Term
| A healthcare provider asking about quiting smoking more than once is the second best predictor in patients quitting smoking. First predictor is having a heart attack. |
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Definition
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Term
| 4 reasons why people change their behavior? |
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Definition
- disadvantages of status quo
- advantages of change
- optimism for change
- intention to change |
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Term
| behavioral change is about ___ not ___. |
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Definition
| - motivation not information |
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Term
| Motivational interviewing is a ___ centered, ___ method for enhancing ___ ___ to change by exploring and resolving ____. |
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Definition
- patient
- directive
- intrinsic motivation
- ambivalence |
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Term
| ___ ___ is primary reason people change. |
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Definition
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Term
| motivational interviewing is an ___, ___ , client centered way of being that manifests through specific techniques and strategies like ___ ___ and ___ ___ __. |
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Definition
egalitarian, empathetic
reflective listening
shared agenda setting |
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Term
| Motivational Interviewing is focused on ___ to change. It has a ___ base and is good for the patient with ___ readiness that is ___, ___, ___, or ___. |
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Definition
- why
- cognitive
- low
- resistant
- angry
- ambivalent
- contemplative |
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Term
| Behavior Therapy/Interviewing is about __ to change. It has a ___ base and is good for the patient with ___ readiness that is ___ and wants ___. |
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Definition
- how
- behavioral
- high
- convinced
- action |
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Term
| Different Models for Motivational Interviewing: |
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Definition
- Medical Model
- Roger's Client-Centered Therapy
- Cognitive Behavioral Therapy
- Transtheoretical Model |
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Term
| The ____ ____ is the most important model in terms of understanding change. It was founded by Prochaska and Diclemente and consists of what 4 main ideas? |
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Definition
- Transtheoretical Model
1. Processes of Change
2. Stages of Change (SOC)
3. Decisional Balance
4. Self Efficacy
Please Stay Don't Stay |
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Term
According to the Transtheoretical Model, what are the Stages of Change:
KNOW THESE STAGES |
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Definition
- Precontemplative
- Contemplative
- Preparation
- Action
- Maintenance |
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Term
| how to practice decisional balance with patient: |
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Definition
| 4 quadrants of pros and cons |
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Term
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Definition
- belief that one self can change
- one's belief in his capabilities to organize and execute the course of action required to produce given attainments |
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Term
| Levels of self efficacy can be different for different behaviors and are not necessarily correlated. |
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Definition
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Term
| Self efficacy is a ___ concept. It is not the same as ____. |
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Definition
- is a modifiable concept
- is not the same as will power |
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Term
| Motivational Interviewing Key Principles: |
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Definition
- Motiviation is to be ilicited from the client, not imposed
- persuasion/information is less effective and may cause resistance
- clinician directs client to examine and resolve ambivalence
- readiness is not a client trait but one that is a product of interaction
- therapeutic relationship is a partnership, not a expert/recipient |
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Term
| Key Goals of the Clinician during Motivational Interviewing: |
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Definition
- Express Empathy
- Develop Discrepancy: How does current behavior conflict with core values?
- Roll with Resistance: client overcomes own obstacles, dance not wresting match
- Support self efficacy: uncover and reinforce it |
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Term
| The provider should express ___. ___ facilitates changes. ___ ___ listenening is fundamental. |
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Definition
empathy
acceptance
skillful reflective |
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Term
| expamples of how to develop discrepancy: |
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Definition
- the client, not the counselor, should present arguments for change
- Change is motivated by a perceived discrepancy between present behavior and important personal goals/values |
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Term
| Tools of Motivational Interviewing: |
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Definition
- open ended questions to get the ball rolling
- reflective listening
- eliciting change talk- interest, confidence, dread, discrepancy |
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Term
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Definition
Can’t be answered yes/no
Cast a broad net
Use respondent’s own words; Don’t label emotions
Are not biased
Have few assumptions
Are non-judgmental or “preachy"
Only ask about one thing at a time |
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Term
| boundaries for open ended questions: |
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Definition
- only use to initiate discussion
- don't use more than 3 in a row
rely more on reflective listening than questioning |
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Term
| define reflective listening: |
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Definition
Statement, not a question
Hypothesis testing
(If I understand you correctly, it sounds like..)
