The Brief Negotiated Interview
Brief Intervention
The Brief Negotiated Interview
Learning Objectives
By the end of this session you will be able to—
Describe an evidence-based practice model of brief
intervention, the brief negotiated interview (BNI).
Apply specific motivational interviewing (MI) skills to
BNI.
Practice SBIRT brief intervention skills using the BNI.
Review of SBIRT
Do you recall the primary
goal of SBIRT?
Review of SBIRT
(continued)
Substance use continuum
Abstinence
Moderate use (lower risk use)
At-risk use (higher risk use)
Abuse
Dependence
Review of SBIRT
(continued)
Along the substance use continuum, with whom
would you negotiate a reduction in use to lower
risk levels? Select all that apply.
a.
Someone with moderate use
b.
Someone with at-risk use
c.
Someone who abuses or is dependent
Review of SBIRT
(continued)
Along the substance use continuum, with whom
would you negotiate a treatment referral for full
assessment and a level of intervention to be
determined? Select all that apply.
a.
Someone with moderate use
b.
Someone with at-risk use
c.
Someone who abuses or is dependent
What Is Brief Intervention?
B
rief
I
ntervention is a brief motivational
and awareness-raising intervention given
to risky or problematic substance users.
What Is the
B
rief
N
egotiated
Interview?
There are several models for brief
intervention, including the BNI, originally
developed by Gail D’Onofrio, M.D., Ed
Bernstein, M.D.,
Judith Bernstein, M.S.N.,
Ph.D.,
and Steven
Rollnick, Ph.D.
The BNI is a semistructured interview
process based on MI that is a proven
evidence-based practice and can be
completed in 5−15 minutes.
Special acknowledgement is made to Drs. Stephen Rollnick, Gail D’Onofrio, and Ed Bernstein for granting
permission to orient participants to the “brief negotiated interview.”
Steps in the BNI
1.
Build rapport—raise the
subject. Explore the pros and
cons of use.
2.
Provide feedback.
3.
Build readiness to change.
4.
Negotiate a plan for change.
1. Build Rapport—Raise the
Subject
1.
Begin with a general
conversation.
2.
Ask permission to
talk about alcohol
or drugs.
1. Build Rapport—Raise the
Subject
continued
What if the patient does not want to talk about
his or her use?
Discuss the Pros and Cons of Use (a)
Help me understand
through your eyes.
1.
What are the good things
about using alcohol?
2.
What are some of the not-
so-good things about using
alcohol?
Discuss the Pros and Cons of
Use—Applying MI (a)
Using open-ended questions—
Enables the patient to convey
more information
Encourages engagement
Opens the door for exploration
Using reflections
Reflective listening
Thinking reflectively
Discuss the Pros and Cons of
Use—Applying MI (b)
Summarizing
Reinforces what has
been said
Shows careful listening
Discuss the Pros and Cons of Use (b)
Summarize using a decisional balance…
2. Provide Feedback (a)
1.
Ask permission to give
information.
2.
Discuss screening
findings.
3.
Link substance use behaviors to any known
consequences.
2. Provide Feedback (b)
Evoke a response:
Positive reaction—move
forward
Negative reaction—revisit
the pros and cons
3. Build Readiness To Change
Could we talk for a few minutes about your interest in
making a change?
On a scale from 1 to 10, 1 being not ready at all and 10
being completely ready, how ready are you to make any
changes in your substance use?
4. Negotiate a Plan for Change
A plan for reducing use
to low-risk levels
OR
An agreement to follow
up with specialty
treatment services
BNI— With At-Risk Patient
View Video Demonstration
BNI Practice Session
Roles
Patient
Interviewer
Observer
Closing Reflection
Based on your performance
in all the practice scenarios,
what skills do you think you
perform well? Which of your
skills needs practice so you
can more effectively help
your patient?
Questions?
What’s Next?
The closing session in this series will discuss
practical aspects of referring patients to
treatment.
Also referred to as the Brief Negotiation Interview or the BNI.
