Motivational interviewing

Question 1

Lifestyle change intervention:

Answer 1

• It should be patient-focused (framed around the patient’s needs and interests).
• It should be health-connected (review the projected impact of the intervention on the patient’s physical or emotional health).
• It should be behavior-oriented (focused on what the patient can “do” differently).
• It should be realistic.
• It should be controllable (framed in terms of what the patient can reasonably control, for example, exercise daily rather than a specific amount of weight loss).
• It should be measurable.
• It should be practical.

Question 2

Stages of Change: provider actions

Answer 2

Precontemplation - Education about the health area

Contemplation - Cost-benefit analysis; develop discrepancy between patient goals and current behavior

Preparation - Brainstorm options; assist in developing a concrete action plan

Action -Encourage tracking/monitoring actions; validate patient and provide feedback; discuss and elicit social support

Maintenance - Check progress; troubleshoot slips/concerns of the patient; reinforce successes and build patient confidence

Relapse - Judge choices, not the patient; focus on pastsuccess; identify new supports that reinforce healthy behavior

Question 3

Stages of change mode

Answer 3

Precontemplation

• Not ready to change; patient does not acknowledge negative consequences
• Encourage patient to evaluate consequences of current behavior
• Explain & personalize the risk
• Recommending action is premature

Contemplation

• Thinking of changing; patient acknowledges consequences but is ambivalent
• Encourage evaluation of pros & cons of behavior change
• Promote new, positive behaviors

Preparation

• Ready to change; patient decides to change
• Encourage small initial steps
• Reinforce positive-outcome expectations

Action

• Making change; patient makes specific, overt changes
• Help identify appropriate change strategies & enlist social support
• Promote self-efficacy for dealing with obstacles

Maintenance

• Changes integrated into patient’s life; focus on relapse prevention
• Follow-up support; reinforce intrinsic rewards
• Develop relapse prevention strategies

Identification

• Behavior is automatic; changes incorporated into sense of self
• Praise changes