lecture 7 Flashcards
what is the difference between counselling and coaching?
counselling is usually about the past, long term, academic, professional
coaching is about the future
counselling and coaching similarities
both facilitated by a guide to maximize life potential
both rely on positive psychology techniques
what are two common problems in the health/fitness field?
- lack of scientific background, but lots of marketing
(flash but no substance) - well-educated individuals but lack skills to communicate w clients
(substance but no flash)
health literacy
capacity of an individual to obtain, interpret and understand health info
health education
planned opportunities for people to learn about health.
knowledge translation.
health communication
bridges gap between health info and health practices.
motivation to perform behaviours
name some barriers to health communication (6)
- disinterest in science
- distrust in scientific community
- bias of individual
- privilege/equity
- health literacy level
- health education exposure
meaning-centered communication is
is intentional, purposeful and aware of the sender/receiver’s context
3 types of persuasion
logos= appealing to logic
pathos= appealing to emotion
ethos= appealing to morals
4 steps in the counselling process
- develop rapport w client
- create a comfortable environment
- establish helping relationship
- help client develop alternatives in pursuit of healthy relationship
what are the most important skills for a counsellor to have?
listening, questioning, explaining, feedback, emphathy
nonverbal active listening skills
eye contact, put yourself at their level, handshake as an intro
7 Verbal skills in counselling
- bridge “yes”“uh-huh” “i see” “go on”
- ask for clarification “please tell me more about..”
- open-ended questions
- repeat/mirror
- paraphrase “so what you’re saying is”
- reflection of meaning and feeling/emotion
“you feel upset and frustrated”
what to consider about each individual
current health status
background
goals
mindset/motivation
accessibility (time, money)
values
support systems
How to start the counselling process? 6 steps
- find out their preferences, needs and expectations
- determine what has motivated them previously
- SMART goals
- decide how to achieve goals (tailor to individual, increase convenience)
- prepare them for obstacles
- retention technniques–
(incentives, logbook, support system)
Motivational interviewing
elicits behavioural change by identifying and resolving ambivalence
“RULE” motivational interviewing
Resist the righting reflex
Understand the patient’s motivations
Listen w empathy
Empower the patient
5 principles of motivational interviewing
- express empathy
- develop discrepancy
- avoid confrontation/arguments
- roll with resistance
- support self efficacy
ambivalence
simultaneously having contradictory beliefs
– costs and benefits
stages of change cycle
precontemplation
contemplation
preparation
action
maintenance
relapse
Motivational interviewing: types of talk (4)/objective
sustain talk
change talk
preparatory talk (DARN)
mobilizing change talk (CATS)
reflections are the
heart of MI
- simple reflection
-complex reflection
- double sided reflection
DARN
desire to change
ability to change
reasons for change
need for change
CATS (talk of active change)
commitment
actions
taking steps
DARN vs CATS
DARN reflects the pro side of ambivalence
CATS indicates movement towards a resolution of ambivalence
4 steps of the fundamental process
- engaging
- focusing
- a) evoking
-MI skills, depth
b) creating discrepancy
-identify ambivalence, build confidence - planning
5 possible outcomes of developing discrepancy
- denial
- decrease self-efficacy
- decrease self-esteem
- change beliefs to align w behaviour
- change behaviour to align w beliefs
how to create discrepancy?
assess and build confidence (use the 0-10 scale)
prior success story
avoid righting reflex
mobilizing change talk “what do you intend to do?”
example of reframing
“you just haven’t found a strategy that works for you yet”
how to plan effectively?
meet them at their level of readiness
mobilizing change talk CATS– implying decision/contract
clear plan (barriers, who, what, when?)
Intrinsic vs extrinsic motivation
Intrinsic motivation “I’m studying because this is so interesting to me”
Extrinsic motivation “I’m studying so my parents will be happy with me”
- Extrinsic motivation is short term (ex. personal trainer praising you for exercising)
- Intrinsic motivation is long term (ex. exercising because you are motivated to maintain a healthy lifestyle)
Interjected regulation=
inner need to follow external motivators based on guilt/pride (ex. posting your workout on social media and getting praise)
Identified regulation=
doing the behaviour because you value it for yourself “I value exercise because it helps me lose weight” or “I exercise because I value health”
Integrated regulation=
behaviour is integrated into your values and beliefs “I am a healthy person”. I am the kind of person that exercises”
Intrinsic motivation=
the behaviour is your motivation “I do exercise for the joy and satisfaction of it. It is fun!”
SDT challenge should not be
too difficult, want to move them along the spectrum and build confidence!!!
ACT (acceptance and commitment therapy)
= focused on distancing yourself from your thought
- Like Buddhism
- My thoughts are not me
- I accept my thoughts for what they are, but I am committed to the behaviour I value
- “I don’t want to exercise today”. I accept/acknowledge that thought BUT I am going to exercise because I value my health
- Moving towards the valued direction despite thoughts/emotions pulling you away in the other direction
- This is NOT about changing your thoughts
ACT promotes
physiological flexibility
Six key processes that are a part of ACT
- Accept that these are the thoughts you are having/there are things you can’t change
- Diffusion= not identifying with your thoughts, they do not define you
- Contact with the present moment! Awareness of the present moment
- Self-As-Context= observing yourself from being distinct from experiences observed “I am experiencing tiredness” instead of “I am tired”
- Values= directions in life that we can choose to guide our behaviour
- Committed Action= taking actions that align with your values
Leadership styles/counselling styles
The preacher= tells you what to do, guilt? judgement, not much dialogue. “drill sergeant”
The expert= facts-oriented, learning-focused. “the teacher”
The director= tells you what to do AND how to do it, little dialogue
The consultant= goals are set by participants w guidance rather than the opposite
