Motivational Interviewing: Inspiring Behavior Change-FREE NO CME-Motivational Interviewing: Inspiring Behavior Change-Video

Video Transcription

Video Summary

Don Stater (addiction and emergency medicine physician) and Rachel Duncan (clinical pharmacist) introduce motivational interviewing (MI) as a patient-centered, collaborative method to strengthen intrinsic motivation for behavior change, emphasizing partnership over paternalism and respect for autonomy. They explain that change is most effective when it comes “from the inside,” warning against the clinician “righting reflex” of immediately giving advice. MI targets ambivalence and aligns care with a patient’s stage of change (precontemplation through action), tailoring conversations accordingly.<br /><br />They outline MI’s four processes—engaging, focusing, evoking, and planning—and teach core communication skills using OARS: open-ended questions, affirmations, reflective listening, and summaries. A brief role-play about smoking before surgery demonstrates using scaling questions (readiness/confidence rulers) and highlighting “change talk” while validating “sustain talk.” They also discuss building discrepancy between current behaviors and deeper values without judgment.<br /><br />The presenters review evidence supporting MI in perioperative care (e.g., reducing substance use, supporting opioid tapering, improving nutrition) and recommend integrating MI across teams via training, EHR prompts, huddles, and quality improvement metrics. A patient attendee reinforces that MI builds trust and openness.

Keywords

motivational interviewing (MI)

patient-centered communication

behavior change stages (transtheoretical model)

OARS skills (open questions, affirmations, reflections, summaries)

righting reflex

change talk and sustain talk

readiness and confidence scaling questions

perioperative care and opioid tapering