MOtivational Interviewing (mohr-2) Flashcards
common dr. complaint
patient does not do what dr asks, despite significant evidence of benefits of change
majority of dr-pt interaction
instruction, advice, telling pts what to do
why individuals change
they decide themselves it is what they want to do
benefits outweigh costs
role of dr
provide info that pt can hear without feeling defensive
dr validates all perspectives-costs and benefits
dr allows pt to make decision for him/herself
stages of change (6)
- precontemplation
- contemplation
- preparation
- action
- maintenance
- relapse
precontemplation
pt not thinking to change resigned to bhavior tried, failed, gave up DENIAL believes consequences aren't serious
contemplation
weigh benefits and costs
ambivalent about change
giving up something enjoyable makes pt feel a loss
assess barriers as well as benefits to change
preparation
experiments with small changes
pt prepares to make specific change
action
taking definitive action to change
desired by drs
praise a lot here to maintain change
maintenance
maintain new behavior over time
ongoing encouragement/support is helpful
continue to appreciate new gains
relapse
normal part of trying to change
usually feels demoralizing
does not mean starting from square 1
recognize attempts to try, not times failed
motivational interviewing
directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence
counseling style
quiet
eliciting
wait for pt to articulate/resolve own ambivalence
dr. does not make decision
dr. encourages pt’s readiness to change by interpersonal interaction
behaviors of interviewing
seek to understand how pt feels about problem and why its a problem
express acceptance
explore pt options both of changing and of NOT changing
monitor pt readiness
affirm pt freedom of choice
principles of interviewing
express empathy support (feels validated) self-efficacy/freedom (pt is in control) roll with resistance develop discrepancy (where pt is and wants to be)
