Behavior Change Counseling Flashcards
1
Q
Manager:
A
- The Boss
- In Control
- Decision Maker
- Responsible
- Authority
- Accountable
2
Q
Consultant/Coach **
A
Better
- Expert
- Advisor
- Not in control
- No authority
- Not the decision maker
- Good listener
- Problem solver
- Filter/explainer/observer
3
Q
Key elements of effective counseling
A
- Ultimately the behavior change needs to come from the patient
- Compelling need for change
- Confident that they can/will do what is suggested and that change will help
- Be empathetic and demonstrate it
4
Q
General approach to coaching
A
- Understand pt beliefs and motivations. you cannot create motivation, you can only identify and redirect existing motivations
- Put the ball in the patient’s court
- Don’t give advice
- When in doubt, reflect back what the patient has been saying
- Try to bring the convo to specific, measurable, achievable goals
5
Q
Steps for coaching
A
- Ask
- Listen
- Reflect
- Empathize
- But what do you want to do?
6
Q
Initiating the conversation
A
- Ask the person how if they are concerned about their weight or physical activity
- Give them time to answer
- Have them draw a weight history
7
Q
Behavioral models
A
- Transtheoretical model (stages of change)
- Health belief model
- Values based counseling
- Motivational interviewing
- Cognitive behavioral therapy
8
Q
Transtheoretical Model
A
- Model of time ordered steps leading to sustained behavior change
- Focuses on the decision making process of the individual
- Relies on self report
9
Q
Stages of Change
A
- Precontemplative
- Contemplative
- Planning
- Action
- Maintenance
- Relapse
- Identification
10
Q
Health Belief Model
A
- Willingness to change relates to the perception of vulnerability for illness and the possible effectiveness of treatment
- @ risk for illness
- Identifies the problem as serious
- convinced the Tx is effective and not overly costly
- Exposed to a cue to take action
- Have confidence that they can perform specific behaviors that will be helpful.
11
Q
What is a compelling need for change?
A
Core values
- Maybe health is not top priority
- for men: health is not even on the list
- for women: family is top, but health is not on the list
- How can you link core values and health behavior change?
12
Q
Motivational Interviewing
A
- Examination and resolution of ambivalence is its central purpose
- Direct persuasion is not an effective method for resolving ambivalence
- Readiness to change / resistance provide feedback about couneslor’s demands
- Build a sense of self-efficacy
- Many people see the problem but don’t feel confident/competent/capable of change
13
Q
What does it take to get behavior change?
A
- Probably about a 7
- Small changes
- High likelihood of success that will build self-efficacy
- Concrete goals that are measurable: what, where, when, how?
14
Q
Cognitive Behavioral Therapy
A
- Focus is on actually changing unwanted behaviors, not motivation
- Self monitoring
- Stimulus control: identify trigger events and deal with them
- Cognitive restructuring: change unhelpful thinking
15
Q
Sample Behavior Chain
A
- Buy cookies
- Leave cookies on counter
- Home in the afternoon, tired and bored
- Urge to eat
- Go to kitchen
- Eat cookies and watch TV
- Eat rapidly until full
- Feel guilty/like a failure
- Restraint weakens further
- More eating
