Theoretical Models, Motivational Interviewing, Therapeutic Alliance

Question 1

list the 6 components of the health belief model (HBM)

Answer 1

1. perceived susceptibility
2. perceived severity
3. perceived benefits
4. perceived barriers
5. cues to action
6. self-efficacy

Question 2

define perceived susceptibility and describe ways you can utilize it

Answer 2

one’s belief of the chances of getting a condition

• define population(s) at risk and their risk levels
• personalize risk based on a person’s traits or behaviors

Question 3

define perceived severity and describe ways you can utilize it

Answer 3

one’s beliefs of how serious a condition and its consequences are

• specify and describe consequence of pt risk and condition

Question 4

define perceived benefits and describe ways you can utilize it

Answer 4

one’s beliefs in the efficacy of the advised action to reduce risk or seriousness of impact

• define action to take
• clarify the positive effects to be expected
• describe evidence of effectiveness

Question 5

define perceived barriers and describe ways to utilize it

Answer 5

one’s beliefs in the tangible and psychological costs of the advised behavior

• identify and reduce barriers through: reassurances, incentives, and assistance

Question 6

define “cues to action” and describe ways to utilize it

Answer 6

strategies to activate “readiness”

• provide how-to-information
• promote awareness
• provide remainders

Question 7

define self-efficacy and describe ways to utilize it

Answer 7

confidence in one’s ability to take action

• provide training, guidance, and positive reinforcement

Question 8

what is the strongest predictor for preventive health behaviors within HBM?

Answer 8

high perceived susceptibility

Question 9

what is the strongest predictor for “sick-role” behaviors in HBM?

Answer 9

low perceived benefits

Question 10

List challenges to the Health Belief Model

Answer 10

1. Careful not to “blame the victim”
2. Be aware that the HBM uses “appropriate fear-based messages” in order to facilitate perceived susceptibility and severity
3. The HBM is best used for a relatively short intervention to achieve a specific change. It may be less effective in achieving long-term change

Question 11

the transtheoretical/stages of change model is broken down into what?

Answer 11

2 dimensions:

stages of change

process of change

Question 12

List the stages of change in the transtheoretical/stages of change model

Answer 12

1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Termination

Question 13

describe the precontemplation stage

Answer 13

(not ready) - person is not serious about and are not considering change

• often uninformed or under informed about consequences
• multiple unsuccessful attempts at change can lead to demoralization

Question 14

describe the contemplation stage of change

Answer 14

(getting ready) - person seriously considering change

• aware of pros of changing, but acutely aware of cons
• weighting between costs and benefits of changing can lead to remaining in this stage for long periods of time

Question 15

describe the preparation stage of change

Answer 15

(ready) - person intends to take action in the next month

• typically, already taken steps in the past year
• individuals in this stage have a plan of action

Question 16

describe the action stage of change

Answer 16

stage in which people have made modifications in their lifestyles within the past 6 months

• recently completed action with intention of reducing risk of a disease or injury

Question 17

describe the maintenance stage of change

Answer 17

stage in which people make modifications in their lifestyle to prevent relapse

• lapse vs relapse
• ID relapse not as a failure to change but an opportunity to learn
• as time progresses temptation to relapse reduces and confidence grows
• for many this stage can last forever

Question 18

describe the termination stage of change

Answer 18

behavior change is complete

• behavior change is so complete that they reach point of “zero temptation and 100% self-efficacy”

Question 19

list the concepts in the process of change

Answer 19

1. consciousness-raising
2. dramatic relief
3. environmental re-evaluation
4. self re-evaluation
5. self-liberation
6. societal liberation
7. countering-conditioning
8. stimulus control
9. contingency management
10. helping relationships

Question 20

define and describe the concept of consciousness-raising

Answer 20

1. Definition → finding and learning new facts and suggestions which support change
2. stage of change → contemplation
3. examples:
   
   1. reading a book/article, talking w/medical pro, talking w/friend

Question 21

define and describe the concept of dramatic relief

Answer 21

1. Definition → experiencing and expressing negative feelings about one’s problem
2. stage of change → precontemplation
3. example
   
   1. writing in a journal, communicating w/friends or spouse

Question 22

define and describe the concept of environmental re-evaluation

Answer 22

1. Definition → assessing how one’s problems affects the physical environment
2. stage of change → precontemplation
3. example
   
   1. realizing second-hand smoke may affect non-smoking children, friends, and spouse

Question 23

define and describe the concept of self re-evaluation

Answer 23

1. Definition → realizing that the behavioral change is part of one’s identity
2. stage of change → precontemplation, contemplation
3. example
   
   1. seeing yourself as a fit person, or seeing yourself make nutritious decisions

Question 24

define and describe the concept of self-liberation

Answer 24

1. Definition → choosing and committing to act on a belief that change is possible, accepting responsibility for change
2. stage of change → preparation
3. example
   
   1. making a New Year’s resolution

Question 25

define and describe the concept of societal liberation

Answer 25

1. Definition → societal support of healthier behaviors
2. Stage of change → across all stages
3. example
   
   1. employee walking programs, smoke-free workplaces, free fruit for shoppers under 12

Question 26

define and describe the concept of counter-conditioning

Answer 26

1. Definition → substituting healthier alternatives for problem behaviors
2. stage of change → action, maintenance
3. example
   
   1. using relaxation or exercise to deal with stress instead of using stress eating

Question 27

define and describe the concept of stimulus control

Answer 27

1. Definition → avoiding triggers and cues
2. Stage of change → action, maintenance
3. Example
   
   1. avoiding friends who smoke, avoiding certain restaurants

Question 28

define and describe the concept of contingency management

Answer 28

1. Definition → increasing the rewards of positive behavioral change and decreasing the rewards for unhealthy behaviors
2. stage of change → action, maintenance
3. example
   
   1. buying new clothes after losing weight rather than eating an unhealthy meal

Question 29

define and describe the concept of helping relationships

Answer 29

1. Definition → seeking and using a strong support system of family, friends, co-workers
2. stage of change → action, maintenance
3. example → working out with your support system, eating healthy with your spouse