Emergency Medicine Half and Half MAT Waiver Training-Module 5: Motivational Interviewing & Evidence-based Counseling

Module 5: Motivational Interviewing & Evidence-based Counseling

Pdf Summary

Motivational Interviewing (MI) is a collaborative conversation style that aims to strengthen a person's motivation and commitment to change. It was developed in the 1980s and has been used in over 25,000 articles and 200 randomized controlled trials. MI can be used in the emergency department (ED) to enhance a patient's willingness to enter treatment for opioid use disorders (OUD). <br />The key components of MI include open questions, affirming, reflecting, and summarizing. Practical aspects of MI include being open-minded, listening more than giving advice, avoiding wordiness and interruptions, and using the patient as a consultant. <br />One technique to enhance motivation in the ED is the Brief Negation Interview (BNI), which involves establishing rapport, providing feedback, enhancing motivation, and negotiating and advising. <br />Change talk is an important aspect of MI, as it helps the patient explore their ambivalence about change. MI is a long game, and the results may not be seen in a single encounter, but it is important to build a therapeutic relationship and plant seeds of change. <br />Screening, Brief Intervention, Referral, and Treatment (SBIRT) is another evidence-based approach that can be used in the ED. SBIRT involves screening patients for unhealthy alcohol use and providing brief counseling interventions. It is not linked to readiness to change and can be used in pre-contemplative patients. <br />Other evidence-based counseling approaches for OUD include Cognitive-Behavioral Therapy, medication management, and mutual support groups such as Narcotics Anonymous and SMART Recovery. <br />Overall, MI and SBIRT are effective techniques that can be used in the ED to enhance a patient's motivation to enter treatment for OUD.

Keywords

Motivational Interviewing

collaborative conversation style

strengthen motivation

commitment to change

emergency department

treatment for opioid use disorders

Brief Negation Interview

change talk

therapeutic relationship

SBIRT