19. Counselling (9%)/ Lifestyle (18%) Flashcards
What to take into consideration when counselling a patient ? (7)
- Set clear therapeutic goals with the patient
- Allow adequate time
- Evaluate your own skills (e.g., Does the problem exceed the limits of your abilities? Are you the right person and is this the right time to unpack the patient’s concerns?)
- Recognize when you are approaching or exceeding boundaries (e.g., transference, counter-transference)
- Recognize when your beliefs or biases may interfere with counselling
- Remain aware of the risks of offering advice versus providing options
- Pay close attention to the quality of the therapeutic relationship and alliance
In the ongoing care of patients, ask about behaviours that, if changed, can improve health.
Name some exemples. (6)
- diet
- exercise
- alcohol use
- substance use
- safer sex
- injury prevention (e.g., seatbelts and helmets)
Before making recommendations about lifestyle modification, explore what?
a patient’s readiness to change, as it may alter advice.
What to acces before making recommendations about lifestyle modification?
Explore a person’s context (e.g., poverty) so as to avoid making recommendations incompatible with the patient’s context.
Name the stages of change
- Precontemplation (Not ready)
- Contemplation (Getting ready)
- Preparation - Action (Ready)
- Maintenance (Sticking to it)
- Relapse (Learning)
Name strategies for this stage of change : Precontemplation (2)
- Highlight advantages for change and problems with current behaviour,
- Harm reduction
Name strategies for this stage of change : Contemplation (4)
- Weigh pros and cons
- Explore ambilance/alternatives
- Identify reasons for change/challenges
- Increase confidence
Name strategies for this stage of change : Preparation - Action (2)
- Goal setting, start date and strategy for change, as well as address challenges
- Support and praise, stress that episodes of relapse are normal
Name strategies for this stage of change : Maintenance (Sticking to it) (1)
Help identify and use strategies to prevent relapse
Name strategies for this stage of change : Relapse (Learning) (1)
Help renew process of contemplation and action without becoming demoralized
Describe : Five A’s (Health risk behaviour)
- Ask “Would you mind if I talked to you about your smoking? How often do you smoke/exercise/wear a seatbelt?”
- Advise “As your doctor, I strongly recommend that you ____. It is one of the most important things you can do for your health.”
- Assess “Are you ready to quit smoking in the next 30 days?”
- Assist “Quitting smoking can be a real challenge. I can help you with this change, as well as pharmacotherapy/community resources/spousal support may help.”
- Arrange ‘I’d like to see you again/call you next week to see how the plan is going.”
Describe : BATHE (Psychosocial problem)
- Background “What’s going on in your life?”
- Affect “How do you feel about this situation?”
- Troubles “What bothers you most about the situation?”
- Handling “How are you coping with the situation?”
- Empathy “It sounds very difficult.”
Describe : RULE (Motivational interviewing for behaviour change) (4)
- Resist the righting reflex
- Understand the patient’s own motivations
- Listen with empathy
- Empower the patient
Name Generic Lifestyle Advices. What to DECREASE ? (5)
- Smoking, alcohol, marijuana, drugs
- Salt, fat, sugar, calories
- Screentime/TV
- Stressful activities/work
- Exposure to triggers (allergies)
Name Generic Lifestyle Advices. What to INCREASE ? (5)
- Exercise
- Healthy eating choices
- Relaxation strategies (breathing)
