W1- Motivational Interviewing and Theoretical Models

Question 1

Knowledge is not enough to produce behavior change, PEOPLE CHANGE WHEN…

• THEY ___________.
• THEY ___________.
• THEY ___________.
• THEY ___________.

Answer 1

• THEY have a perceived need to change.
• THEY are ready to change.
• THEY have the knowledge, skills, and tools to change.
• THEY have a supportive environment.

Question 2

What are (2) common theoretical models?

Answer 2

• Health Beliefs Model (HBM)

- Transtheoretical/Stages of Change Model

Question 3

What are the (6) components of the Health Belief Model (HBM)?

Answer 3

1. ) Perceived Susceptibility
2. ) Perceived Severity
3. ) Perceived Benefits
4. ) Perceived Barriers
5. ) Cues to Action
6. ) Self-Efficacy

Question 4

What is Perceived Susceptibility?

Answer 4

One’s belief of the chances of getting a condition.

Question 5

What is Perceived Severity?

Answer 5

One’s belief of how serious a condition and its consequences are.

Question 6

What is Perceived Benefits?

Answer 6

One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact.

Question 7

What is Perceived Barriers?

Answer 7

One’s belief in the tangible and psychological costs of the advised behavior.

Question 8

What is Cues to Action?

Answer 8

Strategies to activate “readiness”.

Question 9

What is Self-Efficacy?

Answer 9

Confidence in one’s ability to take action.

Question 10

Which HBM concept is each of the following:

1. ) Strategies to activate “readiness”.
2. ) One’s belief in the tangible and psychological costs of the advised behavior.
3. ) One’s belief of the chances of getting a condition.
4. ) One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact.
5. ) Confidence in one’s ability to take action.
6. ) One’s belief of how serious a condition and its consequences are.

Answer 10

1. ) Cues to Action
2. ) Perceived Barriers
3. ) Perceived Susceptibility
4. ) Perceived Benefits
5. ) Self-Efficacy
6. ) Perceived Severity

Question 11

HBM is the strongest predictor for what (2) behaviors?

Answer 11

• Preventative Health Behaviors

- “Sick-Role” Behaviors

Question 12

What are some challenges to the Health Belief Model (HBM)? (3)

Answer 12

• Careful not to “blame the victim”.
• Be aware that HBM uses “appropriate fear-based messages” in order to facilitate perceived susceptibility and severity.
• HBM best used for a relatively short intervention to achieve a specific change. LESS EFFECTIVE in achieving long-term change.

Question 13

When trying to influence an individual or group to make a health change through the HBM 6 concepts, what should we do?

Answer 13

Go through the 6 concepts to see if there is an area or areas that need to be addressed to influence a health change.

Question 14

What are the (2) dimensions of the Transtheoretical/Stages of Change Model?

Answer 14

1. ) Stages of Change

2. ) Process of Change

Question 15

What are the (6) Stages of Change?

Answer 15

1. ) Precontemplation
2. ) Contemplation
3. ) Preparation
4. ) Action
5. ) Maintenance
6. ) Termination

Question 16

What is Precontemplation?

Answer 16

Person is not serious about and are not considering change.

Question 17

What is Contemplation?

Answer 17

Person seriously considering change.

Question 18

What is Preparation?

Answer 18

Person intends to take action in the next month.

Question 19

What is Action?

Answer 19

Stage in which people have made modifications in their lifestyles within the past 6 months.

Question 20

What is Maintenance?

Answer 20

Stage in which people make modifications in their lifestyle to prevent relapse.

Question 21

What is Termination?

Answer 21

Behavior change is complete.

Question 22

Which Stage of Change is each of the following:

1. ) Stage in which people make modifications in their lifestyle to prevent relapse.
2. ) Person intends to take action in the next month.
3. ) Behavior change is complete.
4. ) Person is not serious about and are not considering change.
5. ) Stage in which people have made modifications in their lifestyles within the past 6 months.
6. ) Person seriously considering change.

Answer 22

1. ) Maintenance
2. ) Preparation
3. ) Termination
4. ) Precontemplation
5. ) Action
6. ) Contemplation

Question 23

What are the (10) Process of Change? What Stage of Change are each in?

