Transtheoretical Model of Change

Question 1

Pre-contemplation description

Answer 1

Not thinking about change.
Resistant to change.
Denial.
Cons outweigh pros.

Question 2

Pre-contemplation goal

Answer 2

Patient will begin thinking about change.
Build relationship, express caring concern.
NO scare tactics.
Personalize risk factors.
Educate in small bits over time.
Validate lack of readiness.

Question 3

Contemplation description

Answer 3

“Some day” change.
Ambivalent to change but giving consideration.
Giving up behavior causes sense of loss despite perceived gain.
Barriers vs. benefits.

Question 4

Contemplation goal

Answer 4

Elicit from pt reasons to change and consequences of not changing.
Explore ambivalence.
Pose advice gently to reduce natural resistance.
Question possible solutions for one barrier at a time.

Question 5

Engagement

Answer 5

Attitude not technique that begins immediately.

Patient and doctor initiate and maintain an effective working relationship.

Question 6

Reframing

Answer 6

Help pt think about situation differently from different point of emphasis.

Question 7

Double sided reflection

Answer 7

Acknowledge both sides of ambivalence.

Question 8

Empathic reflection

Answer 8

Convey understand

Question 9

Repeating

Answer 9

Word for word, diffuses resistance.

Question 10

Rephrasing

Answer 10

Slightly alter words and emphasize meaning.

Question 11

2 Critical Steps Before Patient Education

Answer 11

Build patient’s motivation for behavioral change.

Build patient’s motivation for treatment.

Question 12

Core Interviewing Skills - OARS

Answer 12

Open-ended questions.
Affirming by other & self.
Reframing.
Summarizing.