MI Flashcards
Precontemplation
not ready
do not intend to take action in the foreseeable future
may be a function of being uninformed or resistant
as provider: affirm role as resource if they want to discuss harms and benefits
Contemplation
getting ready
ready to make change in the next six months
aware of the benefits but more acutely of the costs
may remain here due to behavioral procrastination
as provider: examine barriers to change and encourage discussion of benefits with that individual
Preparation
ready to take action in the immediate future
plan of action in place, can be recruited for modification programs
as provider: develop smart goals or a plan with the patient; provide info as needed
Action
made actions within the previous 6 months
as a provider: support patient in use of plan
maintenance
working to prevent relapse, but do not apply change processes as frequently
as provider: reinforce daily behavior changes and discuss strategies or prevent relapse
termination
not tempted and have 100% self efficacy
Resistance
reasons to change < reasons not to change
ambivalence
reasons not to change = reasons to change
changing individual
reasons not to change are < reasons to change
motivational interviewing
communication strategy that assesses a patients readiness to change and assist patient in deciding to change
uses patients own arguments for change
Collaboration
partnership where the patient is an expert on themselves
evocation
ideas, solutions, and motivation comes from the client
acceptance
patient has autonomy in choosing their path
every patient has inherent worth and potential that is acknowledged
HCP has a genuine curiosity and effort to understand the patient
compassion
promote patient welfare and prioritize their needs
righting reflex
when HCPs try to fix problems for patients
often leads to resistance for patients
Developing discrepancy in MI
helps guide patient identify their behaviors and values separately
change talk
patients stating their own reasons, abilities, needs and desires for change
Steps of MI conversation
- engagement
- focusing
- evocation
- planning
What does OARS stand for?
Open Ended Questions
Affirmations
Reflective Listening
Summary Statements
When asking a patient how ready they are to change do you use a higher or lower number for comparison?
Lower
Reflective listening
the most frequent response in MI
used to elicit change talk
does not show agreement
What do you do if your patient is defensive?
Focus on building rapport and a therapeutic helping relationship
emphasize their autonomy and choice
use reflective listening to show you understand their perspective
do not double down on the argument
Double Sided Reflection
on one hand x on the other hand y
When to use MI
resolve ambivalence
behavior/lifestyle change
medication nonadherence
