APC: Motivational Interviewing (MI): Brian Bosari, PhD-Motivational Interviewing Video

Video Transcription

Video Summary

The video is a webinar introducing the American Academy of Addiction Psychiatry's monthly webinar series on evidence-based intensive psychotherapy training for addiction psychiatry fellows and faculty. The first topic of the series is motivational interviewing, presented by Dr. Brian Borsari, a health behavioral coordinator and psychologist.<br /><br />Dr. Borsari discusses the definition and processes of motivational interviewing, emphasizing engagement, focusing, evoking, and planning. He highlights the importance of therapist behaviors like open-ended questions, affirmations, reflections, and summaries in facilitating change talk and reducing sustained talk. Strategies for incorporating motivational interviewing into practice are provided, such as asking about the benefits of change and recognizing sustained talk. Dr. Borsari also addresses using motivational interviewing in hospital settings and countering demoralization in patients.<br /><br />The concept of rolling with resistance is discussed, emphasizing personal choice and control for behavior change. It is recommended to avoid coercion and clarify that the decision to change is up to the individual. Engagement and focusing are prioritized, and the evocation stage of motivational interviewing may cause distress, but it is essential for individuals to wrestle with themselves rather than the clinician. Affirmations should be specific and focus on intrinsic strengths.<br /><br />Motivational interviewing may be less effective for individuals with low motivation, such as those with depression, requiring goals clarification and support. Behavior tracking, setting SMART goals, and assessing genuineness of change talk are important for minimal behavioral change. Strategies may be needed for individuals reluctant to change or those who tend to please others.<br /><br />Motivational interviewing is most effective when there is ambivalence towards a changeable behavior and aligns with the individual's goals and values. A success story is shared about a heavy smoker with PTSD who quit smoking due to conflicting values. Curiosity is not explicitly highlighted in motivational interviewing, but it can enhance the effectiveness of the conversation.<br /><br />In summary, the webinar provides an introduction to motivational interviewing and its application in addiction psychiatry, focusing on engagement, focusing, evoking, and planning. Strategies for incorporating motivational interviewing into practice and addressing resistance are discussed.

Keywords

webinar

American Academy of Addiction Psychiatry

evidence-based intensive psychotherapy training

addiction psychiatry fellows

faculty

motivational interviewing

Dr. Brian Borsari

therapist behaviors

change talk

rolling with resistance

behavior change

ambivalence