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Behavioral Medicine Final > Behavior Change Models > Flashcards

Behavior Change Models Flashcards

1
Q

Three tenets of behavioral change

A
  • reduction or elimination of destructive behaviors
  • promotion of healthier lifestyles
  • adherence to medical regimens
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2
Q

what is positive reinforcement

A

reward to INCREASE behavior

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3
Q

what is negative reinforcement

A

-removal of noxious stimulus to INCREASE behavior

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4
Q

what is punishment

A

-APPLY something NEGATIVE to DECREASE a behavior

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5
Q

pavlov’s dogs:
Food –> salivation
Food is the _______ and salivation is the________

A 
food = unconditioned stimulus
salivation = unconditioned response
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6
Q

Dog paired bell to food.
When bell presented by itself,
bell =?
salivating = ?

A 
bell = conditioned stimulus
salivating = conditioned response
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7
Q

List models of behavior change

A
  1. transtheoretical model = stages of change model
  2. self-efficacy model
  3. health belief model
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8
Q

What intervention technique does behavioral medicine teach/ rely on?

A

motivational interviewing

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9
Q

basic behavioral principles include… (list 5)

A
  1. behavioral antecedents
  2. behavioral consequences
  3. counter conditioning
  4. baseline measures
  5. reinforcement
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10
Q

behavioral antecedents

A

come before a behavior; trigger a behavior

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11
Q

behavioral consequences

A

after a behavior

reward or punishment

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12
Q

counter conditioning

A

replace the bad behavior with good behavior

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13
Q

baseline measures

A
  • measure before you start a change plan

- how often you do the behavior trying to change

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14
Q

reinforcement

A

-immediate vs. delayed
-positive vs negative vs. punishment
schedule of reinforcement: intermittent or fixed

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15
Q

which type of reinforcement is more powerful

A

immediate reinforcement

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16
Q

“People will only try to do what they think they can do and won’t do what they think they can’t”…
describes what model of behavior change

A

self efficacy model

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17
Q

4 factors that influence self efficacy

A
  1. mastery experience
  2. vicarious experience
  3. verbal persuasion
  4. somatic & emotional states
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18
Q

mastery experience

A
  • self efficacy model

- providing opportunities for ppl to gain mastery on simple and difficult tasks helps develop self efficacy

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19
Q

What’s a good way to incorporate mastery experiences into behavior change?

A

build mastery experiences into change plan and build them up continually higher and closer to the goal

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20
Q

Vicarious experience

A
  • self efficacy model
  • observation of successes and failures of others who are similar
  • ex: weight watchers
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21
Q

verbal persuasion

A
  • self efficacy model
  • persuaded verbally that they CAN do it
  • like coaches, trainers
    (vs. being told they CAN’T do it)
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22
Q

somatic & emotional states

A
  • self efficacy model
  • physical & emotional states that occur when you contemplate doing something
    - stress, worry, anxiety, fear
  • if emotional state improves, self efficacy is possible
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23
Q

Who developed the Health Belief Model and why?

A
  • social psychologists

- find out why people would or wouldn’t use health services

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24
Q

What are the theoretical constructs of the Health Belief Model?

A
  1. Perceived Threat
  2. Perceived Benefits
  3. Perceived Barriers
  4. Cues to Action
  5. Self Efficacy
  6. Modifying Variables
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25
Q

Thoughts from the Health Belief Model on how to create behavior change

A
  • cost benefit analysis (threat vs benefits vs barriers)
  • need a cue to action
  • need the self efficacy to take action
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26
Q

2 parts of perceived threat

A
  1. perceived susceptibility
    • opinion of chance of getting a condition/disease
  2. perceived seriousness
    - opinion of seriousness of condition & its consequences
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27
Q

perceived benefits

A

one’s opinion of the efficacy of the advised action to reduce risk
-how advantageous it’s going to be to reduce the risk

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28
Q

perceived barriers

A
  • if you think there are barriers, you’re less likely to try

- one’s opinion of the cost to overcome the barriers

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29
Q

cues to action

A

triggers needed to activate readiness

-like dad getting dx’d with cancer

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30
Q

self efficacy

A

confidence in one’s ability to take action

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31
Q

modifying variables

A

culture, education, past experiences, skill, etc

32
Q

Health Belief Model Summary

In order for behavior change to occur, one must:

A
  • weight the threat of the disease against the benefits and barriers
  • be presented with a cue to action
  • have confidence to take action
33
Q

What’s the most important construct of the Health Belief Model?

A

Perceived Barriers

**has the most to do with whether or not a person changes

34
Q

Transtheoretical model =

A

stages of change model

35
Q

Why is the transtheoretical model useful to providers

A
  • brings understanding that not everyone is ready for change right now
  • assessment can be made about a patient’s readiness
  • can match your interventions to the various stages of change
  • can better prepare at-risk persons for action
36
Q

What are the stages in the stages of change model?

A
  1. precontemplation
  2. contemplation
  3. preparation/planning
  4. action
  5. maintenance
  6. relapse
37
Q

Patients will minimize or deny the existence of a problem behavior in which phase?

A

precontemplation

38
Q

Process of change in pre contemplation stage:

A
  • consciousness raising
  • dramatic relief
  • environmental evaluation
39
Q

Goal of the Precontemplation stage?

