19. Counselling (9%)/ Lifestyle (18%) Flashcards
Lors du counseling auprès d’un patient, parlez de quoi?
- Établissez avec le patient des objectifs thérapeutiques clairs
- Donnez-vous suffisamment de temps
- Évaluez vos propres habiletés (p. ex. Le problème dépasse-t-il vos limites ? Êtes-vous la bonne personne et est-ce le bon moment pour ouvrir la discussion sur les préoccupations du patient ?)
- Reconnaissez lorsque vous vous approchez des limites de la relation (p. ex. transfert, contre-transfert)
- Reconnaissez lorsque vos croyances ou préjugés perturbent le counseling
- Demeurez conscient des risques liés au fait de donner des conseils plutôt que de proposer des options
- Portez une attention particulière à la qualité de la relation et de l’alliance thérapeutique
Pour un patient qui considère consulter pour une psychothérapie, clarifiez ses préoccupations et donnez-lui des renseignements réalistes sur le processus et les ressources offertes.
Nommez des examples (7)
- attentes
- moment
- fréquence
- coût
- durée
- devoirs
- établir une relation thérapeutique
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)
