Behaviour Change Flashcards
What are two behaviours involved in our health and well-being?
- lifestyle choices
2. adherence to health advice
Approximately what is the percentage of people who will follow the advice of health professionals?
20% (-40%?)
80% - erect barriers and resist change
What is the purpose of Motivational Interviewing?
Connect into an individual’s capacity for change while identifying any ambivalence to change. Attempt to shift the balance - higher sense of capacity to change over ambivalence to change.
Using Motivational Interviewing, how do you go about shifting the balance of an individual’s capacity to change in relation to their ambivalence to change?
- Assist the person to determine the importance of making the changes
- Assist the person’s confidence in their ability to make the changes.
What techniques help to shift a client’s perspective of the importance of making behavioural changes?
Encouraging the client to evaluate the costs and benefits of the changes, by asking open-ended questions, and helping them to increase their own motivation for change.
- Ask them to rate the importance of the change - 0-10.
- Ask why they gave a certain rating, and not 0.
- Ask them if they don’t make the changes, based on the information they have on their condition, what would be their possible outcomes in 3-5 years (‘Moving foward’).
- Ask them to recount the information they know about their condition - helps them get a greater sense of the importance of the behavioural change.
- Look at most common motivations - social factors, achievement, comfort - how are these contributing to motivation in individual? Which one motivates client - pay attention.
- Tap into personal strengths - what have they overcome before. Which personal strengths did they use. Use those in current situation? Focus on past success/self-efficacy.
- Use role models - if X could do it, so can you.
- Reframe situation
Once motivation starts to increase, how do you assist an increase in individual confidence?
Using same process as increasing motivation.
Ask them to rate their confidence in being able to make and sustain the changes.
Ask why a certain rating, and not 0.
Ask them to recall another time they instigated a behavioural change, and talk about the confidence and capability they had to make a previous change. Relate it back to the current changes.
Besides Motivational Interviewing, what are four prominent approaches to behavioural change:
- Education - informing client as to why changes are necessary for health
- Advice - explaining the best way to improve health and which changes are necessary, and may explain how to implement advice.
- Goal setting - setting SMART goals - providing feedback and praise, modifying goals
- Self-modifying - review of changes made, feedback, modification if req.
What are shortcomings of additional approaches to behavioural changes?
- Education is not enough to motivate individual to make changes
- Client is not involved in the process - practitioner dictates strategy/plan
- Motivation to make changes must be intrinsic and present for individuals to make meaningful changes.
What are the four key principles of Motivational Interviewing:
- Develop discrepancy - paint a clear picture of the differences between where they need to be and where they currently are so they can note the discrepancy between the two.
Ask questions - what would be the benefit of making changes? What are the costs of making the changes. What is the net benefit/cost? How much do they feel they could make the changes? Pros/cons. - Express empathy - see things from the clients’ perspective. Acknowledge where they are at. Need to pay attention, active listening to demonstrate interest/care/empathy.
- Roll with resistance - move on if client shows resistance. Do not engage in oppositional behaviour or argue with client. Change subject. Diffuse tension.
- Develop self-efficacy - help to support the client’s confidence in their ability to change.
- Identify ambivalence - identify/expose any ambivalence to change. Look at why they may feel ambivalent. aim to assist client to feel more empowered to make changes.
What are the top five health issues/risks for mortality?
- High blood pressure
- Tobacco use
- High blood glucose
- Physical inactivity
- Overweight/obesity
Which techniques can help client instigate behaviour change?
- Goal setting - client involved
- Feedback on performance - keep motivation up
- Self-monitoring - teaching client to self-monitor assist their sense of responsibility of changes and enables good quality information back to practitioner
- Practice & consistency
List signs of non-adherence:
- Bringing therapy to premature end - before goal reached
- Being inconsistent with attending appointments
- Not taking prescribed medications/following exercise plan etc
- Not following practitioner advice
Which factors may be involved in increasing adherence by a client?
- Practitioner understanding client worries
- Practitioner aware of client’s beliefs and how these beliefs affect the delivery of advice
- Client/practitioner belief in advice - can affect adherence
What are the 5 steps in the Transtheoretical Model?
PCPAM
- Pre-contemplation - no intention of changing
- Contemplation - considering change - 6 mths time
- Preparation - plan/getting ready for change - 1 mth time
- Action - Instigating change - immediate
- Maintenance/Termination - maintain for min 6 mths
Moving through stages dependent on client’s readiness to make changes.
Identify which stage client is at before embarking on journey.
What is required at the pre-contemplation stage?
Helping client to become aware of any ambivalence to change, identify discrepancies between where need to be and where currently are, increase motivation, increase confidence.
