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Module II: Conducting a brief intervention. How do you approach conversations about behavior change with your patients?. Styles of communication. Styles of communication. Communication styles. Following. Guiding. Directing. An example of directive communication.

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module ii conducting a brief intervention
Module II:

Conducting a

brief intervention

slide3

Styles of communication

Communication styles

Following

Guiding

Directing

slide4
An example of

directive communication

Styles of communication

http://www.youtube.com/watch?v=2fdfzUS1qDc

Used with permission, University of Florida, Psychiatry Dept.

characteristics of directive communication
Characteristics of directivecommunication

Styles of communication

  • Explaining why the patient should make the change
  • Telling the person how they could change
  • Emphasizing how important it is to change
  • Persuading when meeting resistance
characteristics of guiding communication
Respect for autonomy of patient and their goals and values

Readiness to change must be taken into account

Ambivalence is common

Targets selected by the patient, not the “expert”

Expert is the provider of information (patient)

Be empathic, non-judgmental, respectful

Characteristics ofguiding communication

Styles of communication

brief interventions
Brief interventions can be performed in as little 3 minutes

Aimed to motivate those at-risk to change their behavior

Aimed to motivate individuals with more severe risk to seek assessment/treatment

Designed to provide personal feedback, enhance motivation, and promote self-efficacy to promote behavior change

Brief Interventions

Brief interventions

steps of the brief intervention
Steps of the brief intervention:

Steps of the brief intervention

Raise the subject

Provide feedback

Enhance motivation

Negotiate plan

brief intervention steve
Brief intervention: “Steve”

Steps of the brief intervention

http://www.youtube.com/watch?v=b-ilxvHZJDc

slide10
Screening forms act as conversation starters

Ask permission to raise the subject of alcohol/drug use

“Thanks for filling out this form. Would you mind taking a few minutes to talk with me about your alcohol use and how it might relate to your ______?”

Steps of the brief intervention

Raise the

subject

slide11
Point out the patient’s zone of misuse.

Explore connection to health issues if there is one and express concern(s)

Educate about NIAAA Guidelines for low-risk drinking

Use Elicit-Provide-Elicit Model

Steps of the brief intervention

Provide feedback

slide12

Steps of the brief intervention

“On a scale of 0 - 10 , how ready are you to change any aspect of your drinking (drug use)?”

Enhance motivation

  • “Why did you choose that number and not a lower one?”

A strategy that helps the patient identify what motivation already exists towards making change.

slide13

Steps of the brief intervention

  • Explore pros and cons:
    • What are some things you like about your drinking?
    • What are some things you don’t like about your drinking?

Enhance motivation

slide14
Negotiate a plan on how to reduce use, abstain or seek referral

Provide clear advice and express your concerns

Negotiate and secure an agreement regarding changes the patient is willing to make, including scheduling follow-up when needed

Steps of the brief intervention

Negotiate plan

slide15

Readiness ruler

Readiness Ruler: front

slide16

Readiness ruler

Readiness Ruler: back

slide17

Recording the brief intervention

For clinician:

Clinician Name:___________________________ Date: _______________AUDIT Zone: ___________

Brief intervention given?  Raised subject  Not given  Referral recommended  Provided feedback Referral phone number:

 Enhanced motivation 1-800-923-4357

 Negotiated plan

practice richard
Practice: Richard

Practice

  • Form groups of three:
    • Physician
    • Patient
    • Observer
  • Observer: Use the observation sheet and keep track of time