Motivational Interviewing - Week 2 Flashcards
What is a huge problem with communication btw provider and pt?
interruption
What are ways to reduce interruptions?
cell phones OFF dedicate time to listen (present) Let MA and nurse know not to interupt Write down tasks if interrupted pts life on line
What are the 5 rules of motivational interviewing?
- ask permission instead of ultimatums
- elicit change talk instead of lecturing
- open ended QA
- Reflective listening
- Use normalizing when applicable
Ask permission examples
“Do you mind if we talk about your smoking?”
“Can we talk about your health and diet?”
“I see that you drink 8 beers per night. Can we discuss your alcohol use?”
“What do you know about the benefits of quitting tobacco?” or “Do you know how many drinks it takes to be over the legal limit again?”
Elicit change talk examples
“What makes you think you need to change your drinking habits?”
“What might be different in your life if you exercised regularly?”
“Why do you think your spouse is concerned about your smoking?”
What is reflective listening?
reflect words them
no judgement
paraphrase comments
“It sounds like you are very frustrated with your lack of ability to quit smoking. I know that must be very challenging for you.”
“I hear you saying that you would like to give up alcohol completely but it has become such a difficult thing for you to do.”
“I get the feeling that you really do want to change your dietary habits but you are under a lot of pressure in your life and eating brings you comfort.”
Use normalizing when applicable
Normalizing is intended to make the patient feel that they are not alone in their behavior.
Normalizing also reassures that patient that they are not alone in facing difficulty with change.
“There are many people who have difficulty quitting smoking so you are not alone.”
What is decision balancing?
give list of goods and bads of their continue behaviors
“What are the good aspects about your continued smoking and what are the possible bad outcomes of your smoking?”
What is assess readiness to change?
estimate where they are on change scale, tailors discussion
0-3 not ready
4-7 unsure
8-10 - ready
What is the deploying discrepancies (colombo approach)?
Basically, instead of directly pointing out discrepancies in behavior, the HCP prods the patient to explain them.
What is support self-confidence?
“Over the last month, you have not had one alcoholic beverage. That represents a great improvement for you. How have you been able to successfully do that?”
What is affirmations?
genuine and positive statements
“I see that you are attempting to make great changes in your life and I think that reflects strength on your part.”
What do you do at the end of the visit?
summarizing
What is therapeutic paradox?
reverse psychology, may agree with you
