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Motivational Interviewing
-Client centered, directive method for enhancing intrinsic motivation for change and exploring and resolving ambivalence -Reinforce ‘change’ statements
Agenda-Setting Chart
Chart with different behaviors and/or blank circles to use to help set agenda for behavior change
Stress Bucket
Technique used to help discuss stressors, symptoms, and stress releasers
Assess Readiness
How ready are you to change? If 0 was not ready and 10 was very ready, what number would you give yourself?
Assess Importance
How important is it to you to change? If 0 was not important and 10 was very important, what number would you give yourself?
Assess Confidence
If you decided right now to change, how confident do you feel about succeeding? If 0 was not at all confident and 10 was very confident, what number would you give yourself?
EXPLORE IMPORTANCE
DO LITTLE MORE SCALING QUESTIONS EXAMINE PROs AND CONs EXPLORE CONCERNS HYPOTHETICAL ‘LOOK OVER THE FENCE’
SCALING QUESTIONS
ASSESSMENT OF CONFIDENCE If you decided right now to change, how confident do you feel about succeeding? If 0 was not at all confident and 10 was very confident, what number would you give yourself? OPEN-ENDED QUESTIONS… WHY SO HIGH? HOW CAN YOU GO HIGHER?
PROS AND CONS
BALANCE SHEET (Costs/Benefits.. Change or no change)
HYPOTHETICAL LOOK OVER THE FENCE
-SO YOU’RE NOT SURE THAT IT’S A GOOD IDEA TO TRY TO CHANGE YOUR DIET? -WHY DON’T WE JUST IMAGINE FOR A MOMENT THAT YOU DID MAKE THIS CHANGE. HOW WOULD YOU FEEL?
BUILD CONFIDENCE
DO LITTLE MORE SCALING QUESTIONS BRAINSTORM SOLUTIONS PAST EFFORTS: SUCCESSES AND FAILURES REASSESS CONFIDENCE
BRAINSTORM SOLUTIONS
-EMPHASIZE THE PRINCIPLES -PATIENT EXPLORES OPTIONS -PATIENT SELECTS MOST SUITABLE OPTION -CONVEY OPTIMISM & WILLINGNESS TO RE-EXAMINE
PAST EFFORTS
ASK ABOUT MOST SUCCESSFUL ATTEMPT TO DATE
EXCHANGE INFORMATION
-GENERAL INFORMATION EXCHANGE STRATEGY -TYPICAL DAY STRATEGY
GENERAL INFORMATION EXCHANGE STRATEGY
-ELICIT READINESS AND INTEREST -PROVIDE FEEDBACK NEUTRALLY -ELICIT PATIENT’S INTERPRETATION
REDUCE RESISTANCE
-EMPHASIZE PERSONAL CHOICE AND CONTROL -REASSESS READINESS, IMPORTANCE, OR CONFIDENCE -BACK OFF AND COME ALONGSIDE PATIENT
BACK OFF AND COME ALONGSIDE
-DO NOT ATTACK OR DEFEND -USE REFLECTIVE LISTENING TECHNIQUES.. *SO YOU… *YOU FEEL…
Motivational Interviewing
-Person-centered approach -Ambivalence -Change talk -OARS (open questions, affirm, reflect, summarize) -Elicit & respond to change talk -Ask permission before giving advice -Don’t argue against resistance…reflect -Strengthen commitment
Motivational Interviewing Chart Steps
-Establish Report -Set Agenda -Asses Importance & Confidence -Build Confidence/Explore IMportance
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