Term
|
Definition
-All in the hands of the patient.
-All of you will try to help patients
– But the patients have to do all the work!
|
|
|
Term
|
Definition
Helping them to become more self-motivated
|
|
|
Term
|
Definition
1. Individuals progress through stages of change
2. Movement may be forward or backward
3. Movement may be cyclical
-No failure in Modivational Modeling.
|
|
|
Term
Benefits of learning about this Transtheoretical Model theory |
|
Definition
1. More realistic expectations
2. Greater recognition of small accomplishments
3. Greater success over time
4. Less frustration and burn-out
|
|
|
Term
Transtheoretical Model Stages
|
|
Definition
1. Precontemplation
2. Contemplation
3. Determination (Preparation)
4. Action
5. Maintenance
6. Relapse
7. Termination
|
|
|
Term
|
Definition
-Smoking
-Just get them thinking about quiting.
-Make them think they can actually quit.
Not considering change
uGoal: Move to contemplation
uBarriers to moving forward:
1. Knowledge of risks/consequences
2. Self-efficacy
3. Contentment
|
|
|
Term
|
Definition
-Considering the change, but not sure. Their are a lot of questions.
Considering change - ambivalent
uGoal: Move to determination
uBarriers to moving forward:
•Knowledge of risks/consequences
•Self-efficacy
•Contentment
•Indecisiveness
|
|
|
Term
Determination/Preparation
|
|
Definition
Committed to change within 1 month
uGoal: Move to action, design plan
uBarriers to moving forward:
•Loss of commitment
•Knowledge of options
•Making decisions about plans for change
|
|
|
Term
|
Definition
-Help them maintain the change.
Has begun changing behavior
-Goal: Optimize plans, maintain changes
-Barriers to moving forward:
•Failure and disillusionment
•Overconfidence
|
|
|
Term
|
Definition
-Change maintained for 6 months
Behavior change is well-learned typically for 6 months
uGoal: Stable, new lifestyle; attainment of original goals
uBarriers to maintaining maintenance:
•Major losses and stresses
•Failure to attain original goals
|
|
|
Term
|
Definition
-Normal part of the process, they haven’t failed. Learn what went wrong, restage them. All up to the patient.
uResumption of undesired behavior
uRelapse is a normal, expected stage of behavior change
Goals:
•Identify relapse
•Reframe as opportunity to learn
•Restage
|
|
|
Term
|
Definition
-Not even thinking about going back to previous behavior.
uRelapse is highly unlikely
uNew lifestyle is stable
uPrecontemplation about returning to behavior
|
|
|
Term
Motivational Interviewing
(people are ambivalent about change) |
|
Definition
–May not be aware what change is needed
–May misinterpret seriousness of condition
–May understand regimen required, but do not see a way to do it without great difficulty
|
|
|
Term
| 1. Develop Rapport--Techniques |
|
Definition
A. Lifestyle probe
B. Typical Day
–GOAL is to understand. A conversation, not an interrogation!
C. The good, the bad, and the ugly (Get some specifics on how they're dealing with the problem).
|
|
|
Term
|
Definition
-Goal is to have patient direct agenda.
If you could change one thing about your plan for coping with ________ (illness), what would it be?
Consider use of agenda setting chart.
Here are some things that most affect health of people with ________ (diabetes). You are the best judge of what to consider changing. Are you ready to think about changing any one of these? Or do you have other concerns? What would you like to focus on first?
|
|
|
Term
3. Assess importance and confidence
|
|
Definition
Readiness to change is influenced by perceptions of importance and confidence
Important = I believe I need to change
Confidence = I believe that I will be able to change
1. Introduce the assessment
I am not really sure exactly how you feel about changing X. Can you help me by answering 2 simple questions, and then we can see where to go from there?
2. If resistance, back down, do not do assessment
Sometimes it can be a mistake to move too quickly. I don’t want you to feel pressured. Maybe we can talk about this again in the future?
3. Assess Importance
How do you feel at the moment about [change?] How important is it to you to change on a scale of 0 to 10?
4. Assess Confidence
If you decided right now to [change], how confident do you feel about succeeding with this? On a scale of 0-10?
|
|
|
Term
4. Increase motivation for change (increase importance and confidence)
|
|
Definition
-Watch for resistance—a sign you are going too fast.
-If perceived importance is very low, probably best to leave the topic and move onto another area of consultation.
A. Why so high?
You stated it was fairly important to you to personally change [behavior]. Why did you rate it a 6 and not a 1?
B. How can you go higher?
What would it take for you to go from a 6 to a 8 or 9?
What stops you moving up from 6 or 7?
-We’re looking for positive things here. Looking for what’s stopping them.
|
|
|
Term
Dealing with Resistance—3 Traps
|
|
Definition
1. Take control away
Solution: emphasize personal choice
2. Misjudge importance, confidence, or readiness (An 8 may not be the same for them. You need to Reassess).
Solution: reassess readiness, importance and confidence
3. Meet force with force
Solution: back off and come alongside the patient
|
|
|
Term
Henry is a 45 year old married male with a 25 year history of smoking. He comes to your office and tells you that he is seriously considering quitting. He says that he wants to quit for his birthday which is about a month away. What stage of change is Henry experiencing?
|
|
Definition
|
|
