Adult Education, Goals, Contracts and Adherence Flashcards
What are the 6 adult learning principles?
1) They bring experience and knowledge
2) Relevancy orientated
3) Autonomous and self-directed
4) Practical
5) Task centered and problem oriented, life centered
6) Intrinsically motivated
Discuss experience and knowledge
- Share their knowledge and experiences
- Identify personal learning needs
- Learning is enhanced when clients feel that their ideas, feeling, experiences and perspectives are of value and significance
Discuss relevancy oriented
- Need to know what, why and how beforehand and be convinced that a need exists
- Learning is a need, not an end
- They like to be convinced that the learning experience will be worth their time and effort
Discuss autonomous and self-directed
- Need to feel free too direct themselves, take responsibility for their learning
- Expect to be treated as independant, responsible individuals
- Like to be solicited on their perspectives
- They are the decision makes in their lives, should have some say on the content of the session
Describe practical
-For them to be motivated to acquire new skills, they need to believe that the outcome will lead to the development of useful skills
Discuss task centered and problem oriented, life centered
- They like to learn about key ideas and how they apply to a problem relevant to them
- Provide self-evaluation tools to measure progress (food journals)
Discuss intrinsically motivated
-Motivated by internal pressures (improved quality of life, increased self-esteem, health, avoidance of disease)
What are the advantage of including a clients’ spouse?
- Both will hear the advice
- Can check with the spouse for comprehension
- If spouse goes grocery and cooking, allows for questions
- If client is not feeling well, spouse will hear advice
- Allows you to see interactions between the couple around food choices; allow for coaching
What are the disadvantages of including a spouses client?
- Spouse may take over
- Spouse may spend much of the time criticizing the client’s food choices –> Defensive client that shuts down
- Spouse may bring up his/her own food/die t concerns
- You might spend your time pulling the client back into the conversation
What are two examples of including a spouse in the conversation?
1) “Your wife has some important questions about cooking methods, would it be OK with you if I address those now?”
2) “You’ve heard me tell her about what to shop for. How does that sound to you?”
3) “You are clearly concerned about your health. Would you like to set up a time to come in to fully discuss your concern?”
What i the reason that most people do not reach their goals?
-Is that they don’t define them , or ever seriously consider them a believable or achievable
What are 4 key concepts of goal setting?
- Motivation alone is not sufficient to initiate health promoting personal change
- Not achieved through will-power
- Need to learn skills for self-influence
- The first thing is to observe the behaviour to change
What is goal setting?
It is a counselling process, that helps clients define in precise, measurable terms, what they hope to achieve from the work of counseling
Are goals ending points?
NO, goals are starting points, but they are useless until they are described as clear and concrete targets
What should goals involve?
- Involved exploring change options
- Involves exploring past experiences
- Involves building on past successes
- -> Should define and provide structure for subsequent work
In order to make successful behaviour change, what must clients know?
What their target it
–> Increase the motivation to act by building our perceptions of our self-efficacy
What are two things to keep in mind about goal setting?
- most people are not able to change behaviour in one day
- Don’t enter goal setting too quickly
What is the counselors role in goal setting?
- Partnership between counselor and client to develop an action plan
- Counselor is NOT one to set the goal
- Our role is to ensure that the goals meet the goal setting criteria
How should we engage with the client to set goals?
- Elicit clients ideas for change (change talk)
- Explore concerns regarding a selected option (probe)
- Identify a specific goal from a broadly stated goal (narrow the focuss to a specific goal)
How should goals be stated?
Positively
–> i.e. “I won’t eat ice cream while watching TV” vs “I will eat one cup of low-fat ice cream, 3 days/week while watching TV)
What 4 key things does goal setting involve?
1) Giving direction
2) Defining roles
3) Motivating
4) Measuring process
Discuss giving direction
Helps provide structure, purpose
-Helps the counselor and client to decide what is relevant, leads into action and helps client prioritize
Discuss defining roles
- Client knows what is expected of him/her
- Counselor knows what techniques and skills are appropriate
Discuss motivating
- Setting and reaching goals is therapeutic
- Helps client develop optimism and self-confidence about change
- Confirms personal capacity
Discuss measuring progress
- Benchmark the progress
- When the counseling relationship should end
Give examples of 4 questions to probe for details in the goal setting progress
- What is your goal?
- When you say you would like to feel better, what do you mean?
- Describe how your life would be different if you were able to reach your goal. Try and be as detailed as possible
- What do you want to be able to do that you can’t do now?
What are outcome goals?
Related directly to the client changes, required the client to change, shared goals, universal goal that both the client and counselor will agree to work towards
S adjectives?
-Specific, simple, significant
M adjectives?
Measurable, meaningful, manageable
A adjectives?
Attainable, achievable, action-focused
T adjectives?
Timely, time framed and time-limited
Specific?
Identify what, where, when, by whom, with whom
Measurable?
Identify how much, how often
Attainable?
Identify if the goal is realistic given the time and available resources
Relevant?
Identify the importance of your goal to your long term intentions
Time framed?
Identify the time frame and target date for goal completion
Give examples of 3 questions to help gauge a goal’s importance
- How likely are you to follow this goal?
- How important is this goal to you?
- Is this your goal, or is it something other people want you to accomplish?
What is scaling?
A technique that helps both the counselor and client to make complex problems seem like more concrete and tangible
What do scaling questions provide?
A way to move from abstract concepts towards achievable goals
What are scaling questions designed for?
To encourage a client to fully explore a proposed behaviour change and to show where the obstacles might be
How can scaling questions help clients?
- Give clients sense of control
- Can help clients measure their progress
What are important steps in the goal setting process (6) ?
1) Investigate the physical environment, which might hinder goals
2) Examine social support, which might hinder goal
3) Explain positive coping talk
4) Modify goal, if necessary
5) Ask client to verbalize the goal
6) Write down the goal otherwise it could be seen more as a wish
Pre-contemplation stage of goal setting?
-Client often shows up to counseling at the request of someone else, unreadiness, ambivalence
Contemplation stage of goal setting?
To avoid chronic contemplation, the counselor can use baby steps
Preparation stage of goal setting?
As clients are on the verge of momentaneous action, clients in this stage need to set goals
Action stage of goal setting?
Highly motivated clients (outcome goals)
Maintenance stage of stages of change?
Clients have reacher their goals through various actions. NOT a static stage, its continuation, not an absence of change, Keep working at outcome goals
What is a contract
A negotiated agreement between a counselor and a client to implement a particular goal
-Is voluntary
When are contracts useful?
- When client wants structure, and accountability
- Has motivational binding to future goals that is largely the result of not wanting to renege on an agreement impacts
What is more preferable, compliance or adherence?
- Adherence
- -> Compliance conjures more with an image of an authoritarian counselor dictating “diet orders” and expecting obedience
______ is used instead of compliance in the Nutrition Care Process
Adherence
What are six reasons for lack of adherence?
1) lack of education
2) faulty health-care belief
3) lack of necessary skills
4) lack of adequate support
5) constant negative reinforcement
6) depression
