University:
Boston University
Course:
QST SM 101 | Introduction to Management
Academic year:

2020
Views:

315

Pages:

2
Author:

liyakhulaujet

Brief Intervention and Referral: Adult Interview Scoring Sheet PART 1 Note: Points scored for every YES. CRITERIA Y Engagement • Raise subject & ask permission for talk about alcohol (1 points) • Elicit values & how drug/alcohol fits into life (2 points) Maximum score = 3 Comments: Pros and Cons of Alcohol/Drug Use Pros/cons form – part A • Elicit good things • Elicit additional pros • Elicit things liked less • Elicit additional cons, using reason for visit • Sum up and restate in patient’s own words (reflective listening) 5 points per item; maximum score = 25 Comments: Feedback/Discussion • Ask permission to provide feedback • Compare screening responses (self-report of drug and alcohol use) to low risk use (NIAAA low risk drinking guidelines) • Make connection with health problems • Elicit patient response 3 points per item; maximum score = 12 Comments: Assess Readiness to Change • Use general readiness to change question (ruler) • Reinforce positives • Ask, why not less? • Elicit other reasons for changing • Identify strengths and supports 4 points per item; maximum score =20 Comments: Create Action Plan (Prescription for Change) • Elicit specific steps • Write steps on the prescription for change form • Sum up/restate in patients own words • Give referrals if needed • Thank the patient 4 points per item; maximum score = 20 Comments: Maximum score = 80 points Score PART 1 ____ N PART 2 General Performance Feedback: 20 points total; An answer of 5=2 points; 4=1 point; <4=0 • • Language appropriate Reflective listening Not appropriate | | | 0 1 2 Not reflective | | 0 1 | 2 | 3 Appropriate | | 4 5 | 3 Reflective | | 4 5 • Percent of talking by patient compared to interviewer (Voice) | | | | | 0% 20% 40% 60% 80% (1) (5) • Respect • • • • Negotiation(Choice) Affirmations Knowledge of facts Knowledge of resources Disrespectful | | | 0 1 2 | 3 | 4 Respectful | 5 One-sided Agenda | | | 0 1 2 | 3 | 4 Shared Agenda | 5 Not Encouraging Encouraging self-change | 0 | 1 | 2 | 3 | 4 | 5 Low | 0 | 1 | 2 | 3 | 4 High | 5 Low | 0 | 1 | 2 | 3 | 4 High | 5 • Allowing for silence and duration of pauses before jumping in No pause Uses silence effectively | | | | | | 0 1 2 3 4 5 • Listening for cues Misses opportunities | 0 PART 2 SCORE = _________ | 1 | 2 Uses opportunities to go deeper | 3 | 4 | 5 TOTAL SCORE (PARTS 1 & 2) =_______ A successful BNI constitutes a score greater than 80/100 points.