W1- Motivational Interviewing and Theoretical Models Flashcards
Knowledge is not enough to produce behavior change, PEOPLE CHANGE WHEN…
- THEY ___________.
- THEY ___________.
- THEY ___________.
- THEY ___________.
- THEY have a perceived need to change.
- THEY are ready to change.
- THEY have the knowledge, skills, and tools to change.
- THEY have a supportive environment.
What are (2) common theoretical models?
- Health Beliefs Model (HBM)
- Transtheoretical/Stages of Change Model
What are the (6) components of the Health Belief Model (HBM)?
- ) Perceived Susceptibility
- ) Perceived Severity
- ) Perceived Benefits
- ) Perceived Barriers
- ) Cues to Action
- ) Self-Efficacy
What is Perceived Susceptibility?
One’s belief of the chances of getting a condition.
What is Perceived Severity?
One’s belief of how serious a condition and its consequences are.
What is Perceived Benefits?
One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact.
What is Perceived Barriers?
One’s belief in the tangible and psychological costs of the advised behavior.
What is Cues to Action?
Strategies to activate “readiness”.
What is Self-Efficacy?
Confidence in one’s ability to take action.
Which HBM concept is each of the following:
- ) Strategies to activate “readiness”.
- ) One’s belief in the tangible and psychological costs of the advised behavior.
- ) One’s belief of the chances of getting a condition.
- ) One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact.
- ) Confidence in one’s ability to take action.
- ) One’s belief of how serious a condition and its consequences are.
- ) Cues to Action
- ) Perceived Barriers
- ) Perceived Susceptibility
- ) Perceived Benefits
- ) Self-Efficacy
- ) Perceived Severity
HBM is the strongest predictor for what (2) behaviors?
- Preventative Health Behaviors
- “Sick-Role” Behaviors
What are some challenges to the Health Belief Model (HBM)? (3)
- Careful not to “blame the victim”.
- Be aware that HBM uses “appropriate fear-based messages” in order to facilitate perceived susceptibility and severity.
- HBM best used for a relatively short intervention to achieve a specific change. LESS EFFECTIVE in achieving long-term change.
When trying to influence an individual or group to make a health change through the HBM 6 concepts, what should we do?
Go through the 6 concepts to see if there is an area or areas that need to be addressed to influence a health change.
What are the (2) dimensions of the Transtheoretical/Stages of Change Model?
- ) Stages of Change
2. ) Process of Change
What are the (6) Stages of Change?
- ) Precontemplation
- ) Contemplation
- ) Preparation
- ) Action
- ) Maintenance
- ) Termination
What is Precontemplation?
Person is not serious about and are not considering change.
What is Contemplation?
Person seriously considering change.
What is Preparation?
Person intends to take action in the next month.
What is Action?
Stage in which people have made modifications in their lifestyles within the past 6 months.
What is Maintenance?
Stage in which people make modifications in their lifestyle to prevent relapse.
What is Termination?
Behavior change is complete.
Which Stage of Change is each of the following:
- ) Stage in which people make modifications in their lifestyle to prevent relapse.
- ) Person intends to take action in the next month.
- ) Behavior change is complete.
- ) Person is not serious about and are not considering change.
- ) Stage in which people have made modifications in their lifestyles within the past 6 months.
- ) Person seriously considering change.
- ) Maintenance
- ) Preparation
- ) Termination
- ) Precontemplation
- ) Action
- ) Contemplation
What are the (10) Process of Change? What Stage of Change are each in?
- ) Consciousness-raising (Precontemplation)
- ) Dramatic Relief (Precontemplation)
- ) Environmental Re-Evaluation (Precontemplation)
- ) Self Re-Evaluation (Precontemplation, Contemplation)
- ) Self Liberation (Preparation)
- ) Societal Liberation (All Stages)
- ) Counter-Conditioning (Action, Maintenance)
- ) Stimulus Control (Action/Maintenance)
- ) Contingency Management (Action, Maintenance)
- ) Helping Relationships (Action, Maintenance)
Which Process of Change is each of the following:
- ) Assessing how one’s problems affects the physical environment.
- ) Increasing the rewards of positive behavioral change and decreasing the rewards for unhealthy behaviors.
- ) Realizing that the behavioral change is part of one’s identity.
- ) Substituting healthier alternatives for problem behaviors.
- ) Finding and learning new facts and suggestions which support change.
- ) Choosing and committing to act on a belief that change is possible, accepting responsibility for change.
- ) Societal support of healthier behaviors.
- ) Experiencing and expressing negative feelings about one’s problem.
- ) Avoiding triggers and cues.
- ) Seeking and using a strong support system of family, friends, co-workers.
- ) Environmental Re-Evaluation
- ) Contingency Management
- ) Self Re-Evaluation
- ) Counter-Conditioning
- ) Consciousness-Raising
- ) Self Liberation
- ) Societal Liberation
- ) Dramatic Relief
- ) Stimulus Control
- ) Helping Relationships
PART 2: MOTIVATIONAL INTERVIEWING
PART 2: MOTIVATIONAL INTERVIEWING
What are the goals with motivational interviewing?
Work through (with) ambivalence to facilitate change. -Ambivalence to change is normal.
What are the tasks of motivational interviewing? (4)
- Engage- having, sometimes sensitive, conversations with patients
- Focus- focusing on what is important to the patient regarding their behavior and health
- Evoke- help determine the patient’s personal motivation for change
- Negotiate- discuss and negotiate plans for change
What are (4) components of motivational interviewing to keep in mind?
- Collaboration (therapeutic alliance)
- Evocation (not just education)
- Autonomy (not authority)
- Compassion
What are the (4) principles of motivational interviewing?
- Express empathy
- Develop discrepancy
- Roll with resistance
- Support self-efficacy
What is empathy?
- Ability to understand and share the feelings of others…not the same as sympathy.
- Assumes person’s perspectives are understandable and valid.
- Seeks to understand the person’s feelings and perspectives without judgement.
What is discrepancy?
Current behavior versus future goals.
-Point out where they do not match.
What is rolling with resistance?
“Resistance” is just the other side of ambivalence.
Don’t argue against it, pushing against resistance entrenches it.
What are some effective responses that tend to defuse resistance and refocus on change? (3)
- Reflection: simply acknowledge it by reflecting it back.
- Double-sided reflection: on the one hand…and on the other…
- Emphasize person’s ability to choose, control, autonomy.
What is self-efficacy?
Level of confidence individuals have in their ability to perform certain behavior.
What are some strategies for developing self-efficacy? (4)
- Mastery experiences/performance accomplishments
- Modeling/vicarious experiences
- Social persuasion/credible source
- Internal feedback (psychological and physiological)
What is OARS?
4 strategies of motivational interviewing.
- Open-ended questions
- Affirmation
- Reflections
- Summaries
What are the (3) levels of reflective listening?
- ) Repeat or rephrase
- ) Paraphrase/rephrase
- ) Reflect the feelings
- What is change talk?
- What is a good way to remember it?
- Change talk is client talk that leans in the direction of change.
- DARN-CAT
Explain DARN-CAT.
PREPATORY CHANGE TALK
-Desire = Statements about preference to change.
-Ability = Statements about capability.
-Reasons = Specific arguments for change.
Need = Statement about feeling obligated to change.
MOBILIZING CHANGE TALK
- Commitment = Statements about likelihood of change.
- Statements that indicate movement toward action.
- Taking Steps = Statements about actions taken.
What should we do when we hear change talk?
ACT ON IT
When giving advice, a person is more likely to hear and heed your advice if you have ___________.
permission
