Overall Feedback
Overall, the provider did a great job engaging Lori in discussing her opioid use and motivating her to seek treatment. Let’s take a look at the choices he made and how you can put these techniques to work for you in your regular practice.
Conversation Goals
Goal 1: Evaluate for OUD
The provider did a great job being respectful and empathetic while evaluating Lori for opioid use disorder. He took his time and expressed his concern for Lori’s feelings, instead of rushing to complete the visit. Because he listened to her experiences and didn’t judge her, Lori felt comfortable telling him the truth about her increasingly problematic opioid use.
Goal 2: Build Motivation to Reduce Use
The provider did a great job showing Lori empathy to help her build her motivation for treatment! This is a crucial step, since patients who don’t feel motivated during treatment are less likely to stick with it and more likely to relapse.
Goal 3: Decide on Treatment Plan
The provider did a great job helping Lori decide on a treatment plan by providing accurate information about all the different pharmacology options.
Goal 4: Plan Immediate Next Steps
The provider did a great job planning the next steps for Lori. He recommended she seek counseling and described the process for her upcoming intake visit to start buprenorphine. Most importantly, he remembered to discuss life-saving risk-reduction steps, like prescribing naloxone and warning Lori about the danger of mixing medications.
Successful Moments
Here are some things to remember when dealing with this incident:
Asking Open-Ended Questions
“Out of the different options we’ve talked about, do any feel like they would be the right fit for you?”
Phrasing a recommendation as an open-ended question is a good way to avoid seeming controlling. It gives patients an easy way to agree, but leaves open the ability to say why if they’re not comfortable with a suggestion and explain why.
Expressing Empathy
“It sounds like you’ve been carrying this alone for a long time.”
Showing empathy by validating a patient’s feelings is a good way to make a connection with them and help them feel less guilt or shame about their condition. Affirming their strengths and normalizing their experiences are also good techniques.
Respectfully Sharing Information
“Would it be alright if we talk about some treatment options that are available to you?”
Asking permission before sharing new information is a good way to show patients respect. Then after you share the information, you can follow up by asking their response to keep them engaged.
Here are some common pitfalls, and how well the provider navigated them:
Factual Errors
The provider did a great job, and didn’t make any factual errors in his information about pharmacology.
Rushed the Patient
The provider did a great job taking his time to talk to Lori and not rushing her into any decisions.
Lack of Empathy
The provider did a great job avoiding unempathetic language and approaches.
Recommendations
In future conversation with patients who have opioid use disorder, remember that the following techniques can help you build and maintain the relationship you need to help them seek recovery.
Open-Ended Questions:
Ask questions without a yes/no or one-word answer.
Showing Empathy:
Affirmation: Acknowledge your patients’ autonomy, strengths and past successes to build their confidence.
Validation: Acknowledge that your patients’ struggles are real and important.
Normalizing: Acknowledge other people have had and overcome the same challenges.
Respectful Sharing of Information:
Ask Permission before sharing new information.
Use Ask-Tell-Ask to learn what patients already know before sharing new information, then follow up to be sure they understood.