Motivational Interviewing: Schizophrenia and Alcohol Use Disorder

Abstract

Purpose: The aim of this quality improvement (QI) project was to refresh the education of providers and support staff at CODAC on the open-ended questions, affirmation, reflection, and summary (OARS) technique of motivational interviewing (MI) and offer strategies to implement OARS. The long-term goal was to encourage providers to adopt this technique to reduce ambivalence and excessive drinking in patients with co-occurring schizophrenia and alcohol use disorder (AUD). Background: Schizophrenia is a mental disorder with a high rate of suicide compared to the general population. People with schizophrenia have a higher rate of alcohol use (47%) than the general population (16%). Research has shown that MI improves symptoms of schizophrenia, helps the patient overcome ambivalence, and reduces the inclination for excessive drinking. Method: This QI project was based on a change proposal outcome using the Plan-Do-Study-Act (PDSA) model. The design included a pre-and post-test survey that assessed the providers’ consistent use of the OARS technique. The pretest was administered 18 days before the implementation date via Qualtrics to determine the provider's knowledge of the OARS technique of MI. The post-test survey was conducted directly after the in-service to evaluate providers and support staff knowledge, intent, and readiness to use the OARS technique. Results: The pre-and post-surveys were analyzed using the difference in percentages. There were nine (N=9) providers and support staff who participated and completed the intervention. The findings showed an increase in knowledge, intent to use, and positive attitudes posttest towards using the OARS technique. Conclusion: Implementing the OARS technique of MI to change risky behavior in patients with co-occurring schizophrenia and AUD was supported by robust evidence from research, indicating that MI is an evidence-based intervention (EB) to change behavior effectively. Patients with co-occurring schizophrenia and AUD are often ambivalent about excessive drinking; however, mental health providers can help them resolve this ambivalence using the OARS techniques of MI.