WK5 - Behavioural Counselling Flashcards
What can behavioural counselling also be used for?
- promotes motivation/resolve ambivalence regarding Ex
- identify/problem solve barriers to Ex engagement
- activate resources to support Ex adherence/maintenance
What are the 5As?
- Assess - understand Ct’s current behaviour, related knowledge, thoughts/feeling about change
- Advise - clear/specific recommendations –> benefits/risks of Ct behaviour based on interests/concerns
- Agree - mutal commitment between Ct + practitioner on goals –> consistent with Ct interest/willingness
- Assist - identify strategies, problem solve barriers, active resources (personal, social, enviro) for change
- Arrange - follow-up/evaluation of change efforts (may require adjusting strategies) -> refer if required.
What are the key components for client centred communication/counselling?
- eliciting Ct’s POV (priorities, concerns, expectations) - actively respecting these
- understand Cts wider context beyond immediate issue (social influences, physical setting)
- establishing/maintaining partner =ship with Ct to develop goals/strategies (shared decision making)
- tailoring info/activities to Ct POV
What are the 8 specific communication skills consistent with a client-centre approach?
- open ended q’s
- active listening
- expressing empathy
- acknowledging/accepting ambivalence
- non-judgemental approach avoiding argument
- collaborative agreement and discussions
- provide support and encouragement
- promoting flexibility and sense of control
Give 4 facts about the 5A Behavioural Counselling Framework.
- 5A framework is Ct-centred, evidence-based clinic tool for health behaviour change
- endorsed by numerous health agencies as framework for PA counselling
- approach is applicable to range of settings and practitioenrs - used to promote Ex
- framework identifies 5 key communication tasks
What are the advantages of the 5A Framework?
- coherent way to structure/organise behaviour change communication with Ct
- incorporates principle that are known to facilitate behaviour change, esp. individual tailoring
What is the philosophy behind the 5A framework?
Elicit Ct’s POV, provide personalised info, work with Ct to identify goals nad activate strategies that are consisten with their values/interests
Strategies used within each stage, and to what extent, will vary by Ct need and parameters of counselling contact
Define Assess in 5A framework?
- elicit Ct POV
- More gathering info, than providing
Key Ax info relates to…
* what client’s understands/defines the “problem” or “desired outcome” and the salience of Ex to that.
* what Ex is currently done
* How Ct thinks, feels about Ex and Ex change
Define Advise
- provide advise after eliciting Ct POV
- advice offered in warm/empathic manner
After gathering info…
* summarise Ct perceptions of risks/benefits
* provide saliant info to confirm/clarify Ct knowledge/understanding
* provide clear/strong advice regarding change, link back to Ct’s interest
What does “Advise” acknowledge?
Pros/cons provide basis for practitioner to confirm Ct understanding - gently provide info to improve knowledge/correct misunderstandings
Such info pertains to…
* nature of problem based on causes, consequences, current management
* relationship between Ex and problem
* perceived risks w Ex and contraindications
* Ex targets/parameters
* results of formalised Ax
* various management options/recommendations
Define Agree
Practitioner and Ct mutally commit to change/collaborate to identify goals
Agreement reached after considering options, consequences and Ct preference
Practitioner contributes “expert” info on Ex options, considerations/recommendations. Ct contributes info on what is acceptable, feasible, consistent w interests/preferences
What is ambivalence?
Haveing mixed/contradictory thoughts/feelings - identify benefits/disadvantages of Ex
Ambivalence is normal and understandable part of change between Ct goals/values/behaviour
How to respond?
* express empathy on ambivalence
* develop awareness of discrepancy between Ct goals/values/behaviour
* avoid arguing/direct confrontation
* adjust Ct’s resistance
* support Ct’s self-efficacy (confidence) and being (appropriately) optimistic
Define Assist
- identifying and problem solving Ex barriers and int/ext resources to support adherence
- behaviour change requires more than info and instruction = multi-level process, influenced by intra/interpersonal and enviro factors
- assistance techniques vary by Ct need/presentation, practitioner style, constraints, resources
- work TOGETHER, focus on Ct’s preferences and experiences
What are the specifc strategies for ‘Assist’?
- Action Plan - detailed of what to do, when, frequency, duration, where, how.
- instruction - how to Ex - verbal, written, pictorial
- Demonstration - how to perform Ex
- Graded tasks - break down Ex into smaller/easier tasks - small successes
- self-monitoring - Ct keeps record of Ex
- Review - extent to which Ex was achieved (behavioural) - extent of outcomes achieved (outcome review)
- feedback - providing data on Ex performance
- Rewards - praise/recognition for attempts/efforts towards Ex
What do Ex barriers relate to?
- behaviorual (Ex complexity, effort required), intra-personal (attitude, lack of enjoyment)
- Interpersonal (criticism needing help with time competing tasks)
- Contextual factors (Ex setting, time demands)
