Chapter 4 - supporting lifestyle change

Question 1

MI

Answer 1

client centered approach to facilitate behavior change – particularly for people who are ambivalent about change

Question 2

Ambivalence

Answer 2

someone experiences simultaneous opposing thoughts and attitudes about the + and - aspects of behavior

Question 3

MI vs. Directing style

Answer 3

Guide on the side vs. professional advising and specific direction giving

Question 4

Righting reflex

Answer 4

tendency to direct individuals in order to “fix” what seems to be wrong

Question 5

The SPIRIT of MI - 4 core components

Answer 5

a) Collaboration - dancing rather than wrestling
b) Acceptance - unconditional positive regard
c) Compassion - give priority to the needs of the client = rapport
d) Evocation - call on client’s inner wisdom; avoid should do or must do

Question 6

CORE skills of MI

Answer 6

OARS
O = open ended questions
A = affirming
R = reflective listening
S = Summarizing

Question 7

General rule, reflections:every question asked

Answer 7

2-3 reflections for every question asked

Question 8

Sample reflections

Answer 8

Simple - restate what the client has said
Complex - guess at underlying meaning
Straight - simple or complex response to a client’s sustain talk
Amplified - overstated reflections
Double sided - restate and join both sustain and change talk with AND

Question 9

Three other reflective responses

Answer 9

Encouraging - Paraphrasing - Reflecting emotional content

Question 10

Processes or FLOW of MI - 4

Answer 10

1) engaging - convey a feeling of professional, unconditional positive regard
2) focusing - agenda setting or mapping
3) evoking - discovering and discussing the client’s own motivations for change
4) planning - reflects the preparation stage of TTM

Question 11

CBC - cognitive behavior coaching

Answer 11

identify counterproductive thoughts and beliefs, challenge them, replace them with thoughts more likely to generate positive outcomes

Question 12

Cognitive distortions

Answer 12

irrational and usually harmful thought patterns that interfere with a person’s well being

Question 13

Irrational beliefs

Answer 13

unreasonable concept, often from family/culture - assumed to be true/high value - does NOT mesh with what is true

Question 14

Unproductive thinking - mnemonic

Answer 14

A - activating event or situation
B - Belief about the event
C - Consequences - emotional and behavioral
D - Disputing negative thinking and replacing with positive
E - Effect –> more productive emotions/behaviors

Question 15

Two leading causes of relapse

Answer 15

fatigue and stress

Question 16

4D cycle of Appreciative Inquiry

Answer 16

1) discover
2) dream
3) design
4) deliver

Question 17

Goal setting theory - 4 mechanisms

Answer 17

1) directed attention - direct thoughts and behaviors
2) mobilized effort - needs to be seen as achievable & positive - or likely to give up
3) Persistence
4) Strategy - goals stimulate this

Question 18

Goal moderators

Answer 18

1) goal commitment – needs to be FROM them, self determination theory
2) goal importance
3) self efficacy - higher = better
4) feedback - feed forward mechanism
5) task complexity - process and product goals needed

Question 19

SMART goals

Answer 19

S = specific
M = measurable
A = attainable
R = relevant
T = time bound

Question 20

GROW model

Answer 20

G = Goal = How can I help you? What do you want to achieve?
R = Reality = How does your current situation affect this goal and your approaches to achieving it?
O = Options = think outside the box; If you could do anything, what would you do? Also OBSTACLES
W = Will = What will help to increase your success? How often will you review your progress?