SUD 101: Best Clinical Practices for Treating Opioid Use Disorder in Pregnancy and the Postpartum Period-Team-based Takeaway Guide

Pdf Summary

This document is an interprofessional “takeaway guide” summarizing key Motivational Interviewing (MI) skills for healthcare teams, organized in two sections.

<strong>Section 1</strong> outlines MI recommendations tailored to specific professions. Physicians are encouraged to avoid the “Righting Reflex” (the urge to immediately fix behavior), because it can increase patient defensiveness and “sustain talk,” and to shift into <strong>SMART planning</strong> once commitment is present. PAs are advised to use the <strong>Focusing</strong> task to align the clinical agenda with patient priorities through shared decision-making, and to strategically reduce sustain talk through selective responding. APRNs are reminded that <strong>Engaging</strong> and re-engaging through reflective listening is continuous, and that <strong>evoking change talk</strong> by exploring ambivalence helps patients articulate their own reasons to change. Pharmacists are encouraged to use MI to address ambivalence that undermines medication adherence and to foster <strong>self-efficacy</strong>, emphasizing patient strengths when discussing medication plans (e.g., buprenorphine or nicotine replacement therapy).

<strong>Section 2</strong> provides recommendations each profession offers to the broader team. Physicians emphasize the need for a <strong>unified MI approach</strong> across team members to avoid mixed messaging (e.g., scare tactics undermining MI) and note that outcomes improve when teams both elicit change talk and reduce sustain talk. PAs highlight the importance of <strong>aligned agendas</strong> via focusing to prevent fragmented goals, and recommend <strong>complex reflections</strong> to deepen exploration of ambivalence. APRNs reinforce collaborative <strong>SMART goals</strong> and suggest summarizing change talk as a “change talk bouquet,” followed by a question about next steps. Pharmacists advocate for patient empowerment using <strong>Ask–Offer–Ask</strong> when sharing medication information and stress prioritizing safety by offering <strong>naloxone rescue information</strong> even when patients decline formal treatment.

Asset Subtitle

A tool to provide important course takeaways from and for specific members of the team designed to help the team learn from and about one another.

Keywords

Motivational Interviewing

MI skills

healthcare teams

change talk

sustain talk

shared decision-making

reflective listening

self-efficacy

SMART goals

medication adherence