Behavior Change Facilitation

Question 1

Aspects of engaging with the patient

Answer 1

• Expression appreciation for and encouraging the patient’s insight
• Establishing a partnership
• Minimize status differentials
• Choose an appropriate role for the interaction
• Emphasize the patient’s autonomy and self efficacy

Question 2

When trying to address behavior change in a patient, even if there are multiple behaviors that may be beneficial to their health to change, it helps to facilitate change if you both choose to ___.

Answer 2

When trying to address behavior change in a patient, even if there are multiple behaviors that may be beneficial to their health to change, it helps to facilitate change if you both choose to focus on one.

One way to get at this subtly is to ask the patient, “If you could change one aspect of your health, what it would it be?”

Question 3

Change Talk

Answer 3

Talk in which patients express their own Desires, Abilities, Reasons, and Needs for change, as well as Commitment to change (acronym: DARN-C).

Encouraging your patient to talk this way and positively reinforcing them when they do can help facilitate change. Ways to do this may include:

Summerizing/Robertsonian interviewing

On-a-scale-from-1-to-10

Ask-tell-ask (ask the patient a question, give them new information, ask what that means to them)

Question 4

Coming up with a plan

Answer 4

Often the most difficult part of behavior change. The SMART model is intended to be a guiding tool. Ensure that the plan is:

Specific, Measurable, Achievable, Relevant (to the patient!!!!), and Time-bound

Question 5

Agenda setting

Answer 5

Providing an agenda and simply addressing issues as they arise on it removes your desire and imposed direction from the conversation. Patients feel more free to engage and feel less challenged. You can even invite them to choose where to start on the agenda, allowing them to select what they feel most comfortable talking about.

Question 6

Pros and cons

Answer 6

Patients often feel of two minds about the status quo and the change. Inviting them to state the pros and cons as they preceive them can help them make a decision. Your next step is to clarify whether change is a possibility.

Question 7

Assess importance (why) and confidence (how)

Answer 7

When addressing these, spend time where it is needed! If the patient sees importance in the change already, do not bother with pros and cons. Meet your patient where they are at on this spectrum.

Question 8

Central thesis of the motivational interviewing paper

Answer 8

Elicit change talk from your patient, wherever they may be at, and respond with continuous prompting and listening, reinforcing the pathways that lead to the patient talking about change.

Question 9

“So where does that leave you now?”

Answer 9

Can be a powerful tool to encourage patients to put forth a view about where they would like to go from where they are right now

Question 10

Use of silence

Answer 10

Just wait and your patient will fill the need to keep going and fill the silence.

Question 11

Stages of Change model

Answer 11