Three studies in the past decade from BC and Manitoba have found that when case managers use motivational interviewing (MI) to engage their income assistance clients, many more quickly overcome the employment barriers they face and move forward in finding work and leaving assistance. The Centre has just completed a project that adds to this knowledge base with practical insights about how readily the approach can be adopted.
The new study used mixed research methods, combining a rigorous double random-assignment trial with qualitative implementation research. A total of 28 case managers and 154 income assistance clients across 7 WorkBC locations in the lower mainland of BC enrolled in the study. The Centre’s researchers sought to understand the pros and cons of integrating MI into case management practice from the perspectives of 15 case managers and to measure the impact of this implementation on their clients’ use of services, job search and participation in the labour market.
The project’s implementation research suggested that case managers valued being trained to use MI greatly. They readily identified MI as a potentially useful tool for employment counselling. As they practised the approach, they found MI useful for clients who were ambivalent to making change in their lives. However, they also reported a mismatch between the principles of MI and the rules they needed to follow with respect to managing their caseload. The sequencing and timelines of their regular tasks sometimes conflicted with their efforts to perform MI fully as intended. Perhaps as a consequence, data from follow-up surveys and administrative records offered no evidence that more clients were able to transition into full-time employment by virtue of being eligible for MI case management. Although 10 per cent of program group clients with MI-trained case managers entered full-time employment within three months of study enrollment, close to 9 per cent of equivalent control group clients with non-MI case management did so as well – an impact not statistically different from zero. Nonetheless, the program group did experience increased referrals to other programs.
The project found that the full integration of MI into client interactions in WorkBC settings was challenging. Perhaps as a consequence, the quantitative results were inconclusive with respect to the impacts on employment and income assistance receipt. Those considering implementation of MI while seeking to significantly change client outcomes would need to consider broader changes to the organization of case management, beyond provision of the intensive training itself, to ensure conditions conducive to the approach are fully implemented.
A short video based on the project can be viewed below. An overview of the research findings was be presented during a CfEE webinar on Tuesday, June 27, 2017. Click here for the webinar blog post which includes the full webinar recording.
The pilot is being funded by the Government of Canada and the Province of British Columbia through the Ministry of Social Development and Social Innovation’s Community and Employer Partnerships Research and Innovation Fund.