Answer 23

1. ) Consciousness-raising (Precontemplation)
2. ) Dramatic Relief (Precontemplation)
3. ) Environmental Re-Evaluation (Precontemplation)
4. ) Self Re-Evaluation (Precontemplation, Contemplation)
5. ) Self Liberation (Preparation)
6. ) Societal Liberation (All Stages)
7. ) Counter-Conditioning (Action, Maintenance)
8. ) Stimulus Control (Action/Maintenance)
9. ) Contingency Management (Action, Maintenance)
10. ) Helping Relationships (Action, Maintenance)

Question 24

Which Process of Change is each of the following:

1. ) Assessing how one’s problems affects the physical environment.
2. ) Increasing the rewards of positive behavioral change and decreasing the rewards for unhealthy behaviors.
3. ) Realizing that the behavioral change is part of one’s identity.
4. ) Substituting healthier alternatives for problem behaviors.
5. ) Finding and learning new facts and suggestions which support change.
6. ) Choosing and committing to act on a belief that change is possible, accepting responsibility for change.
7. ) Societal support of healthier behaviors.
8. ) Experiencing and expressing negative feelings about one’s problem.
9. ) Avoiding triggers and cues.
10. ) Seeking and using a strong support system of family, friends, co-workers.

Answer 24

1. ) Environmental Re-Evaluation
2. ) Contingency Management
3. ) Self Re-Evaluation
4. ) Counter-Conditioning
5. ) Consciousness-Raising
6. ) Self Liberation
7. ) Societal Liberation
8. ) Dramatic Relief
9. ) Stimulus Control
10. ) Helping Relationships

Question 25

PART 2: MOTIVATIONAL INTERVIEWING

Answer 25

PART 2: MOTIVATIONAL INTERVIEWING

Question 26

What are the goals with motivational interviewing?

Answer 26

``` Work through (with) ambivalence to facilitate change. -Ambivalence to change is normal. ```

Question 27

What are the tasks of motivational interviewing? (4)

Answer 27

- Engage- having, sometimes sensitive, conversations with patients - Focus- focusing on what is important to the patient regarding their behavior and health - Evoke- help determine the patient’s personal motivation for change - Negotiate- discuss and negotiate plans for change

Question 28

What are (4) components of motivational interviewing to keep in mind?

Answer 28

- Collaboration (therapeutic alliance) - Evocation (not just education) - Autonomy (not authority) - Compassion

Question 29

What are the (4) principles of motivational interviewing?

Answer 29

- Express empathy - Develop discrepancy - Roll with resistance - Support self-efficacy

Question 30

What is empathy?

Answer 30

- Ability to understand and share the feelings of others…not the same as sympathy. - Assumes person’s perspectives are understandable and valid. - Seeks to understand the person’s feelings and perspectives without judgement.

Question 31

What is discrepancy?

Answer 31

Current behavior versus future goals. | -Point out where they do not match.

Question 32

What is rolling with resistance?

Answer 32

“Resistance” is just the other side of ambivalence. | Don’t argue against it, pushing against resistance entrenches it.

Question 33

What are some effective responses that tend to defuse resistance and refocus on change? (3)

Answer 33

- Reflection: simply acknowledge it by reflecting it back. - Double-sided reflection: on the one hand...and on the other… - Emphasize person’s ability to choose, control, autonomy.

Question 34

What is self-efficacy?

Answer 34

Level of confidence individuals have in their ability to perform certain behavior.

Question 35

What are some strategies for developing self-efficacy? (4)

Answer 35

- Mastery experiences/performance accomplishments - Modeling/vicarious experiences - Social persuasion/credible source - Internal feedback (psychological and physiological)

Question 36

What is OARS?

Answer 36

4 strategies of motivational interviewing. - Open-ended questions - Affirmation - Reflections - Summaries

Question 37

What are the (3) levels of reflective listening?

Answer 37

1. ) Repeat or rephrase 2. ) Paraphrase/rephrase 3. ) Reflect the feelings

Question 38

- What is change talk? | - What is a good way to remember it?

Answer 38

- Change talk is client talk that leans in the direction of change. - DARN-CAT

Question 39

Explain DARN-CAT.

Answer 39

PREPATORY CHANGE TALK -Desire = Statements about preference to change. -Ability = Statements about capability. -Reasons = Specific arguments for change. Need = Statement about feeling obligated to change. MOBILIZING CHANGE TALK - Commitment = Statements about likelihood of change. - Statements that indicate movement toward action. - Taking Steps = Statements about actions taken.

Question 40

What should we do when we hear change talk?

Answer 40

ACT ON IT

Question 41

When giving advice, a person is more likely to hear and heed your advice if you have ___________.

Answer 41

permission