Affirms and validates (i.e., expresses empathy)
Keeps the client thinking and talking
Avoids arguing
Rolls with resistance |
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Term
| Reflective listening is more effective than questioning |
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Definition
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Term
| Techniques for Reflective Listening: |
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Definition
- undershooting
- short jumps
- simple, short statements
- acknowledge cons, emphasize pros
- negative reverse/paradoxical overshoot |
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Term
| Negative reverese/paradoxical overshoot when to use: |
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Definition
- use when stuck at ambivalence
- yes but syndrome high risk/fail safe |
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Term
| levels of reflective listening: |
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Definition
1. Restate- same words
2. Rephrase- slightly different words
3. Paraphrase- interpret, infer meaning
4. Deduce- connect the dots
5. Summative- review and synthesize |
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Term
| example of pre-reflective listening? |
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Definition
- Do you mean that?
- must be yes/no question |
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Term
| example of restating and rephrasing: |
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Definition
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Term
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Definition
| what are you saying, what did you mean |
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Term
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Definition
| what are you going to say/what are you feeling |
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Term
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Definition
| where are we/where are we going with this |
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Term
| Good starters for restating, rephrashing, and paraphrasing: |
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Definition
Responding to Content: "It sounds like..."
Responding to Affect: "You feel...." |
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Term
| good starters for deducing: |
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Definition
| Responding to meaning : You feel __ because ____ |
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Term
| “I want to quit smoking because I don't want another heart attack; I want to see my kids grow up” |
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Definition
Content reflection
“You see a connection between your smoking and the possibility of having another heart attack”
Feeling reflection
“You are scared that you might have another heart attack”
Meaning reflection
“Your children are important to you and you want to be there for them” |
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Term
| “It sucks that in Virginia you can’t buy a six pack after midnight…on nights like this, I really need to kick back and have a few” |
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Definition
Content reflection
“You won’t be able to buy any beer tonight after you get off of work at midnight”
“You wish you could buy some beer tonight”
Feeling reflection
“You are frustrated that you can’t buy beer whenever you want to”
“You’ve had a tough day and you feel the need to wind down and relax”
Meaning reflection
“Drinking helps you cope with difficult days”
“Drinking is an important part of your life” |
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Term
| self motivational statements: |
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Definition
We become more committed to that which we voice
Client takes the “positive” side of the argument
Client “discovers” discrepancy of current behavior with core values and goals
Client states their pros/reasons for change
Client solves own barriers |
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Term
| 3 steps to eliciting change talk: |
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Definition
1. Recognizing change talk when you hear it.
2. Reinforcing change talk.
3. Eliciting change talk from your client. |
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Term
| Ways to ellicit change talk: |
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Definition
- pros and cons matrix
- motivation scale
- confidence scale |
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Term
| strategy 1 of ellciting change talk via "could have been lower" elicits ___outcome expecations. You said your confidence was a 7, why is it 7 instead of 1? |
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Definition
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Term
| elliciting change talk strategy 2 "could have been higher" technique ellicits ___ outcome expectations/barrier. You said your confidence is a 5, what would it take to get it to 9 or 10. |
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Definition
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Term
| how to develop value descrepancies: |
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Definition
give them list of values, traits, and characteristics snd have them point out 3-4 most important
goal is to help patient find a link b/w their core values and health behavior |
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Term
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Definition
give patient list of strategy options for change and ask which would work best for them and which they would be willing to try
- or do a prioritizing list and ask which one they would like to work on first and which ones are most important to deal with |
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Term
| bringing it all together: |
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Definition
Get permission
Assess 1-10 interest/confidence
Probe higher/lower
Reflect/Summarize
Assess core values
Link behavior to values
Summarize
Where does that leave you?
Where do we go from here? |
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Term
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Definition
Resistance to new feeding approach
Change not always feasible (low readiness)
May not work with low verbal clients
May not work with certain conditions
Anorexia, Depression
Who should be the counselor?
What to expect ?
How much time can you give?
When to refer
Ethnic and cultural considerations
Follow-up |
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Term
| Markers of a productive Motivational Interviewing experience: |
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Definition
- client does most of the work
- client accepts possibility of change
- client accepts responsibility for change (intrinsic internal motivation)
- upward slope of commitment language within or between sessions
- dancing, not wrestling |
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