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Using Motivational Interviewing to Discuss Substan ...
Video: MI part 2 with Brian Borsari
Video: MI part 2 with Brian Borsari
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Video Summary
This webinar, part of the American Academy of Addiction Psychiatry's Advanced Addiction Psychotherapy series, features Dr. Brian Borsari discussing motivational interviewing (MI), an evidence-based psychotherapy technique useful in addiction treatment. The session reviews foundational MI components: engagement, focusing, evoking, and planning, emphasizing MI spirit—genuine partnership, compassion, acceptance, empathy, autonomy, and evocation of clients’ own motivations for change.<br /><br />Dr. Borsari highlights core MI skills—Open-ended questions, Affirmations, Reflections (simple and complex), and Summaries (OARS)—used to elicit and strengthen client change talk (expressions favoring change) while understanding but not reinforcing sustain talk (expressions favoring status quo). He addresses the common pitfall called the “fixing reflex,” where clinicians inadvertently push clients toward change, leading to resistance or “discord.” Instead, MI requires resisting directive impulses, focusing on listening, understanding ambivalence, and fostering autonomy.<br /><br />The webinar explores how to skillfully evoke change talk through reflective listening and affirmations, emphasizing that clients often move toward change when they feel understood and empowered rather than pressured. The importance of collaboration in planning concrete, realistic steps toward change is also discussed.<br /><br />A significant part of the webinar is the video demonstration “The Confirmed Smoker” by Terry Moyers, showcasing expert MI in action with a smoker ambivalent about quitting. The conversation tactfully explores the client’s conflicting feelings, values, fears, and desires without judgment, illustrating effective evocation and transition toward planning.<br /><br />Throughout, Dr. Borsari stresses the therapeutic alliance, cultural sensitivity, and adapting MI to individual clinician style while maintaining MI spirit. The webinar concludes with Q&A addressing sustained talk, cultural considerations, therapist discord, and personal reflections on proficiency and authenticity in MI practice.
Keywords
Motivational Interviewing
Addiction Treatment
Brian Borsari
American Academy of Addiction Psychiatry
Advanced Addiction Psychotherapy
MI Spirit
OARS Skills
Change Talk
Fixing Reflex
Therapeutic Alliance
The Confirmed Smoker
Cultural Sensitivity
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