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Mindful patient management > Week 5 > Flashcards

Week 5 Flashcards

1
Q

What is motivational interviewing?

A

An effective way of talking with people about change

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2
Q

What are some difficult decisions that we face later in life?

A
  • Medical decisions
  • Retirement
  • Living alone
  • Accepting help
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3
Q

What is lack of change/when change is hard, it is NOT as a result of…?

A
  • Lack of information
  • Laziness
  • Oppositional personality
  • Denial
  • Resistance
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4
Q

When change is hard, it is often because of ____

A

Ambivalence

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5
Q

What is ambivalence?

A

Wanting and not wanting the change or wanting incompatible things at the same time

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6
Q

What does ambivalence lead to, because it is uncomfortable?

A

Anxiety, which then leads to procrastination

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7
Q

Procrastination is often mistaken for ___

A

Resistance

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8
Q

How does motivational interviewing help with ambivalence?

A
  • Can help resolve ambivalence and help elicit a person’s own motivation to change
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9
Q

What are the underlying concepts of motivational interviewing?

A
  • Partnership
  • Acceptance
  • Compassion
  • Evocation
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10
Q

What does the partnership component of motivational interviewing include?

A

Work collaboratively and avoid the expert role

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11
Q

What does the acceptance component of motivational interviewing include?

A

Respecting the client’s autonomy, potential, strengths, and perspective

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12
Q

What does the compassion component of motivational interviewing include?

A

Keep the client’s best interest in mind

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13
Q

What does the evocation component of motivational interviewing include?

A

The best ideas come from the client

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14
Q

What are the skills necessary to master for motivational interviewing?

A
  • Open questions
  • Affirmations
  • Reflections
  • Summaries
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15
Q

What are affirmations?

A

Statements about anything positive noticed

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16
Q

What do we use affirmations in motivational interviewing for?

A

To build a sense of self confidence or self efficacy

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17
Q

What is reflective listening?

A

Understanding what the client is thinking and feeling then saying it back to the client. (most important)

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18
Q

What do we use reflections for in motivational interviewing?

A
  • To convey empathy and understanding.

- To be able to see things through our patient’s eyes

19
Q

What is a summary?

A

A long reflection of more than one client statement

20
Q

What is the most important use of summary in motivational interviewing?

A

It provides an opportunity for the provider to become strategic and guide the client towards healthy behavior change by selectively summarizing the client’s own reasons for change

21
Q

What are the processes of motivational interviewing in order?

A
  • Engaging
  • Focusing
  • Evoking
  • Planning
22
Q

What is engaging?

A

The process fo establishing a trusting mutually respectful relationship

23
Q

What are the things to avoid when engaging with a patient?

A
  • Assessing too early
  • Telling how to fix problem
  • Power differential
  • Labeling
24
Q

What are the things to do when engaging with a patient?

A
  • Feeling welcome
  • Feeling comfortable
  • Feeling understood
  • Exceeding expectations
  • Having mutual goals
  • Feeling hopeful
25
Q

What is focusing?

A

An ongoing process of seeking and maintaining direction

26
Q

What does focusing involve?

A

Setting an agenda or agreeing on an agenda while considering patient’s and provider’s goals and priorities, in an effort to create a clear direction for the goal plan

27
Q

How does a provider accomplish focusing?

A

With the use of the OARS skills.

  • Open questions
  • Affirmations
  • Reflections
  • Summaries
28
Q

What is evoking?

A

Eliciting a client’s own motivation for change.

29
Q

What are we evoking in motivational interviewing?

A

Change talk

30
Q

What is change talk?

A

Client speech that favors movement in the direction of change

31
Q

What are some ways to encourage change talk?

A

Ask questions like:

  • Why do you want to make a change?
  • What are the reasons to change?
  • What would some of the benefits be?
  • How might you go about making a change?
  • What would be your 1st step?
32
Q

What is planning?

A

Developing a specific change plan that the client agrees to and is willing to implement

33
Q

What are the 10 strategies for evoking change talk?

A
  1. Ask Evocative Questions
  2. Explore Decisional Balance
  3. Ask for Elaboration
  4. Ask for Examples
  5. Look Back
  6. Look Forward
  7. Query Extremes
  8. Use Change Rulers:
  9. Explore Goals and Values
  10. Come Alongside
34
Q

What are the characteristics of “Ask Evocative Questions” for evoking change talk?

A

Ask open question, the answer to which is change talk.

35
Q

What are the characteristics of “Explore Decisional Balance” for evoking change talk?

A

Ask first for the good things about status quo, then ask for

the not-so-good things.

36
Q

What are the characteristics of “Ask for Elaboration” for evoking change talk?

A

When a change talk theme emerges, ask for more details. In what ways? Tell me more…? What does that look like?

37
Q

What are the characteristics of “Ask for Examples” for evoking change talk?

A

When a change talk theme emerges, ask for specific examples. When was the last time that happened? Give me an example. What else?

38
Q

What are the characteristics of “Look Back” for evoking change talk?

A

Ask about a time before the current concern emerged. How were things better, different?

39
Q

What are the characteristics of “Look forward” for evoking change talk?

A

Ask what may happen if things continue as they are (status quo). Try the miracle question: If you were 100% successful in making the changes you want,
what would be different? How would you like your life to be five years from now?

40
Q

What are the characteristics of “Query Extremes” for evoking change talk?

A

What are the worst things that might happen if you don’t make this change? What are the best things that might happen if you do make this change?

41
Q

What are the characteristics of “Use Change Rulers” for evoking change talk?

A

Ask, “On a scale from zero to ten, how important is it to you to [target change] - where zero is not at all important, and ten is extremely important? Follow up: And why are you at ___and not _____ [lower number than they stated]? What might happen that could move you from ___ to [higher number]? Instead of “how important” (need), you could also ask how much you want (desire), or how confident you are that you could (ability), or how committed are you to (commitment). Asking “how
ready are you?” tends to be confusing because it combines competing components of
desire, ability, reasons and need.

42
Q

What are the characteristics of “Explore Goals and Values” for evoking change talk?

A

Ask what the person’s guiding values are. What do they
want in life? Using a values card sort can be helpful here. If there is a “problem”
behavior, ask how that behavior fits in with the person’s goals or values. Does it help realize a goal or value, interfere with it, or is it irrelevant?

43
Q

What are the characteristics of “Come Alongside” for evoking change talk?

A

Explicitly side with the negative (status quo) side of ambivalence. Perhaps _______ is so important to you that you won’t give it up, no matter what the cost.

Mindful patient management (5 decks)

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