Helping Patients Change

Question 1

What are more powerful? PICs or NFUs (test question)

Answer 1

PICs- Positive Immediate Certain

positive reinforcement

Question 2

How do you analyze a problematic behavior using the PIC/NIC technique?

Answer 2

Organize consequences
first by Positives/Negatives
then Immediate/in Future
then Certain/uncertain

Question 3

Which reinforcers are more powerful

Answer 3

things that happen immediately and are positive

Question 4

What was the relationship between positive/negative and certain/uncertain

Answer 4

negative things are uncertain

positive things are certain

Question 5

apply behavior analytic techniques to someone who is smoking and then quiting

Answer 5

When someone is quitting:
all the positives are in the future and uncertain
all the negatives are immediate and certain
This is the opposite of smoking
all positives are immediate and certain
negatives are in future and uncertain

Question 6

Order the power of consequence from strongest to weakest (TEST QUESTION first and last important)

Answer 6

PIC & NIC > PIU > PFC & NFC & NIU > PFU & NFU

Question 7

Examples of matching treatment to a patients stage of change

Answer 7

• focus on immediate benefits, show pictures- more powerful consequence, make consequences that are UF more IC
• can target ABCs - have them track triggers and avoid or manage differently, have them engage in behaviors that are incompatible with smoking

Question 8

reinforcer

Answer 8

increase the probability of a behavior

Question 9

punisher

Answer 9

decrease the probability of a behavior

Question 10

Positive

Answer 10

Reinforcers or punishers added

Question 11

Negative

Answer 11

Reinforcers or punishers removed

Question 12

What are the Stages of Change? (on test)

Answer 12

1. precontemplation
2. contemplation
3. preparation
4. action
5. maintenance

Question 13

Precontemplation

Answer 13

not really concerned with problem

Question 14

contemplation

Answer 14

acknowledge problem, ambivalence about change, very mix feelings about change

Question 15

preparation

Answer 15

plan to change soon, serious about change, pros for change outweigh the cons, appear ready to change

Question 16

action

Answer 16

begin change, evident to others, other may recognize change and reinforce it positively

Question 17

meintenance

Answer 17

> 6 months, work doesnt end, may no longer be evident to others,

Question 18

What are the general principles of motivational interviewing?

Answer 18

Resist the "righting reflex"
Rolling with resistance
Develop discrepancy
Express empathy
Support self-efficacy

Question 19

Know the best interventions for each stage of the stages of change…

Answer 19

its on the test

Question 20

intervention strategies for Precontemplation

Answer 20

• inquire about past attempts at behavior change
• use patient-centered, empathic approach
• discuss the health problem
• explore the “cons” to change

Question 21

Intervention strategies for contemplation

Answer 21

• discuss the history of the problem behavior
• discuss the health consequences of the behavior
• discuss the benefits of change
• building self-confidence of change (self- efficacy)

Question 22

Intervention strategies of preparation

Answer 22

• match patient to appropriate behavior change strategy
• refer to appropriate treatment provider, if necessary
• facilitate development of realistic goals

Question 23

intervention strategies of action

Answer 23

• consider self-help materials such as bibliotherapy
• give support for behavior change
• problem solve for barriers to change
• give relapse prevention training

Question 24

intervention strategies for maintenance

Answer 24

• provide on going support for lifestyle changes
• give health feedback, emphasizing improvements
• address pros of behavior change
• discuss other related behavior change issues (ex. possible reg consequences of change)