Utilize the "Brief Negotiated Interview" approach for brief interventions. This method involves concise interactions to address issues efficiently. It helps in engaging individuals, discussing concerns, and formulating actionable steps for positive change. The approach involves a structured conversation to navigate the intervention process effectively. Implementing this strategy can lead to impactful outcomes within a limited timeframe, making it ideal for addressing prevalent issues promptly. By utilizing this approach, professionals can tailor interventions to suit individual needs and facilitate meaningful discussions.
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Presentation Transcript
Brief Intervention The Brief Negotiated Interview
Learning Objectives By the end of this session you will be able to Describe an evidence-based practice model of brief intervention, the brief negotiated interview (BNI). Apply specific motivational interviewing (MI) skills to BNI. Practice SBIRT brief intervention skills using the BNI.
Review of SBIRT Do you recall the primary goal of SBIRT?
Review of SBIRT (continued) Substance use continuum Abstinence Moderate use (lower risk use) At-risk use (higher risk use) Substance Use Disorders (SUDs) Abuse Dependence
Review of SBIRT (continued) Along the substance use continuum, with whom would you negotiate a reduction in use to lower risk levels? Select all that apply. a. Someone with moderate use b.Someone with at-risk use c. Someone who abuses or is dependent
Review of SBIRT (continued) Along the substance use continuum, with whom would you negotiate a treatment referral for full assessment and a level of intervention to be determined? Select all that apply. a. Someone with moderate use b.Someone with at-risk use c. Someone who abuses or is dependent
What Is Brief Intervention? Brief Intervention is a brief motivational and awareness-raising intervention given to risky or problematic substance users.
What Is the Brief Negotiated Interview? There are several models for brief intervention, including the BNI, originally developed by Gail D Onofrio, M.D., Ed Bernstein, M.D., Judith Bernstein, M.S.N., Ph.D., and Steven Rollnick, Ph.D. The BNI is a semistructured interview process based on MI that is a proven evidence-based practice and can be completed in 5 15 minutes. Special acknowledgement is made to Drs. Stephen Rollnick, Gail D Onofrio, and Ed Bernstein for granting permission to orient participants to the brief negotiated interview.
Steps in the BNI 1. Build rapport raise the subject. Explore the pros and cons of use. 2. Provide feedback. 3. Build readiness to change. 4. Negotiate a plan for change.
1. Build RapportRaise the Subject 1. Begin with a general conversation. 2. Ask permission to talk about alcohol or drugs.
1. Build RapportRaise the Subject continued What if the patient does not want to talk about his or her use?
Discuss the Pros and Cons of Use (a) Help me understand through your eyes. 1. What are the good things about using alcohol? 2. What are some of the not- so-good things about using alcohol?
Discuss the Pros and Cons of Use Applying MI (a) Using open-ended questions Enables the patient to convey more information Encourages engagement Opens the door for exploration Using reflections Reflective listening Thinking reflectively
Discuss the Pros and Cons of Use Applying MI (b) Summarizing Reinforces what has been said Shows careful listening
Discuss the Pros and Cons of Use (b) Summarize using a decisional balance
2. Provide Feedback (a) 1. Ask permission to give information. 2. Discuss screening findings. 3. Link substance use behaviors to any known consequences.
2. Provide Feedback (b) Evoke a response: Positive reaction move forward Negative reaction revisit the pros and cons
3. Build Readiness To Change Could we talk for a few minutes about your interest in making a change? On a scale from 1 to 10, 1 being not ready at all and 10 being completely ready, how ready are you to make any changes in your substance use?
4. Negotiate a Plan for Change A plan for reducing use to low-risk levels OR An agreement to follow up with specialty treatment services
BNI With At-Risk Patient View Video Demonstration
BNI Practice Session Roles Patient Interviewer Observer
Closing Reflection Based on your performance in all the practice scenarios, what skills do you think you perform well? Which of your skills needs practice so you can more effectively help your patient?
Whats Next? The closing session in this series will discuss practical aspects of referring patients to treatment.
