Helping Patients Change Flashcards
What are more powerful? PICs or NFUs (test question)
PICs- Positive Immediate Certain
positive reinforcement
How do you analyze a problematic behavior using the PIC/NIC technique?
Organize consequences
first by Positives/Negatives
then Immediate/in Future
then Certain/uncertain
Which reinforcers are more powerful
things that happen immediately and are positive
What was the relationship between positive/negative and certain/uncertain
negative things are uncertain
positive things are certain
apply behavior analytic techniques to someone who is smoking and then quiting
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
Order the power of consequence from strongest to weakest (TEST QUESTION first and last important)
PIC & NIC > PIU > PFC & NFC & NIU > PFU & NFU
Examples of matching treatment to a patients stage of change
- 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
reinforcer
increase the probability of a behavior
punisher
decrease the probability of a behavior
Positive
Reinforcers or punishers added
Negative
Reinforcers or punishers removed
What are the Stages of Change? (on test)
- precontemplation
- contemplation
- preparation
- action
- maintenance
Precontemplation
not really concerned with problem
contemplation
acknowledge problem, ambivalence about change, very mix feelings about change
preparation
plan to change soon, serious about change, pros for change outweigh the cons, appear ready to change
action
begin change, evident to others, other may recognize change and reinforce it positively
meintenance
> 6 months, work doesnt end, may no longer be evident to others,
What are the general principles of motivational interviewing?
Resist the "righting reflex" Rolling with resistance Develop discrepancy Express empathy Support self-efficacy
Know the best interventions for each stage of the stages of change…
its on the test
intervention strategies for Precontemplation
- inquire about past attempts at behavior change
- use patient-centered, empathic approach
- discuss the health problem
- explore the “cons” to change
Intervention strategies for contemplation
- 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)
Intervention strategies of preparation
- match patient to appropriate behavior change strategy
- refer to appropriate treatment provider, if necessary
- facilitate development of realistic goals
intervention strategies of action
- consider self-help materials such as bibliotherapy
- give support for behavior change
- problem solve for barriers to change
- give relapse prevention training
intervention strategies for maintenance
- 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)
