Interviewing Strategies to Promote Behavior Change

Question 1

Key Elements of Effective Counseling

Answer 1

Ultimately the behavior change needs to come from the patient

The patient must see a compelling need for change.

The patient must feel confident that they can/will do what is suggested and that the proposed change will help.

Be empathic and demonstrate it

Question 2

General Approach

Answer 2

Understand the patient’s beliefs and motivations, you can only identify and redirect existing motivations.

“put the ball in the patient’s court”.

Avoid the temptation to give advice.

When in doubt, reflect back what the patient has been saying.

Try to bring the conversation to specific measurable achievable goals.

Question 3

General Strategy

Answer 3

ask–> listen–> reflect–> empathize–> But what do you

want to do?

Question 4

Behavioral Models

Answer 4

Transtheoretical Model (Stages of Change)
Health Belief Model
Values Based Counseling
Motivational Interviewing
Cognitive Behavioral Therapy

Question 5

Model of the time ordered steps leading to sustained behavior change.
Focuses on the decision making process of the individual.
Relies on self report.

Answer 5

Transtheoretical Model

Question 6

Posits that a person’s willingness to change relates to their perception of their vulnerability for illness and the possible effectiveness of treatment.

Behavior change occurs if a person:
Perceives themself as at risk for illness.
Identifies the problem as serious.
Convinced that treatment is effective and not overly ‘costly’.
Exposed to a cue to take health action.
Have confidence that they can perform specific behaviors that will be helpful.

Answer 6

Health Belief Model

Question 7

Health Belief Model

Answer 7

Helps you focus on reasons that the patient does not find a medical issue motivating

Question 8

Transtheoretical Model

Answer 8

Helps you assess readiness, doesn’t tell you what to do