Practice Makes Perfect: The Art of Motivational Interviewing

Using a textbook to study the art of motivational interviewing is one thing, but putting it into practice—alongside an expert—is a step up to a higher level of education. That’s the goal of Symposium 10, “Introduction to Building Skills in Motivational Interviewing,” which will be presented at 8 am Sunday in Orange Ballroom D, Lower Level.

Judith Martin, MD, FASAM, ABAM Diplomate, leads the symposium, which will take an interactive approach to educating clinicians about this highly effective and systematic intervention for evoking internally motivated change. Dr. Martin is the Deputy Medical Director for Community Behavioral Health Services and Medical Director for the Substance Use Services for the San Francisco Department of Public Health.

“Motivational interviewing is a way of deciding, with a patient, what they want to do to solve a problem related to any chronic illness or behavior change,” she said. “It’s a good, brief intervention in a busy office, and effective across any specialty.”

The session will leverage the experience of four professionals who will teach the skill at small roundtables, giving attendees an opportunity to hone the skill through role-play and feedback, Dr. Martin said.

Motivational interviewing is grounded in research on a process of natural recovery, with patients moving through stages of change, assisted by the clinician. Evaluation of the discussion of change and readiness to change guides the interaction, she said. Motivational interviewing can be used as the ‘brief intervention’ part of SBIRT—Screening, Brief Intervention, and Referral to Treatment—a hot topic in itself, she said.

The U.S. Preventative Services Task Force (USPSTF) recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. The USPSTF found adequate evidence that brief behavioral counseling interventions are effective in reducing heavy drinking episodes in adults engaging in risky or hazardous drinking. These interventions also reduce weekly alcohol consumption rates and increase adherence to recommended drinking limits, Dr. Martin said. Since then, insurance companies have developed requirements for screening and billing codes for brief interventions.

Unfortunately, research suggests that although a majority of pediatricians and family practitioners report providing some alcohol prevention services to adolescent patients, they do not universally or consistently screen and counsel for alcohol misuse, she said. Barriers include a perceived lack of time, familiarity with screening tools, training in managing positive results, and available treatment resources.

“We think that motivational interviewing is a base skill that anyone who works in the field of addiction medicine and behavior change should have,” Dr. Martin said. “However, even if you know and understand motivational interviewing, the best way to gain confidence is to practice. This session will give you the chance to practice with an expert.”