The Elder Service Connections program once again features in a new scholarly article published in the April issue of The Journal of Family Violence. In the article, the RISE Research Team – the people who designed our intervention model – explores the efficacy of Motivational Interviewing to address elder abuse and self-neglect (EASN). Along with EAIME Executive Director Patty Kimball, our research colleagues Andie MacNeil and David Burnes from the University of Toronto; MT Connolly from USC; Erin Salvo from APS; Geoff Rogers from Hunter College; and Stuart Lewis from Dartmouth co-authored the article, entitled Use of Motivational Interviewing by Advocates in the Context of an Elder Abuse Response Intervention: The Rise Project, using data gleaned through qualitative interviews and focus groups with four of our ESC Advocates.
The goal of this research was to examine the implementation of one of the RISE Model’s key interventions – Motivational Interviewing – from the Advocates’ perspectives, both to learn more about how MI is adapted in the ESC context and to understand the strengths and shortcomings of this approach with older adults experiencing abuse or neglect. MI is a common, evidence-based approach to behavior change that:
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Uses communication to guide people through change, rather than simply listening or directing;
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Empowers people to change by drawing our their own meaning, importance, and capacity for change; and
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Relies on a respectful and curious way of being with people that facilitates a neutral process of change and honors client autonomy (Miller & Rollnick, 2013).
This practice aligns well with the person-centered philosophy that underpins the Elder Service Connections program. As the researchers note, “MI encourages the client-practitioner dyad to collaboratively work within the realm of the client’s goals, which means that each client can determine what change looks like to them.”
The research identified three domains that describe the experiences of Advocates using MI in their work: the therapeutic relationship, specific techniques, and implementation challenges. Each of these domains is explored thoroughly in the article, which concludes that MI is a “useful and highly amenable approach for working with older adults experiencing EASN, as it helps clients navigate their feelings of ambivalence that surround their mistreatment situation and further encourages them to consider their own motivation and ability for positive change.” Specifically, Advocates called out the importance of creating trust necessary to tackle the difficult issues surrounding EASN through a strong therapeutic relationship; using reflective listening to validate client experiences and ambivalence about change; and the need to reinforce client autonomy in making change. Challenges experienced by Advocates centered on reluctance to change, which often emerges when an older adult feels like they are at “rock bottom”, in a place where change is not possible. In addition, some clients are clear about their goals and express a desire for change, but there is a mismatch between the stated goal and their behavior that inhibits the change process.
We’re excited that Patty and the research team have been able to contribute to the important – and under-studied – topic of specific intervention modalities for people experiencing elder abuse…and thank you to the EAIME staff who participated in the research. We’re proud to be making a difference, not only with our clients and their supporters, but also to a scholarly understanding of how social workers and other professionals working in this field might better respond to elder abuse and neglect.
