ICL 10.3: Brief Behavior Change Interventions Flashcards
why do people with clear medical problems not change their behaviors to help themselves?
they have a more external locus of control
engrained mental pathways
what are the erroneous perceptions of behavior change?
treating behavior is the same as treating disease; it is not!!
behavior change is about doctor’s agenda not the patients; it is about the patient’s agenda!!
intent to change equals behavior change; it does not!!
non-adherence to treatment plan means patient does not care about health; this is wrong!!
knowledge about one’s condition equals motivation to change; it does not!!
what is health psychology?
study how cognitive and behavioral principles can be used to prevent illness and promote physical health
what is behavioral medicine?
medical specialty focused on the study of non-biological factors influencing physical health and illness
what is the transtheoretical model of change?
- precontemplation
- contemplation
- preparation
- action
- maintenance
T/F: until one is motivated to change there is nothing we can do
false
motivational interviewing is amazing! it’s good for people in pre-contemplation
the one thing that doesn’t work though is telling the person they have to change
T/F: it usually takes a crisis (hitting the bottom) to motivate one to change
false
most people that change a health behavior, it’s not when they hit the bottom
T/F: motivation is influenced by human connections
true
we can become motivated in isolation without any interaction but for the most part it’s VERY influenced by connection
that’s why in medicine, it’s so important to have a real human connection with your patient
T/F: “readiness” for change involves a balancing of the “pros” and “cons” to change
true
if you want me to quit smoking, the patient usually sees all the cons but the doctor is giving you pros that the patient isn’t considering
but if through an intervention through motivational interviewing, you can help the patient look at the pros of change and this is when motivation and behavior change really happen
T/F: creating motivation for change usually requires confrontation
eh depends on how you define confrontation and what type of confrontation you’re doing
what are some of the reasons patients may be/appear resistant to change?
- interpersonal discord; lack of human connection
do not feel understood or listened to
feel judged by provider
feel like they are “wrestling” with provider
- ambivalence; pros and cons
feel 2 ways about change
vary in motivation level
lack confidence, feel demoralized
what is the Information-Motivation-Strategy Model?
IMS model believes patients follow only treatments, suggestions of lifestyle change that they have been:
- informed about and understand
are motivated to adhere to - are able to achieve within their resource limitations and
- strategies available to them
what is the information part of the IMS model?
- patients do not understand what is being asked of them
what might patients not understand: diabetes, heart event, BP, etc.
- patients do not feel the costs of change are worth perceived benefits
- education DOES NOT EQUAL motivation: what do you “know” is not healthy for you but you do anyway? Why?
What might patients not understand?
in the information part of the iMS model, how should physicians evoke and communicate information/risk?
how do we know what they ‘already know?”
elicit-inform-elicit! ask them what they know, then when you know what they know, inform them, then elicit what they understood from what you just informed them
ELICIT: tell me what you know about heart health, tell me what you know about diabetes, tell me your understanding of how diabetes effects a person’s health, what do you know about the relationship between diet and blood sugar levels?
INFORM: keep in mind health literacy, use analogies, just lay out facts
ELICIT: what are you thinking now? can you tell me what we just talked about?
when you ask do you understand and the patient nods yes, that’s unreliable!
what is the motivation aspect of the IMS modeL?
if patient has some understanding/appreciation for intervention they then must see a need for change
physician needs to evaluate beliefs, positive/negative attitudes towards the specific change/intervention
when benefits of patient effort outweigh concerns/barriers the patient is less “ambivalent” about change and likely to move towards change
motivational Interviewing focuses on evoking/eliciting from patient their thoughts and beliefs before telling them your thoughts and beliefs
