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Brief Action Planning (BAP) and Motivational Interviewing (MI) for C-L Psychiatry: A Stepped-care Approach to Health Behavior Change
Persistent unhealthy patient behaviors, including non-adherence, unhealthy use of alcohol, tobacco, prescription and other drugs, poor nutrition/over-eating, and sedentary lifestyle account for 70-80%, or more, of the overall burden of chronic illness, disability, and death in the U.S. C-L psychiatrists grapple with these complex behavioral issues in their clinical, consultative, and educational work, but rarely receive sufficient training in targeted evidence-based medical interviewing strategies. This 4-hour course aims to provide C-L psychiatrists with conceptual models and pragmatic skills to systemically address health behavior change complexities in their roles as clinicians and teachers. Specifically, the course will present an integrative stepped-care approach, starting with the eight core competencies of Brief Action Planning (BAP) and supplementing these skills, as needed, with focused applications of concepts and skills from the field of Motivational Interviewing (MI). From MI, the course will highlight: Spirit of MI; recognizing and responding to change and sustain talk/ambivalence; and using the Four Process Model of MI for patients not ready for action planning. BAP is a highly structured, pragmatic, and versatile MI-consistent tool to help people change and to support self-management for health. BAP was initially developed by Steven Cole, MD, and colleagues, circa 2000, as a patient self-management support tool for the Health Disparities Collaboratives in Federally Qualified Health Centers for diabetes, heart disease, depression, and asthma. Since then, BAP has been widely used in the US and internationally (e.g.16 peer-reviewed publications and thousands of “hits” on google searches). MI is an evidence-based collaborative conversation style for strengthening a person’s own motivation and commitment to change. The core text has been translated into over 28 languages; there are over 3000 trainers in 58 languages. More than 1500 clinical trials and over 170 systematic reviews and meta-analyses have been published, with about one-third devoted to alcohol and substance use problems, demonstrating consistent small-to-medium average effect size on measures of health outcomes (d=.3 to .4). Eight faculty, including 3 members of MINT (Motivational Interviewing Network of Trainers), from 5 academic medical centers representing 5 disciplines (psychiatry, addiction medicine, pediatrics, preventive medicine, and sociology) will present core concepts, discuss clinical and educational uses of BAP/MI in their institutions, host Zoom break out groups for participants to practice skills with feedback, and lead plenary discussions and Q and A. After completing this course, participants will be able to apply the concepts and skills of this stepped-care approach to health behavior change in their own clinical work as well as their educational work with colleagues and trainees. Should they choose to do so, participants will also be well-positioned to pursue more advanced training to facilitate health behavior change.
Speakers
Steven Cole
Professor of Psychiatry, Emeritus | Stony Brook University School of Medicine
Yuri Jadotte
Assistant Professor and Associate Director of Preventive Medicine Residency Program | Renaissance School of Medicine at Stony Brook University
Taranjeet Ahuja
Communication Skills, Co-Leader; Assistant Professor of Science Education & Pediatrics | Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Following time in private practice, Dr. Ahuja assumed a position in academics as an Assistant Professor of Science Education & Pediatrics at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. She completed her Master of Science in Education (MSEd) at Hofstra University. She has been full-time faculty at the Zucker School of Medicine for approximately 9 years. Dr. Ahuja currently holds the title of Co-Leader of the Communication Curricular Thread, which is a four-year longitudinal curriculum. Previous to this role, she was Director of the Ambulatory Clerkships.
In addition to her other responsibilities, Dr. Ahuja teaches physical diagnosis, clinical reasoning and is a bedside clinical coach. She is a Co-Director of the Tell Me More® elective. She also serves as a facilitator for PEARLS, a case-based learning course designed to help students learn the key concepts of biomedical science embedded in real patient cases.
Finally, Dr. Ahuja has maintained a pediatric clinical practice and is board certified by the American Board of Pediatrics.
Roy Stein
Clinical Professor | University of North Carolina School of Medicine
Deepa Sannidhi
Associate Clinical Professor | UC San Diego School of Medicine
Camila Romero
Assistant Clinical Professor | University of California San Diego, Preventive Medicine
Richard Frankel
Professor of Medicine and Geriatrics | Indiana University School of Medicine
Trained as a qualitative researcher his interests include face-to-face communication, the role of technology and its effects on quality, safety, and outcomes of care. Dr. Frankel has been a medical educator for the past 40 years. He was the co- director of the internal medicine residency program at Highland Hospital/University of Rochester and, while there, served as co-director of the Program and Fellowship in Advanced Biopsychosocial Medicine. At IUSM, he co-led a successful five-year school- wide initiative to change the culture of the medical school using appreciative inquiry, an organizational change strategy that focuses on what is working well and how to get more of it rather than focusing on what’s wrong and how to fix it.
Dr. Frankel completed his undergraduate degree at Colgate University and obtained a PhD in sociology from the Graduate School and University Center of the City University of New York. He completed postdoctoral training at Boston University and was a Fulbright Research Fellow in Uppsala, Sweden. He a founding Fellow of the Academy for Communication in Healthcare and has published more than 275 scientific papers and edited 7 books. Outside of work, he enjoys biking, hiking, collecting antiquarian 1st editions, and digital photography.
Igor Koutsenok
Professor of Psychiatry | University of California San Diego
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Speakers
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