Behaviour Change Flashcards
Social cognitive theory
proposes that people learn via experience, includes reciprocal determinism–> dynamic interaction b/w individual, their enviroment and their behaviour
4 constructs impact behaviour: self efficacy, outcome expectations, self regulation, barriers and facilitators.
self efficacy most effective at predicting behaviour change
4 sources of self efficacy
mastery experiences, vicarious experiences, social persuasion, emotional state,
Self efficacy and physical activity
strong relation b/w self efficacy and health behaviour change and maintence.
self efficacy impacts persons choice of behavioural setting, effort invested, persistence
self regulation
ability to monitor and control thoughts, actions, emotions. Involves avoiding of temptations that distract from long term goal. QEP work with client to develop self regulating aspects of self monitoring, scheduling and planning, setting goals, and positive self talk.
self regulation skills
self-monitoring, scheduling and planning, setting goals, positive self talk
Self Determination theory (SDT)
Focus on degree to which behaviour is self determined and process though which individual acquires motivation to initiate and maintain new behaviours. Assumes client is inherently motivated to seek out challenges and succeed. Recognizrs the importance of social enviroment
SDT: 3 psychological needs
1.independetly solve problems (autonomy)
2.To master tasks (competence)
3. To interact socially (relatedness)
Foster volition, motivation and engagement–> enhanced performance, persistence and creativity
SDT motivation: Amotivation
no intention or desire to engage in physical activity
SDT motivation: External regulation
motivated o engage in PA because of external forces
SDT motivation: Introjected regulation
Participate in PA without accepting as their own (ir to prove they can)
SDT motivation: Identified regulation
consciously values goal as personally important and therefore motivated to participate in physical activity
SDT motivation: Integrated regulation
Physical activity goal fully assimilated with self. Similar to intrinsic motivation but behaviour remains external to self
SDT motivation: intrinsic motivation
Values and participates in physical activity for sheer enjoyment
How does QEP use SDT
QEP works to bolster autonomy, competence and relatedness for physical activity by: promoting sense of ownership and control over PA, guide throguh active examination of own reasons for A, encouraging choices and self intiution by proving menu of options =, help clients identify realistic goals and pricing postive feedback for successes, create welcoming enviroment. Some clients will never reach intrinsic motivation–> still help see PA as w/in control to promote adherence
Trans-Theoretical Model (TTM)
Poeple change habitual behaviours slowly, passing throguh series of specific stages; each characterized by particular pattern of psychological and behavioural changes. 5 stages of readiness for change- may skip or cycle back throguh stages
Trans-Theoretical Model (TTM): Precontemplation
Not intending to make a change, belief that they cannot change or demoralized by past failures.
Trans-Theoretical Model (TTM): contemplation
Planning to make change in next few months. Aware of benefits of change and increasingly dissatisfied with results of not changing. Individuals in this stage have not yet resolved ambivalence
Trans-Theoretical Model (TTM): Preparation
Decided to take action and actively planning to do so in immediate future. Motivators are strong and defined and ambivalence has been addressed. Boundary b/w preparation and action is fluid- people often move back and forth b/w planning and taking action.
Trans-Theoretical Model (TTM): Action
Committed to new behaviour and consstently engaging in it
Trans-Theoretical Model (TTM): Maintenance
New behaviour adopted and maintained for several months- behaviour firmly established and individual confident in ability to stick with it. Several attempts at change likely before maintence, progression through process my strengthen behaviour change as individuals learn from past regressions.
Stage of change scale
tool for QEP to access progress- understanding stage of change helps guide client throguh action and maintenance.
QEP considerations: Precontemplative
unlikely to react well to being told why they should exercise, more effective tot talk throguh their own reasons why- stimualte self exploration of own benifits and barriers to change
QEP considerations: contemplative
Need good listener, empathetic and patient as work throguh ambivalence to find own reasons to change. Beneficial to focus on bolstering self-efficacy in ability to succeed.
QEP considerations: preparation
Experimenting is important as try new behaviour- helps client discover new physical activity experiences hey my enjoy- effective to help find enjoyment and success
QEP considerations: Action
at high risk of replase. Positive reinforcement of new behaviour is important. Change things up regularly to keep things fresh and interesting
Health Action Process Approach (HAPA)
Suggests initiation, adoption and maintence of health behaviour is structured in a process including a motivation and volition phase.
HAPA includes self efficacy and outcome expectancies as predictor of new behaviour change. Suggests intention and volition are most proximal predictors of change.
HAPA: planning
key at the pre-action stage.
Separated into: action planning and coping planning. Action planning is more important for initiation and coping planning is more important for maintenance.
Motivational interviewing
way to work with clients to asses motivation and confidence to change behaviour. helps facilitate clients own examination of postive and negative aspects of change- client recognized as expert of own life and is actively empowered to identify, evaluate and choose changes that work for them
4 elements reflecting spirit of motivational interviewing
partnership, acceptance, compassion, evocation
Motivational interviewing basics; key features
style of being rather than technique. Use open ended questioning, active listening, eliciting change talk, managing resistance to change, guide from where want to be and where are currently
key features: help client; discover own interest; examine ambivalence- to elicit and strengthen change talk, enhance confidence in taking action, strengthen commitment to change, plan and begin change
open ended questioning
helps client find power to change from within. Interviewer must draw out client hisotry, motivation and prior history. Cannot be answered YES/NO
Active listening
Essential to develop insight required to facilitate client exploration of motivation and options for change. Tools of active listening can be used to demonstrate understanding of info client shares. many types” content reflection, feeling/meaning reflections, amplified negative reflections, double-minded reflections, active reflections
Eliciting “change talk”
to help work throguh ambivalence- can use motivational interviewing to elicit change talk- discussion of clients desires, need for change.
encourage and reinforce change talk by asking about considering how life might unfold w/out change.
Managing sustained talk
Resistance to change can be evident in clients sustained talk. Rather than offering counter argument- allow client to express reasons without feeling pressured or judged- can strategically deescalate and refocus discussion so progress can be made by considering other perspective’s. When not sufficient- may use amplified negative reflection for client to re-evaluate
Developing discrepancy
motivational interviewing helps explore gap b/w current and where you want to be. Larger gap- harder to justify current behaviour and change is more attractive and less ambivalence is presnt. MI helps client reflect advantages and disadvantage’s to facilitate move towards change. Requires reflection and open ended questioning. Separate behaviour from person and reflect back to client to highlight discrepancies- client understands potential consequences of behaviour- can articulate concern and commitment to change.
Self-Efficacy in Motivational Interviewing
Building self efficacy is core to MI. QEP strive to bolster client self efficacy so have capacity to make regulare PA part of life. Compliment taking first step, perserverance-what learned from past
3 phases of motivational interviewing
- Exploring- draw out client history, build rapport, identify behaviour are to be discussed
- Guiding- steering conversation toward possibility of change- asking to consider life w/ and w/out change- see discrepancy b/w life and goals
3.chosing: once commitment to change occurs, conservation moves to discussion of how to put plan into action
Brief Action Planning
Highly structured, stepped care, self management support technique
Key features of Brief Action Planning
may take less than 5 mins- can easily be accomplished in 20-30 min consultation.
Flexible- can be used during initial visit or follow up- can be used once or more with same client. QEP trained to used and deliver BAP
HOW was BAP developed
based on literature. Need to support the development of cleints slef-efficacy and creation of appropriate action plans. Derived from MI w/ emphasis on spirit of MI- several studies promote used
HOW to use BAP
begins with questions that may be broad
second question probes client self efficacy for using confidence ruler- rate confidence to carry out action pan from 1-20
3rd question- way to support client accountability
