Motivational interviewing Flashcards
motivational interviewing is a method of causing __
motivational interviewing is a method of causing behavior change
6 stages of behavior change
- precontemplation
- contemplation
- preparation
- action
- maintenance
- relapse
precontemplation is __ about change
precontemplation is NOT yet THINKING about change
contemplation is __ about change
contemplation is THINKING about change
at what stage can you temporarily exit the stages of change circle
preparation
relapse is __ and __
relapse is normal and common
5 steps of contemplating change
- Identifying the behavior: this is how I eat
- Identifying a problem: eating this way is a problem
- Desiring a change: I want to eat better
- Feeling confident about a change: eating better will help me be healthier and feel better
- Doing it!
3 values of stages of change models
- Sending a patient home even thinking about change is a huge step
- Knowing where patients are stuck may help you narrow down the likely barriers
- Framework that can be used to facilitate empathy
the 4 spirits of MI
- acceptance (autonomy and empathy)
- collaboration
- compassion
- evocation
MI: acceptance
if given a choice, more likely to __
MI: acceptance
if given a choice, more likely to make a change
__ acceptance facilitates change
nonjudgmental acceptance facilitates change
MI: acceptance
__ is normal
MI: acceptance
ambivalence (not knowing where you are) is normal
MI: collaboration
being an equal partner
MI: compassion
MI is not a magic bullet or trick
MI: evocation
eliciting patient’s perspective as well as “change talk”
change talk consists of the patient’s expression of their own __, __, __, and __ for behavior change
change talk consists of the patient’s expression of their own desires, ability, reasons, and need for behavior change
sustain talk consists of the patient’s expression of their own __, __, and __ for behavior change
sustain talk consists of the patient’s expression of their own desires, reasons and need to stay the same, and inability for behavior change
MI: where is the patient? what is their perspective?
empathy, use stages of change
collect info
MI: what are the micro-skills needed?
Person centered guiding skills (OARS)
Giving information (includes suggestions, voicing your concerns, etc.)
“Rolling with resistance”
MI: what is the overarching goal as a physician
Paying attention to, reflecting, eliciting, and reinforcing change talk: the reasons, desire, ability, need, etc. for behavior change
The more change-talk you hear from the patient, the more likely they are to want to change
O in OARS
These are questions that invite the patient to say more than a yes, no, number or one word answer.
A in OARS
These are statements that reinforce and convey recognition of the patient’s strengths, abilities, efforts, as well as past and current successes
R in OARS
These are statements in which the provider repeats (exact words), rephrases (slight re-wording), or paraphrases (e.g., amplifying the thought or feeling, use of analogy, making inferences).
S in OARS
These are statements in which the provider reviews patient’s stance on the behavior at the current moment and can be a useful tool to then elicit the “next steps” with a key question.
