For centuries, doctors have been regarded as the “experts” when it comes to healthcare. Many patients take their recommendations very seriously, yet the conversation can often feel one-sided. In the past, medical diagnosis and treatments were commonly presented as ultimatums with an if-then explanation: “If you don’t take this medicine you will not get better” or “If you don’t stop smoking you will get lung cancer”. Over the last 30 years, there has been a gradual shift in thinking that has led to the belief that establishing relationships and building a partnership between a provider and a patient is clinically more beneficial.
Motivational Interviewing (MI) is a technique partners in the nine-county region are benefitting from regularly. Funded by Care Compass Network (CCN) through the Delivery System Reform Incentive Payment (DSRIP) program, health care systems and community-based organizations learn the following in an all-day seminar:
- The difference and relationship between Motivational Interviewing and Client Centered Counseling
- The ‘4 Pillars’ of Motivational Interviewing Spirit
- Demonstrate the use of the Core Skills of Motivational Interviewing, OARS
- Learn different counseling styles that evoke resistance
- Demonstrate how to provide educational information in an MI congruent manner
- Learn what Sustain Talk and Change Talk is
- Learn the role of Directive vs Directional stance when practicing MI
Paul Warren, of NDRI-USA Training Institute, led the session and helped participants put theory into practice by having them pair up with someone from the group and perform a “real-playing” exercise. One partner would play the role of the patient while the other would act as the provider. Warren would encourage them to practice listening in a way that would allow them to repeat back to the patient what they had just heard. This process is called reflective listening, where the provider demonstrates an acute awareness of the patients challenges and needs and gives them validation and confirmation that their concerns have been heard.
“Paul is a terrific trainer,” shared Christine McAvoy Paul, Deputy Director of Chenango Health Network in Norwich, NY. “The techniques are second nature to him, but he assured us that with more and more practice, it will come naturally to us as well.” She heard about the training in an email from Care Compass Network and thought it would be a great opportunity for her staff and herself. . McAvoy Paul oversees a team of six, serving the health needs of a population across a 4-county region. “We have been very involved as a partner with CCN and have been working with the Care Transitions team,” explained McAvoy Paul. “We’ve been active with implementing the Health Coach model and recognized the MI training as a valuable part of that process.”
Motivational Interviewing originated as a tool for working with patients experiencing substance use disorders. It proved to be an effective way for healthcare professionals to evoke the patients’ intrinsic motivation for change. CCN is taking an active role in promoting the integration of this method of care-counseling especially in primary care settings. “This is something we need to embrace in this next phase of Value-based Healthcare,” noted Bouakham Rosetti, Project Manager from CCN. “We’ve had as many as 20 people attend each of the day-long sessions. The response has been extremely positive and we have had to put partners on a waiting list. The participants represent healthcare professionals and community-based organizations such as Health Navigators, Nursing Managers, Health Access Coordinators, Social Workers, Practice Administrators, and more,” she shared.
Bouakham serves as the Project Manager for Project 3ai – Primary Care and Behavioral Health Integration (Model 1 and Model 2) and Project 4aiii – Strengthening Mental Health and Substance Use Disorder Infrastructure. The focus on the behavioral health initiatives is to promote evidence-based screenings, early identification of behavioral health and primary care issues, provide appropriate interventions and warm handoffs to outpatient treatments and/or community-based organizations to address identified Social Determinants of Health needs. These projects along with many others, help continue the effort to reduce unnecessary Emergency Room visits and hospital readmissions.
“All health care systems and community-based organizations are looking at different methods to effectively engage patients in their health care and improve the patient experience. Patients want care and will seek care where they feel welcome, heard, and understood,” Bouakham explained. “This is one of the reasons whey Care Compass Network believes in offering MI, Mental Health First Aid Training and other evidence-based trainings to our partners.” Care Compass Network currently offers primary care clinics that are participating in Project 3ai Model 1 a $10,000 training reimbursement. These funds help offset some of the revenue loss accrued while staff members are attending trainings that promote integration.
For more information about Motivational Interviewing, read the article “What is Motivational Interviewing?” by SAMHSA.
Care Compass Network will be offering the following Motivational Interviewing training sessions in November. Additional Motivational Interviewing training dates will be forthcoming throughout the year. If you would like to attend, please click the registration link below to sign up.
November 15th in Ithaca, NY – Click here to register
November 29th in Painted Post, NY – Click here to register
December 7th in Binghamton, NY – Click here to register
December 12th in Norwich, NY – Click here to register