Motivational Interviewing (MI) Skill Building
MI is an evidence-based, collaborative style of conversation that is intended to strengthen a person's own motivation and commitment to behavior change. Poor adherence to medication is a behavior that can be a substantial obstacle to mental wellness and MI has shown that it may support a patient's ability to persist through the challenges that can interfere with medication adherence.1

The core concepts and skills of Motivational Interviewing are demonstrated in the 4 videos below, developed in collaboration with Damara Gutnick, MD, a recognized expert in the field. The Overview video describes how to incorporate the key concepts of MI into discussions with your patients. It is important to view that video first. The next 3 videos illustrate MI being used in a clinical setting, by different members of the care team – a prescriber, a pharmacist, and a care manager.

To Deliver a Motivational Interviewing Workshop 
There are 2 copies of a script that accompany each video under "Workshop Resources." The Leader's copy lists the specific MI principles or skills as they occur throughout the discussion. A second copy, intended as a participant handout, does not provide this information. To advance skill building, participants follow along with the video, and independently list the MI skills or principles as they are demonstrated.

An overview: the spirit and skills of MI by Damara Gutnick, MD

In this overview, Dr Gutnick discusses the core principles and skills of MI, and gives tips about how to integrate MI into your practice.


A provider demonstrates MI skills in a talk with a patient who has bipolar depression

During a behavioral health visit with a young woman who has bipolar depression and is trying to manage the pressures of graduate school, a prescribing health care provider illustrates the spirit and skills of MI that are described in the Overview video.

Prescriber/Patient Video Leader Guide

Prescriber/Patient Video Participant Knowledge Check

A clinical pharmacist applies the principles of MI with a patient who has multiple comorbidities

This video shows a pharmacist using MI during an unscheduled call to a 54-year-old man with multiple comorbidities who did not pick up his medication after it was recently renewed.

Pharmacist/Patient Video Leader Guide
Pharmacist/Patient Video Knowledge Check

A care manager has a discussion with a patient with schizophrenia and puts MI skills into practice

During a weekly telehealth visit with a patient who has schizophrenia and is reluctant to take his medication, a care manager illustrates many of the core principles and skills described in the Overview video.

Care Manager/Patient Video Leader Guide

Care Manager/Patient Video Participant Knowledge Check


References
  1. Rollnick S, Miller WR, eds. Motivational Interviewing: Helping People Change. 3rd ed. The Guilford Press; 2013.
  2. McKenzie K, Chang YP. The effect of nurse-led motivational interviewing on medication adherence in patients with bipolar disorder. Perspect Psychiatr Care. 2015;1:36–44.
  3. Byerly M, Fisher R, Whatley K, Holland R, Varghese F, Carmody T, Magouirk B, Rush AJ. A comparison of electronic monitoring vs clinician rating of antipsychotic adherence in outpatient with schizophrenia. Psychiatry Res. 2005;133(2–3):129–133.
  4. Sajatovic M, Valenstein M, Blow FC, Ganoczy D, Ignacio RV. Treatment adherence with antipsychotic medications in bipolar disorder. Bipolar Disord. 2006;8:232–241.
  5. Depp CA, Lebowitz BD, Patterson TL, Lacro JP, Jeste DV. Medication adherence skills training for middle-aged and elderly adults with bipolar disorder: development and pilot study. Bipol Disord. 2007;9(6):636–645.
  6. Svarstad BL, Shireman TI, Sweeney JK. Using drug claims data to assess the relationship of medication adherence with hospitalization and costs. Psychiatr Serv. 2001;52:805–811.
  7. Li J, McCombs JS, Stimmel GL. Cost of treating bipolar disorder in the California Medicaid (Medi-Cal) program. J Affect Disord. 2002;71:131–139.