Psych CASC / OSCE · Professional — communication and psychological therapies
CASC: Motivational interviewing — alcohol cut-down in dual diagnosis
Ten-minute motivational interviewing station: engage a patient with schizophrenia and hazardous drinking, use OARS, evoke change talk, avoid righting reflex, negotiate one concrete next step, and manage partner pressure without coercion.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
CASC: Motivational interviewing — alcohol cut-down in dual diagnosis
Candidate instructions
You are the psychiatry registrar. Alex, 34, has schizophrenia managed with monthly paliperidone palmitate. Drinking has increased to most days. Mildly raised GGT. Missed one depot. Partner in the waiting room wants you to "tell him he has to stop or else." Your tasks in 10 minutes:[1][2]
- Engage and set a collaborative agenda about alcohol and treatment adherence.
- Use MI spirit and OARS; minimise advice stacks.
- Elicit importance and confidence; respond to sustain talk without arguing.
- Strengthen change talk and negotiate one specific next step.
- Address risk briefly (falls/driving/withdrawal red flags) without abandoning MI style.
- Manage the partner's demand without colluding with coercion.
References5ShowHide
- [1]Miller WR, Rose GS Toward a theory of motivational interviewing Am Psychol, 2009.PMID 19739882
- [2]Miller WR, Rollnick S Ten things that motivational interviewing is not Behav Cogn Psychother, 2009.PMID 19364414
- [6]Amrhein PC, Miller WR, Yahne CE, et al. Client commitment language during motivational interviewing predicts drug use outcomes J Consult Clin Psychol, 2003.PMID 14516235
- [9]Glynn LH, Moyers TB Chasing change talk: the clinician's role in evoking client language about change J Subst Abuse Treat, 2010.PMID 20418049
- [16]Schwenker R, Dietrich CE, Hirpa S, et al. Motivational interviewing for substance use reduction Cochrane Database Syst Rev, 2023.PMID 38084817