, Linköping, Sweden
  2. Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
  3. HELIX VINN Excellence Centre, Linköping University, Linköping, Sweden

Abstract

Background

Motivational Interviewing (MI) as a method for promoting change has been evaluated with convincing results in several areas, e.g. smoking cessation and drug rehabilitation. While it has also been adapted to social work, its effects in such areas are less documented. In 2012, the Swedish Social Insurance Agency decided to implement MI as a new method for officials to use to promote return-to-work and labor market reintegration to people on sick leave. In this study, we aim to analyze the organizational conditions for implementing MI in sickness insurance practice.

Methods

An explorative qualitative study was carried out focusing on the use of MI in two contexts: in regular practice, and in a development project with MI as a central project component, carried out in cooperation with the Public Employment Service. In regular practice, 43 individual interviews were carried out with officials and managers. In the project, continuous focus groups and individual interviews with project workers and managers were carried out over a two-year period. The material was analyzed using a qualitative content analysis.

Results

Insurance officials were generally positive towards using MI. However, in regular practice the use of MI was prevented by strained working conditions, lack of organizational support structures and low priority from the management. In the project, officials also experienced lacking support structures, but managed to use MI extensively and develop and maintain their skills through informal support from colleagues. Cooperation with employment service officials also facilitated the promotion of clients’ work-oriented goals, and translating these into action.

Conclusions

Organizational conditions played a pivotal role in whether MI was to be applied or not, illustrating that the implementation of new work routines need to be accompanied with managerial priority, and sufficient time for learning the method and for developing the necessary practical skills. Further, the results point to the need to account for organizational conditions of implementation when assessing the evidence for MI and other methods in evaluations and intervention studies, since flawed implementation of MI could not be attributed to the method itself.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Social issues