Intro to Brief Intervention Flashcards
What is SBIRT?
SCREENING all patients for early identification of substance use problems
BRIEF INTERVENTIONS for at risk patients using Motivational Interviewing principles and techniques to elicit their own motivation for change
Careful REFERRAL and “warm handoffs” to specialists for TREATMENT of high risk patients
Precontemplation
Not ready for change
- not intending to take action in the forseeable future, not in the next 6 months
- may be underinformed about consequences, &/or demoralized about their ability to change.
Contemplation
thinking about change
- intend to change in the next 6 months
- aware of reasons to change but also of the cons of changing, ambivalent and not ready for traditional action oriented change programs.
Preparation
getting ready to make change
- intending to take action in the next month
- they often have taken significant action in the last year and have a plan of action –> they are ready for assistance in changing.
Action
making the change
-they made modifications in their life-style in the last 6 months that is significant enough to reduce risk for disease. -Vigilance against relapse is critical.
Maintenance
sustaining the behavior change until integrated into lifestyle
-working to prevent relapse but they are less tempted and more confident that they can continue their change.
How far can a patient move through stage changes during a brief intervention?
only one stage change at most
Regression in stages of change
Regression to an earlier stage from any of the stages is common but often they do not go all the way back to precontemplation.
Processes of Change-Experiential
- Consciousness raising
- Dramatic relief
- Environmental re-evaluation
- Social liberation
- Self re-evaluation
Consciousness Raising
increased awareness of the causes, consequences and cures for a problem behavior.
–> Interventions include feedback, education, interpretation, respectful confrontation, bibliotherapy & media campaigns.
Dramatic Relief
increasing emotional experiences which will enable improved feelings if action is taken.
–> Psychodrama, role play, grief, personal testimony & media campaigns.
Environmental Re-evaluation
affective and cognitive assessments of how the behavior affects other people including the desire to be a role model.
–> Empathy training, documentaries, family interventions.
Social Liberation
increased opportunities or alternatives not previously available to the person.
–> Advocacy, policy changes health promotion for minority populations.
Self Re-evaluation
affective and cognitive assessments of ones own self-image with and without a particular unhealthy habit.
–>Healthy role models, values clarification and imagery.
Processes of Change-Behavioral
- -> work best when person is in later stages of change
1. Stimulus Control
2. Helping Relationships
3. Counter Conditioning
4. Reinforcement Management
5. Self Liberation
