Behaviour Change

Question 1

Social cognitive theory

Answer 1

proposes that people learn via experience, includes reciprocal determinism–> dynamic interaction b/w individual, their enviroment and their behaviour
4 constructs impact behaviour: self efficacy, outcome expectations, self regulation, barriers and facilitators.
self efficacy most effective at predicting behaviour change

Question 2

4 sources of self efficacy

Answer 2

mastery experiences, vicarious experiences, social persuasion, emotional state,

Question 3

Self efficacy and physical activity

Answer 3

strong relation b/w self efficacy and health behaviour change and maintence.
self efficacy impacts persons choice of behavioural setting, effort invested, persistence

Question 4

self regulation

Answer 4

ability to monitor and control thoughts, actions, emotions. Involves avoiding of temptations that distract from long term goal. QEP work with client to develop self regulating aspects of self monitoring, scheduling and planning, setting goals, and positive self talk.

Question 5

self regulation skills

Answer 5

self-monitoring, scheduling and planning, setting goals, positive self talk

Question 6

Self Determination theory (SDT)

Answer 6

Focus on degree to which behaviour is self determined and process though which individual acquires motivation to initiate and maintain new behaviours. Assumes client is inherently motivated to seek out challenges and succeed. Recognizrs the importance of social enviroment

Question 7

SDT: 3 psychological needs

Answer 7

1.independetly solve problems (autonomy)
2.To master tasks (competence)
3. To interact socially (relatedness)
Foster volition, motivation and engagement–> enhanced performance, persistence and creativity

Question 8

SDT motivation: Amotivation

Answer 8

no intention or desire to engage in physical activity

Question 9

SDT motivation: External regulation

Answer 9

motivated o engage in PA because of external forces

Question 10

SDT motivation: Introjected regulation

Answer 10

Participate in PA without accepting as their own (ir to prove they can)

Question 11

SDT motivation: Identified regulation

Answer 11

consciously values goal as personally important and therefore motivated to participate in physical activity

Question 12

SDT motivation: Integrated regulation

Answer 12

Physical activity goal fully assimilated with self. Similar to intrinsic motivation but behaviour remains external to self

Question 13

SDT motivation: intrinsic motivation

Answer 13

Values and participates in physical activity for sheer enjoyment

Question 14

How does QEP use SDT

Answer 14

QEP works to bolster autonomy, competence and relatedness for physical activity by: promoting sense of ownership and control over PA, guide throguh active examination of own reasons for A, encouraging choices and self intiution by proving menu of options =, help clients identify realistic goals and pricing postive feedback for successes, create welcoming enviroment. Some clients will never reach intrinsic motivation–> still help see PA as w/in control to promote adherence

Question 15

Trans-Theoretical Model (TTM)

Answer 15

Poeple change habitual behaviours slowly, passing throguh series of specific stages; each characterized by particular pattern of psychological and behavioural changes. 5 stages of readiness for change- may skip or cycle back throguh stages

Question 16

Trans-Theoretical Model (TTM): Precontemplation

Answer 16

Not intending to make a change, belief that they cannot change or demoralized by past failures.

Question 17

Trans-Theoretical Model (TTM): contemplation

Answer 17

Planning to make change in next few months. Aware of benefits of change and increasingly dissatisfied with results of not changing. Individuals in this stage have not yet resolved ambivalence

Question 18

Trans-Theoretical Model (TTM): Preparation

Answer 18

Decided to take action and actively planning to do so in immediate future. Motivators are strong and defined and ambivalence has been addressed. Boundary b/w preparation and action is fluid- people often move back and forth b/w planning and taking action.

Question 19

Trans-Theoretical Model (TTM): Action

Answer 19

Committed to new behaviour and consstently engaging in it

Question 20

Trans-Theoretical Model (TTM): Maintenance

Answer 20

New behaviour adopted and maintained for several months- behaviour firmly established and individual confident in ability to stick with it. Several attempts at change likely before maintence, progression through process my strengthen behaviour change as individuals learn from past regressions.

Question 21

Stage of change scale

Answer 21

tool for QEP to access progress- understanding stage of change helps guide client throguh action and maintenance.

Question 22

QEP considerations: Precontemplative

Answer 22

unlikely to react well to being told why they should exercise, more effective tot talk throguh their own reasons why- stimualte self exploration of own benifits and barriers to change

Question 23

QEP considerations: contemplative

Answer 23

Need good listener, empathetic and patient as work throguh ambivalence to find own reasons to change. Beneficial to focus on bolstering self-efficacy in ability to succeed.

