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Review
. 2017 Sep;85(9):549-565.
doi: 10.1055/s-0043-115216. Epub 2017 Sep 7.

[Motivational interviewing with alcohol-dependent patients]

[Article in German]
Review

[Motivational interviewing with alcohol-dependent patients]

[Article in German]
Michael Spaeth et al. Fortschr Neurol Psychiatr. 2017 Sep.

Abstract

Motivational interviewing with alcohol-dependent patients Alcohol-dependent patients do not need to be motivated from the outside. They are mostly ambivalent, and the inner voice, which already speaks for change (change talk), is heard through motivational interviewing, carefully strengthened and developed together with the patient. The practitioner has to deal with the human spirit of motivational interviewing and should be able to communicate with empathy, respect, congruence, and openness. The patient's autonomy should always be maintained. Advice is only given upon request. The conversation style is directive-guiding instead of authoritariansteering. OARS and the EPE principle are the motivational interviewing basics, which are consistently applied over 4 processes of motivational interviewing: engaging, focusing, evocing, and planning. The likelihood of change talk increases as soon as discrepancies between life goals and alcohol consumption emerge. An increased rate of change talk makes a change in behavior more likely. If a patient argues against change (sustain talk), one should not confront, but should consistently work with reflections, reframing, and an emphasis on autonomy. Motivational interviewing can be applied in different settings and populations, should be learned by the entire team (best professional guidance) in teamwork, and be subjected to a critical and constant evaluation.

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Conflict of interest statement

Interessenkonflikt: M. Spaeth hat keine Interessenkonflikte. S. Bleich erhielt Honorare und Zuwendungen von Lundbeck und Servier. Zudem ist er 2. Vorsitzender der Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) sowie Vorsitzender des Instituts für Arzneimittelsicherheit in der Psychiatrie AMSP e.V. T. Hillemacher erhielt Honorare und Zuwendungen von den Firmen Servier, Otsuka, Lundbeck, Bristol-Myers Squibb, Desitin und Tromsdorff. Überdies war er für die Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) an der Leitlinienentwicklung tabak- und alkoholbezogene Störungen beteiligt.

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