Motivational interviewing for internal medicine patients with - - PowerPoint PPT Presentation

Motivational interviewing for internal medicine patients with addictions

Tommy Brothers, MD @tdbrothers thomas.brothers@dal.ca

CSIM Annual Meeting 2019

Conflict Disclosures

Definition: A Conflict of Interest may occur in situations where the personal and professional interests of individuals may have actual, potential or apparent influence over their judgment and actions.

“I have no conflicts to declare”

Company/Organization Details Advisory Board or equivalent Speakers bureau member Payment from a commercial organization. (including gifts or other consideration or ‘in kind’ compensation) Grant(s) or an honorarium Patent for a product referred to or marketed by a commercial organization. Investments in a pharmaceutical

• rganization, medical devices company or

communications firm. Participating or participated in a clinical trial

CSIM Annual Meeting 2019

Brothers: Motivational interviewing in patients with addictions – October 3, 2019

The following presentation represents the views of the speaker at the time of the presentation. This information is meant for educational purposes, and should not replace other sources

• f information or your medical judgment.

Learning Objectives:

• Apply principles of motivational interviewing, trauma-informed care,

and harm reduction when working with patients experiencing medical complications of severe substance use disorders.

• Consider how these approaches may enable us to provide more

compassionate and effective care

@CATIEinfo

Harm reduction

• Meeting people “where they are”
• Helping people identify and achieve their

goals with non-judgment

• Promoting health without requiring

abstinence from substances as a prerequisite

Harm reduction

• Meeting people “where they are”
• Helping people identify and achieve their

goals with non-judgment

• Promoting health without requiring

abstinence from substances as a prerequisite

Trauma-informed care

5 principles:

• 1. Trauma awareness and acknowledgment
• 2. Safety and trustworthiness
• 3. Choice, control, and collaboration
• 4. Strengths-based and skills-building care
• 5. Cultural, historical, and gender issues

BC Mental Health. Trauma-informed practice guide. 2013

Stages of change

www.porticonetwork.ca

Motivational interviewing - Principles

• Express empathy
• Develop discrepancy
• Roll with resistance
• Support self-efficacy
• Be curious

Motivational interviewing - Techniques

• Ask permission
• Ask open-ended questions
• Listen reflectively
• Summarize
• Affirm
• Elicit self-motivational change statements

Working with patients who use drugs

• 1. Assess substance use
• 2. Discuss difference between drug use, risky

use, and addiction

• 3. Review potential harms
• 4. Explore goals regarding their substance use
• Use same, reduce harms
• Use less, reduce harms
• Stop using (abstinence), reduce harms

Adapted from Giftos J, 2018

@CATIEinfo

Diane Bailey Lisa Barrett Julia Belliveau Matt Bonn Emily Cameron Sam Campbell Jolene Cook Emma Garrod Leah Genge HaliFIX OPS HANDUP John Fraser Sam Hickcox Sean Hurley Elaine Hyshka Lois Jackson Susan Kirkland Cindy MacIsaac Dave Martell Trish McKay Ashley Miller Patti Melanson Kim Mosseler Tiffany O’Donnell Holly Richards Steve Robinson Ken Rockwood Dave Saunders Andrea Sereda Rick Swaine Natasha Touesnard Colin Van Zoost Duncan Webster @tdbrothers thomas.brothers@dal.ca Dalhousie Faculty of Medicine R.S. Smith Fellowship in Medical Research Canadian Society of Internal Medicine Hui Lee Health Promotion Scholarship

thomas.brothers@dal.ca @tdbrothers