Question 24

QEP considerations: preparation

Answer 24

Experimenting is important as try new behaviour- helps client discover new physical activity experiences hey my enjoy- effective to help find enjoyment and success

Question 25

QEP considerations: Action

Answer 25

at high risk of replase. Positive reinforcement of new behaviour is important. Change things up regularly to keep things fresh and interesting

Question 26

Health Action Process Approach (HAPA)

Answer 26

Suggests initiation, adoption and maintence of health behaviour is structured in a process including a motivation and volition phase.
HAPA includes self efficacy and outcome expectancies as predictor of new behaviour change. Suggests intention and volition are most proximal predictors of change.

Question 27

HAPA: planning

Answer 27

key at the pre-action stage.
Separated into: action planning and coping planning. Action planning is more important for initiation and coping planning is more important for maintenance.

Question 28

Motivational interviewing

Answer 28

way to work with clients to asses motivation and confidence to change behaviour. helps facilitate clients own examination of postive and negative aspects of change- client recognized as expert of own life and is actively empowered to identify, evaluate and choose changes that work for them

Question 29

4 elements reflecting spirit of motivational interviewing

Answer 29

partnership, acceptance, compassion, evocation

Question 30

Motivational interviewing basics; key features

Answer 30

style of being rather than technique. Use open ended questioning, active listening, eliciting change talk, managing resistance to change, guide from where want to be and where are currently
key features: help client; discover own interest; examine ambivalence- to elicit and strengthen change talk, enhance confidence in taking action, strengthen commitment to change, plan and begin change

Question 31

open ended questioning

Answer 31

helps client find power to change from within. Interviewer must draw out client hisotry, motivation and prior history. Cannot be answered YES/NO

Question 32

Active listening

Answer 32

Essential to develop insight required to facilitate client exploration of motivation and options for change. Tools of active listening can be used to demonstrate understanding of info client shares. many types” content reflection, feeling/meaning reflections, amplified negative reflections, double-minded reflections, active reflections

Question 33

Eliciting “change talk”

Answer 33

to help work throguh ambivalence- can use motivational interviewing to elicit change talk- discussion of clients desires, need for change.
encourage and reinforce change talk by asking about considering how life might unfold w/out change.

Question 34

Managing sustained talk

Answer 34

Resistance to change can be evident in clients sustained talk. Rather than offering counter argument- allow client to express reasons without feeling pressured or judged- can strategically deescalate and refocus discussion so progress can be made by considering other perspective’s. When not sufficient- may use amplified negative reflection for client to re-evaluate

Question 35

Developing discrepancy

Answer 35

motivational interviewing helps explore gap b/w current and where you want to be. Larger gap- harder to justify current behaviour and change is more attractive and less ambivalence is presnt. MI helps client reflect advantages and disadvantage’s to facilitate move towards change. Requires reflection and open ended questioning. Separate behaviour from person and reflect back to client to highlight discrepancies- client understands potential consequences of behaviour- can articulate concern and commitment to change.

Question 36

Self-Efficacy in Motivational Interviewing

Answer 36

Building self efficacy is core to MI. QEP strive to bolster client self efficacy so have capacity to make regulare PA part of life. Compliment taking first step, perserverance-what learned from past

Question 37

3 phases of motivational interviewing

Answer 37

1. Exploring- draw out client history, build rapport, identify behaviour are to be discussed
2. Guiding- steering conversation toward possibility of change- asking to consider life w/ and w/out change- see discrepancy b/w life and goals
   3.chosing: once commitment to change occurs, conservation moves to discussion of how to put plan into action

Question 38

Brief Action Planning

Answer 38

Highly structured, stepped care, self management support technique

Question 39

Key features of Brief Action Planning

Answer 39

may take less than 5 mins- can easily be accomplished in 20-30 min consultation.
Flexible- can be used during initial visit or follow up- can be used once or more with same client. QEP trained to used and deliver BAP

Question 40

HOW was BAP developed

Answer 40

based on literature. Need to support the development of cleints slef-efficacy and creation of appropriate action plans. Derived from MI w/ emphasis on spirit of MI- several studies promote used

Question 41

HOW to use BAP

Answer 41

begins with questions that may be broad
second question probes client self efficacy for using confidence ruler- rate confidence to carry out action pan from 1-20
3rd question- way to support client accountability