A

to increase the patient’s willingness to contemplate the connection b/t behavioral health and physical health

40
Q

Strategies of pre contemplation stage

A
  • ask for permission to discuss problem
  • explore patient’s awareness
  • GENTLY point out discrepancies
  • express CONCERN that goal may not be achievable without addressing behavior
  • ask pt. to think or read about situation b/t visits
41
Q

Patient is thinking about the problem and the cost vs benefits of continuing with the problem vs trying to change in what stage

A

contemplation

42
Q

process of change at contemplation stage

A

self evaluation

43
Q

Goal of Contemplation stage

A

to help patients resolve their ambivalence to a point where they are enabled to commit to a specific plan and timetable for taking action

44
Q

Strategies of contemplation stage

A
  • ask for pt’s perspective before offering advice
  • identify pros & cons of change
  • identify obstacles and possible solutions, to consider making a commitment
  • suggest a trial run
45
Q

Patient experiences a sense of urgency at which stage of change?

A

preparation

46
Q

process of change at preparation stage

A

self-liberation

47
Q

goal at the preparation stage

A

encourage patients to set a date to start action on the problem

48
Q

strategies at the prep stage

A
  • summarize pt’s SPECIFIC reasons for change and their plan
  • help them choose a specific approach
  • make sure plan is CLEAR to follow
  • assess conviction & confidence
  • reassurance
  • follow up
49
Q

4 steps to enlisting the patient in the preparation stage

A
  1. share decision making about problem and treatment plan
  2. assess conviction & confidence to follow through
  3. identify barriers and problem-sove to remove/diminish them
  4. Agree on simple regimen and write it out
50
Q

How to share decision making about problem and tx plan

A
  • explore pros and cons
  • agree on best option for pt.
  • tailor to individual habits and routines
51
Q

How to assess conviction and confidence to follow through

A
  • conviction = 1-10, how convinced you need to do this?

- confidence= 1-10 how confident are you that you can carry out the plan

52
Q

How to identify barriers and try to diminish them

A

what would get you from a 6 to a 7

53
Q

how to agree on a simple regimen and write it out

A
  • preprinted forms
  • highlight specifics
  • can pt. read?
  • follow up and ask
54
Q

patient makes daily efforts to overcome the problem in which stage?

A

action

55
Q

process of change at action stage

A
  • reinforcement management
  • helping relationships
  • counter conditioning
  • stimulus control
56
Q

goal at the action phase

A

to anticipate what might be needed to maintain initial changes in behavior

57
Q

strategies at action phase

A
  • ask how efforts are going
  • reinforce efforts!
  • modify plan if not working well
  • give helpful suggestions to reduce risk of early relapse
  • arrange follow ups for support
58
Q

patient has overcome the problem and remains vigilant to backsliding at what stage

A

maintenance

59
Q

process of change at maintenance stage

A
  • reinforcement management
  • helping relationships
  • counter conditioning
  • stimulus control
60
Q

goal at maintenance stage

A

-emphasize that the new behavior can become an integral part of a more healthful and satisfying lifestyle

61
Q

strategies of the maintenance stage

A
  • how is pt. maintaining changes made in action stage
  • show support/admiration
  • ask about slips and how pt responded
  • ask what pt. has learned about change process
  • discuss this as permanent change
62
Q

patient has gone back to the problem on a regular basis after a period of successful resolution..what stage is this?

A

relapse

63
Q

process of change at relapse stage

A

depends where patient has fallen back to

-which stage did they fall back to?

64
Q

goal of relapse phase

A

to assist patient in learning how to ANTICIPATE and CORRECT these vulnerabilities when patient takes action again

65
Q

strategies at relapse stage

A

-dont get frustrated or judge patient
-IDENTIFY STAGE OF RELAPSE
-reframe relapse = valuable learning experience
-

66
Q

individuals resist coercion, why?

this is why_____ doesn’t work

A

Motivated to maintain sense of autonomy, so “pushing” doesn’t work

67
Q

it is better to build on a patient’s ________ to change vs. pushing them

A

self motivation

68
Q

What is the goal of motivational interviewing?

A

-identify what maintains behaviors, including ambivalence to change, and support people in adopting new behaviors

69
Q

motivational interviewing is _____ centered

A

client

70
Q

5 principles of motivational interviewing

A
  1. express empathy
  2. avoid argument
  3. support self efficacy
  4. roll with resistance
    - behaviors in opposition to desired change
    - use reflection
  5. develop discrepancy
    - mixed feelings about change
    - help pt. ID ambulance and move towards change
71
Q

9 Strategies of Motivational Interviewing

A
  1. initiating change talk
  2. motivation ruler
  3. asking about extremes
  4. continuing change talk
  5. identifying ambivalence
  6. double-sided reflection
  7. discuss past success
  8. establish clear cut, specific goals
    9 .create a plan with follow up
72
Q

motivation ruler

A

why not a 1 or 2? how could we move up to 6 or 7

73
Q

asking about extremes

A

best and worst possible outcomes

74
Q

continuing change talk

A

ask for more detail, reflect pt’s thoughts

-encourage change talk to continue

75
Q

double sided reflection

A

reflecting both sides of ambivalence

-on the one hand i hear you saying…

76
Q

change is a process, not an ______

A

event

77
Q

remember to use mostly_______

A

questions

Behavioral Medicine Final (3 decks)

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