Motivational Interviewing and other Therapeutic Modalities for Addiction (2025-2026 Recording)-Motivational Interviewing and other Therapeutic Modalities for Addiction Recording

Video Transcription

Video Summary

Dr. Leah Leisch presented a didactic session on therapeutic modalities for substance use disorder treatment, with emphasis on motivational interviewing (MI) and how it fits into broader care. She described MI as a communication style grounded in partnership, evocation, acceptance, and compassion, not “wrestling” with patients. Key MI skills included open-ended questions, affirmations, reflections, summaries, and ask-offer-ask when sharing information. She highlighted the importance of identifying change talk versus sustain talk and practicing empathic reflections, including simple, complex, double-sided, amplified, and metaphor-based reflections. She also discussed using summaries to “pick the flowers” of change talk from a conversation and translate that into a shared plan.<br /><br />The second half covered other therapies. Contingency management was presented as one of the most effective treatments for stimulant use disorder, using immediate, escalating rewards for specific target behaviors such as abstinence, attendance, or medication adherence. Cognitive behavioral therapy (CBT) was framed as a structured, instructional approach focused on thoughts, feelings, and behaviors, often involving worksheets and homework. Dr. Leisch also reviewed dialectical behavior therapy (DBT), 12-step facilitation, motivational enhancement therapy (MET), and community reinforcement and family training (CRAFT). She noted Project MATCH findings showing CBT, MET, and 12-step facilitation all improved alcohol outcomes, with some patient-specific differences. Throughout, she emphasized that accurate empathy is essential in all therapeutic approaches.

Keywords

motivational interviewing

substance use disorder

therapeutic modalities

change talk

sustain talk

contingency management

cognitive behavioral therapy

dialectical behavior therapy

12-step facilitation

motivational enhancement therapy

community reinforcement and family training

accurate empathy

stimulant use disorder

Project MATCH