Motivational Interviewing

Question 1

What factors can influence behaviour?

Answer 1

Barriers and enablers

Question 2

Behaviour change models and frameworks

Answer 2

1. Health Belief Model
2. Stages of change model
3. Theoretical Domains Framework

Question 3

Benefit of models and frameworks

Answer 3

Help us to understand behaviours and suggests strategies to target influences on behaviours

Question 4

Health Belief Model; People are more likely to undertake a health-related action if:

Answer 4

• they perceive that a health threat can be avoided
• they have a positive expectation that adopting a recommendation action will overcome the health threat
• they are confident that they can adopt the recommended health action

Question 5

HBM: How to support behaviour change (5)

Answer 5

1. Increase client’s perception of their vulnerability to the health problem/threat
2. Highlight the seriousness of the problem and its consequences
3. Present the benefits of the recommended action to manage the problem
4. Identify barriers to adopting the recommended action
5. Identify cues to action or a readiness plan

Question 6

What does the HBM not account for?

Answer 6

• Person’s attitudes, beliefs or other individual determinants that indicate a persons acceptance of a health behaviour
• Behaviours that are habitual (e.g. smoking)
• Behaviours that are performed for non-health related reasons such as social acceptability
• Environmental or economic factors that may prohibit or promote recommended action

Question 7

What does the HBM assume?

Answer 7

• That everyone has access to equal amounts of information on the illness or disease
• That “health” is the main goal in the decision making process

Question 8

Stages of Change Model (5)

Answer 8

1. Pre contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance

Question 9

What is the pre-contemplation stage

Answer 9

The client is not yet considering change or is unwilling to change

Question 10

What is the contemplation stage

Answer 10

The client acknowledges concerns and is considering the possibility of change in the near future but is ambivalent and uncertain

Question 11

What is the preparation stage

Answer 11

The client is committed to and planning to make a change in the near future but is still considering what to do - moves from thinking about behaviour change to planing it

Question 12

What is the action stage

Answer 12

Client is actively taking steps to change (and has done so) but has not yet reached a stable state

Question 13

What is the maintenance stage

Answer 13

Client has achieved initial goals and is not working to maintain goals/prevent ‘relapse’

Question 14

What is motivational interviewing?

Answer 14

A client-centred, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence

Question 15

What do people need to do to make a change in behaviour?

Answer 15

1 Recognise that the current behaviour is a concern or problem

2. Believe that they will be better off if they change
3. Believe that they are able to change

Question 16

Motivational strategies for a client in the pre-contemplation stage

Answer 16

• Establish rapport, ask permission and build trust
• Raise doubts or concerns in the client about current behaviour
• Express concern and keep the door open
• Give information on risks, pros & cons

Question 17

Motivational strategies for a client in the contemplation stage

Answer 17

• Normalise uncertainty
• Aim is to tip the decisional balance scales toward change
• Discuss & weigh pros/cons

Question 18

Motivational strategies for a client in the preparation stage

Answer 18

• Develop collaborative relationship and make it clear the client has choice
• Clarify the client’s own goals and identify what they think could be successful strategies
• Negotiate a change or treatment plan (be specific - dates, amounts, etc.)
• Consider and address any barriers to change (e.g. family, health, time, resources, etc.)
• Help the client enlist social support

Question 19

Motivational strategies for a client in the action stage

Answer 19

• Review status and seek commitment to the specific behavioural change at each session
• Acknowledge difficulties for the client in early stages of change
• Help the client identify high-risk situations/triggers and develop coping strategies
• Help find new re-inforcers/rewards/replacement behaviours

Question 20

Motivational strategies for a client in the maintenance stage

Answer 20

• Support lifestyle changes
• Affirm the client’s resolve and self-efficacy
• Help the client practice and use new coping strategies to avoid ‘relapse’
• Develop a plan B if the client resumes previous behaviours
• Review long-term goals with the client