Panel Paper: Evaluating the Use of Motivational Interviewing in Washington State’s TANF Case Management

Saturday, November 10, 2018
8226 - Lobby Level (Marriott Wardman Park)

*Names in bold indicate Presenter

Christina McHugh, Brent Baxter and Jerry Kosierowski, Washington State Department of Social and Health Services

Motivational Interviewing (MI) is a counseling method and form of collaborative conversation for strengthening a person's own motivation and commitment to change while addressing the common problem of ambivalence about change. Motivational Interviewing has proven successful in encouraging change in several social and health program areas including behavioral health, substance abuse treatment, and the criminal justice system. While Temporary Assistance to Needy Families (TANF) customers exhibit similar ambivalence to change, few studies have tested the effectiveness of MI within TANF case management.

Traditionally, TANF case management has taken a directive, deficit-based approach that assumes a client lacks knowledge or insight that the case manager can provide. MI is a person-centered approach that encourages the customer to plan change. In 2017, Washington State’s Department of Social and Health Services (DSHS) selected six Community Services Offices (CSOs) to pilot the use of MI within TANF case management. Following best practices in adult learning, TANF social workers and case managers completed extensive MI training requiring them to demonstrate skill competency through ongoing monitoring. This presentation will present the initial findings from an evaluation of these pilots, with updated results expected in 2019.

The pilots and evaluation required close collaboration between researchers, state TANF policy and operations managers, local CSO administrators, and front line staff. Our mixed method evaluation includes a descriptive study, an implementation evaluation, and an impact evaluation. The descriptive study compares the characteristics of 1) pilot site staff who completed MI training and demonstrated skill competency with 2) staff at non-pilot sites who did not complete MI training. Through the descriptive study, we aim to identify potential scalability challenges and opportunities to provide additional staff support. The implementation evaluation – including site visits, focus groups, and interviews with pilot site staff – will identify successes, challenges, and best practices for integrating MI into TANF case management.

Lastly, through a quasi-experimental design, the impact evaluation will examine MI’s effects on TANF customers’ employment, wages, length of TANF stay, TANF sanctions, and barriers to self-sufficiency. To develop a comparison group, we use propensity score matching to identify a comparable group of case management staff without MI training at CSOs not involved in the pilot. Through a unique data match using human resources, staff training, case management, and customer administrative data, we will compare the customer outcomes of MI-trained case manager caseloads to comparison group caseloads.

This presentation will present the initial findings from each component of the evaluation and provide the field with lessons learned on using MI in TANF case management. In addition, we will speak to the challenges of working with various state administrative data systems and how we overcame them to conduct a novel impact evaluation.