Laura Mohr Flashcards
one of the most common complaints of physicians
patients who will not listen
change behavior
majority of time, because they decide themselves its what they want
if challenged - will defend their current behavior
role of expert
provide info in way patient can hear without being defensive
expert validates all perspectives, costs and benefits
expert than moves out of way and allows patient to make decision for him/herself
stages of change
precontemplation contemplation preparation action maintenence relapse
precontemplation
patient not thinking about change
denial occcurs here
believes consequences are not serious
contemplation
weighting benefits and cost
assessing barrier as well as benefits to change
ambivalence about change
preparation
experiment with small change
prepare to make specific change
action
taking definitive action to change
most desired by physician
need to praise here to maintain change
maintenance
maintain new behavior over time
need encouragement and support
appreciate new gains
relapse
not necessarily starting from ground zero again
motivational interviewing
directive, client-centered counseling style for eliciting behavior by helping clients to explore and resolve ambivalence
key points
motivation to change elicited from patient
patients task to articulate and resolve ambivalence
persuasion is not effective
counseling style is generally a quiet and eliciting one
physician directive in helping patient examine ambivalence
readiness to change is not a trait, but a product of interpersonal interaction
partnership/companionship, not expert/recipient role
principles of motivational interviewing
express empathy
support self-efficacy - patients in control
roll with resistance - be fine with where they are
develop discrepancy - change occurs when discrepancy exists between where patient is and where they want to be
motivational interviewing most useful?
precontemplation
contemplation
relapse
single most important thing you have as physician?
your reputation***
