Motivational Interviewing - Mohr Flashcards
What is the “role of the expert” in changing behavior?
The job of an expert is to provide information in a manner that patients can hear without feeling defensive.
The expert validates all perspectives; costs and benefits.
The expert then moves out of the way and allows the patient to make a decision for his/herself.
Describe precontemplation
First stage of change
“dozen donuts…I’m good”
“my family has an addictive trace in them”
“this is the way I am… the way I’m wired”
“plenty of people smoke and don’t get cancer”
Denial occurs here
Describe contemplation
Second stage of change
“I know I need to but…”
Patients start to weigh benefits and cost
Describe preparation
Third stage of change
Start to experiment with small changes
“I only had ten donuts this morning (instead of 12)”
Describe action
Fourth stage of change
Taking action to cause change
Most desired by physicians (to see in their patients)
Describe maintenance
Fifth stage of change
Maintaining new behavior over time
Support and encouragement important here
Describe relapse
Normal process of change
Feelings of demoralization
Relapse does not mean starting from “ground zero” again
Need to be careful here…not focus on sense of failure
Define motivational interviewing (MI)
A directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence
“A partnership with the patient”
Key point in MI:
The physician is directive in helping the patient to examine and resolve ambivalence NOT making the decision
Relationship with the patient during MI:
The therapeutic relationship is more like a partnership or companionship than expert/recipient roles
Is readiness to change a patient trait?
No, it is “a fluctuating product of interpersonal interaction”
Important questions to ask during MI:
ASK What do you think about your (smoking)?
ASK Do you think it’s a problem? Why?
EXAMINE What are the benefits/costs to changing?
KEY TO EXAMINE What are the benefits/costs to NOT changing?
What would you like to do?
What is your ultimate goal with physical MI?
To help the person in front of you, not to just treat the disease
What are some phrases that reinforce the patients ownership of his/her own health?
I think you have make a good decision for yourself…
I think you will when you feel the time is right…
Both of these affirm the clients freedom of choice and self direction
Three most important stages of change seen in MI?
Precontemplation
Contemplation
& Relapse
