Express Learners: Watch the basic S.O.A.R. conversation and setting limits videos. View the S.O.A.R. pocket cards and "Words that Work" Infographics, Opioid Contract, and complete opioid conversation scripts.
Expert Learners: Complete express path and view MI path based on your time and interest level.

S.O.A.R Through "Difficult Conversations" Video

In this clinical example, you will see a practitioner working with a patient to reduce her use of opioid medications.

Note the use of S.O.A.R. technique developed by Laura Heesacker and E. Krebs

S: Shared Decision Making when safety allows, avoid backing patients into a corner.

Lower Risk = Higher Shared Decision Making

O: Outcomes- Focus on what the patient cares about:

Improved quality of life
Protection from opioid-related harm
Staying under the care of the team

A: Assurance and Validation

All pain is real
Make eye contact
Observe behavior
Physical exam at every visit

R: Risk and Redirect

Risk belongs to the drug
Use universal precautions (UDS, PDMP, behavioral contracts.)
Redirect conversation from pain to function

Running time 6:03 minutes

https://www.youtube.com/watch?v=KvlQuaOogUE

View the S.O.A.R. Pocket Cards

SOAR Pocket-Cards-for-Difficult-Conversations.pdf

View "Words that Work" Scripts

Words That Work for Opioid Conversations Short Version.pdf

View Complete Script for Having Difficult Opioid Discussions

Opioid Conversation Scripts-Words that Work-Full Version (1).pdf

Setting Limits and Behavioral Contracts

In this interview segment, Dr. Blum describes how to use a behavioral contract to prevent problems at the time you start prescribing opioids for a patient and talks about how to set limits in an emphathic and non-blaming way if that does become necessary.

Running time 6:13 minutes

https://www.youtube.com/watch?v=EUIRxO8-__g&feature=youtu.be

View a Typical Contract that You Can Use in Practice

SamplePatientAgreementForms.pdf