Motivational Interviewing for Challenging Conversations

Motivational interviewing is a patient centered, collaborative style of communication that represents one tool to help clinicians overcome the challenges of conversations surrounding opioid tapers. MI can help strengthen motivation and interest in health behavior change. With regard to initiating an opioid taper, MI may elicit reasons for committing to an opioid taper, confirm beliefs in the ability to successfully complete a taper, and increase commitment to a treatment plan. Additionally, MI may increase provider comfort and skill in guiding conversations that have potential to cause conflict and undermine patient-provider rapport. Although training and education about the use of MI has proliferated in medical education, providers often report that incorporating MI into their daily practices is challenging due to the abstract nature of its concepts and pressure to maintain brief appointment times. This course will: review the spirit of MI and barriers to using it in practice; define/list challenges specific to using MI in the long-term opioid therapy population; provide concrete examples of clinical situations in which an opioid taper is clinically indicated; and discuss MI-consistent phrases that can be incorporated into common scenarios regarding long-term opioid therapy. (Recorded at PAINWeek 2017)