Module 7 Flashcards
Which of the following is not a consideration for the type of goal you should choose for a client?
What is most important to them now?
Are their friends and family supportive of their goals?
Are they new to a complex task?
Do they have the ability, commitment, resources and feedback?
Are their friends and family supportive of their goals?
Margaret C is a 68 y.o lady who was diagnosed with Parkinson’s Disease 5 years ago. She has recently had a fall and although she has recovered physically her confidence is low and she is currently much less independent and active than she was prior to the fall.
List and describe two (2) evidence-based strategies that could be used to enhance her self-efficacy for physical activity.
Feedback: Providing feedback by comparing the participant’s performance with the performance of others, followed by feedback on the participant’s past performances. There is a significant association between both of these types of feedback and self-efficacy.
Vicarious Experience: Physical activity self-efficacy was significantly higher when vicarious experience was included as a technique. Seeing another individual at a similar level perform the behaviour can raise the individual’s belief that they too possess the capabilities to master the same activity.
(Ashford et al., 2010)
What is a physical activity moderator? Elaborate on your answer using an example.
A physical activity moderator influences or modifies the relationship between physical activity and its outcomes.
E.g. Feedback: depending on its type, frequency and quality can impact how physical activity leads to specific outcomes.
If someone is learning a new exercise for the first time, they are likely to improve faster and become more efficient and strong in the movement if they are receiving high quality feedback from an exercise professional than if they were trying to copy how they saw someone else do it in the past.
Sue is a 55 yr old woman with multiple sclerosis. She has tried on several occasions to commence an exercise program but is currently only active intermittently and has been referred to an exercise physiologist. At her first appointment the exercise physiologist provides Sue with an extensive, detailed description of why it is important for people with MS to be physically active and the benefits Sue would accrue if she were active on a more regular basis.
Using the stage of change model, explain why this approach is unlikely to be successful, and provide two (2) approaches might be more likely to succeed.
Sue is likely in the contemplation or preparation stage of change, as she has previously attempted to start an exercise program but is currently only active intermittently. At this stage, simply providing information on the benefits of exercise is unlikely to motivate her, as this assumes she is ready to take immediate action. A more effective approach would involve motivational interviewing to address Sue’s ambivalence about behavior change, helping to build a therapeutic relationship, explore her motivations, and support her self-efficacy. Additionally, engaging Sue in a shared goal-setting process to outline specific, achievable goals can increase her intrinsic motivation by giving her something concrete to aim for in her exercise journey.
According to Sugavanam T, et al (2013), there are nine (9) potential differences in how stroke patients and rehabilitation professionals view goal setting. Outline four (4) of these differences.
1) Patients are often unclear about the meaning of goal setting and their role in the process. As a result, they feel less positive about taking part in goal setting and the collaborative process compared to professionals, who view all aspects of goal setting more favourably.
2) Patients are usually more optimistic than therapists about the results they expect to achieve, which can lead them to feel like they haven’t reached their goals as much as they had hoped.
3) Patients and professionals differ on how they set goals, types of goals set, and how they perceive goal attainment.
4) Professionals reported higher levels of collaboration during goal setting than patients.
Define what an Open vs a SMART goal is.
Provide one (1) example of each type of goal.
Open Goal: A goal that is loosely defined and lacks specific criteria for achievement. It focuses more on the general process or exploration rather than a specific outcome. E.g. “I want to get better at walking without my mobility aid”.
SMART Goal: a goal that follows a framework designed to set clear, structured and attainable goals. Stands for specific, measurable, achievable, relevant and timely. E.g. “I want to improve my 6MWT by 50m in 4 weeks time. I will achieve this by going on walks 3 times per week at a moderate intensity.”
Outline the four (4) principles of Motivational Interviewing and how you would explain them.
Expressing Empathy: Involves understanding and reflecting the client’s feelings and experiences without judgement. The goal is to create a safe, supportive environment where the individual feels heard and understood which creates a strong therapeutic relationship.
Developing Discrepancy: Involves helping the client recognise the gap between their current behaviour and their broader goals or values. The aim is to help the person the person see how their current actions are inconsistent with their desired outcomes, which can create intrinsic motivation for change.
3) Rolling with Resistance: Roll with the client’s resistance as a sign of ambivalence, and guiding them to explore their own motivations. Not arguing or pushing back when ambivalence is expressed, rather using it as a learning experience to highlight the benefits of physical activity to encourage positive change.
4) Supporting Self-Efficacy: Builds the client’s confidence in their capacity to change by highlighting their strengths, past successes, and resources. This is an important motivator as they are the one who is ultimately responsible for choosing and carrying out change. The practitioners own belief in the client’s ability to change becomes self-fulling prophecy and helps them make positive change.
Provide the definition for Motivational Interviewing.
MI is a client-centred, goal-orientated counselling approach to enhance an individual’s intrinsic motivation to change behaviour by exploring ambivalence and helping the client shift towards making a change.
What is intrinsic motivation?
Refers to the drive to engage in an activity or behaviour because it is inherently enjoyable or satisfying, rather than for external rewards and pressures.
Encourages lasting behaviour change by helping individuals tap into their own intrinsic motivation, increasing the likelihood of sustained commitment and success.
What is Ambivalence, and why is it important to the Motivational Interviewing process?
Refers to the state of having mixed or conflicting feelings about a behaviour, decision, or change. Common when people are contemplating change, where they recognise both the benefits of change and the reasons to stay the same.
MI helps people weigh the pros and cons of change, leading to a deeper understanding of their own motivations and values, encouraging talks of change to help the individual resolve their ambivalence in favour of making a positive change.
