Integrated Behavioral Cases

Question 1

Know the Transtheoretical Model of Change

What stages should the physician offer help?

Answer 1

Precontemplation

Contemplation

Preparation

Action

Maintenance

Question 2

In which stage should you be quiet and non-judgemental, quietly supportive, NOT TRYING TO HELP?

Answer 2

Contemplation

Question 3

In motivational interviewing, what should be done to get the conversation started?

Answer 3

Ask permission to broach whatever subject (weight, smoking, nutrition, etc)

Question 4

Give examples of “change talk” vs. “maintenance talk”

Answer 4

Change talk: “It would be nice if I could be more active with my kids”

Maintenance talk: “I’ve tried losing weight before but it all came back”

Question 5

How should the physician respond to change talk?

Answer 5

Change talk: it would be nice to be more active with my kids

Physician reflection: Working on your health would make it easier to be more active

Question 6

How should the physician respond to maintenance talk?

Answer 6

Maintenance talk: I’ve tried losing weight before but I gained it all back

Physician: Last time it didn’t work and that was disappointing

Question 7

In precontemplation and contemplation, what is the best physician response?

Answer 7

Reflection

Can also ask if anyone has ever been concerned about their health, or if they would like to talk about changing in the future or pros/cons

Question 8

What is the best physician response to the Preparation stage?

Answer 8

Reflection is helpful

Ask about confidence in making the change and ask why they are so confident (nicely)

Ask if they would like help and give resources if yes.

Question 9

What is the best physician response to the action stage?

What should you not do?

Answer 9

Reflection

DO NOT be enthusiastic, reinforcing, cheerful or too supportive