3005PSY Week 3 PDF

3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 precontemplation, contemplation, prepa- Transtheoretical Model ration, action, maintenance...

3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 precontemplation, contemplation, prepa- Transtheoretical Model ration, action, maintenance Collaboration Spirit of Motivational Interviewing Evocation Autonomy 1. Engaging: to establish rapport 2. Focusing: process of motivational interviewing 3. Evoking: covering the clients own mo- tivation for change 4. Planning a client-centered, directive method for enhancing intrinsic motivation to change What is motivational interviewing? by exploring and resolving ambivalence developed originally for substance abuse motivational interviewing can be used in combo to engage people with other alone and intervention approaches they don't think there is an issue defensive/resistant in precontemplation mode focus is to build client's motivation for change for change to happen in precontempla- the advantage to change has to outweigh tion the negtives change strategies for precontemplation link client with social liberation forces stage stage of change in which people are con- sidering changing behavior in the next 6 months contemplation stage assess feasibility and cost of change wants to understand behaviour provide info on a disorder/recovery contemplation change strategy push advantages of change self monitoring 1/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 functional analysis analyse alternative reinforcers preparation stage poised to change in next month goal setting change strategy for preparation stage develop change plan develop coping skills started to modify the problem action stage been trying to promote change for past 6 months appraisal of high risk situations alternative reinforces should be applied change strategy in action stage assessment of social support so they are helpful for goals change has occurred for 6 months + find alternative sources of satisfaction and enjoyment maintenance strategies assist in the individual's coping strate- gies vigilance of cognitive distortions maintain environmental control problem has resumed, cycle begins relapse again, individual returns to contempla- tion/precontemplation stage opportunity for greater awareness of high strategy for relapse risk situations and coping strategies no support that ppl move thru stages in a linear fashion cognitive processed show evidence of contemplation/prep stages empirical support for transtheoretical theory supports change being a cognitive process first then behavioural MI is successful with substance abuse and benefits adolescents 2/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 express empathy how to show empathy in MI develop discrepancy support self efficacy empathetic listening nondirective statements building rapport in MI allow client to decide direction reinforce change statements reinforce change statements, bolster mo- tivation for change, create discrepancy goals with MI with client values and goals and behav- iour what to focus on reflecting in MI talk about change (affirm it too) set tentative agenda being where client is explore perceptions Do's in Motivational interviewing empathetic reflection affirm client self efficacy summary at end Don't scold, lecture, judge, accuse, or assume to know what the patient should do Don't's in motivational interviewing don't overly ask questions offer advice until sufficient motivation is built elicit arguments in favor of change explore advantages to change how to elicit self motivational statements how does the problem affect people close to you see it as a sign your methods aren't work- ing, and how can you change tactics? avoid confrontation what to do in face of resistance Do's: reflection, amplified/double sided reflection, shift focus, agree w them, re- framing, paradox, encourage free choice 3/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 arguing interrupting 4 main signs of resistance denying ignoring simple reflection allows for exploration over defensiveness acknowledges it but in an extreme fash- ion (so you're never going to stop drink- amplified reflection ing ever in your life and continue this forever) Reflections that capture both sides of a dilemma that is fostering ambivalence double sided reflection (you feel sad about idea of not drinking but also feel like your relationship will fall apart if you continue) problem recognition (you see how this is causing issues) concern (will you be okay with this if you questions to elicit self motivation continue this issue) querying extremes (so you imagine you'll continue this forever?) intention to change (I want to do this) optimism about change (life will be better pro's for change talk when I weigh less) querying extremes Weighing the pros and cons to change (this is a client task) pros and cons of behaviour, and change decisional balance (make sure to dig into asking for exam- ples, how/when/what ways) main goal of MI helping the client get to a point where how to support self efficacy they feel they can change scaling q's on confidence levels for change 4/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 evocative q's scaling q's review past successes how to build confidence and readiness personal strengths brainstorming reframe failure evocative questions 'how might you do this' 'how confident are you that you can quit ruler assessment drinking' personal strengths 'who could help you with this?' review past successes 'how did you succeed in the past?' 'what if you just used the feedback that reframing failure being in that situation doesn't support you?' if the obstacle was gone, how would you hypothetical change go about this permanently finished with problem be- haviours not sequential, people jump around and permanent exit in transtheoretical model can relapse at any point useful as a way to help understand moti- vation engaging - establish working relationship focusing -develop/maintain a direction for change key principles in Motivational interview- evoking - elicit client's own motivation for ing change (their ideas and feelings) planning - process involves developing client's commitment to change and for- mulating action plan wanting 2 things at once, then stop con- ambivalence sidering it because it's uncomfortable developed motivational interviewing after William Miller success with addicts 5/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 Open-ended questions Affirmations OARS Reflective listening Summaries conversation Motivational Interviewing focuses on ____ as a method for change natural language can show willingness, commitment, reluctance directing speech to elicit change guiding 'we could brainstorm' following 'whatever you think is best' question: why/how/ is this important? when faced with ambivalence, instead of how important? giving advice do this less about you and more about client's desire for change increases participation efficacy for MI large effect size effective as a brief intervention being empathetic develop discrepancy spirit of motivational interviewing roll w resistance support autonomy absolute worth accurate empathy acceptance includes autonomy support affirmation falling into 'expert' trap things to avoid with MI enhance what person already has, they just need to tap into it collecting: pull together info linking: connect previous/current convos summary stage looks like transitional: shift/close session/move to another topic picking up discrepancies between them exploring values and goals allows for and behaviour 6/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 allow them to engage in self confronta- tion 'why is this meaningful' assessment: too many questions expert: client is expert on self premature focus: focusing before engag- ing traps to avoid falling into with MI labelling: diagnostic labelling blame: blaming for failed attempts chat: talking too much about wrong things desires/goals/why this is important positivity questions to focus on when engaging expectations hope/optimism finding one or more specific goals/out- comes has to be client directed focussing stage includes client decides when/how to change (un- less high risk of harm) may enter ready for change or get there through MI process contemplation stage (unless counselling what stage do most clients enter MI at? is mandated) An approach the clinician uses to ask, lis- ten and inform that encourages patients to talk about and hear their intrinsic mo- tivation for change Elicit-Provide-Elicit learn what they already know, fill in any gaps, give time to reflect/be open to dis- agreement, elicit reactions, understand- ing, reflection EMPHASIZE PERSONAL CHOICE resolve ambivalence in direction of change recognise, elicit, respond to change talk 7/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 aim to increase commitment goals with evoking stage closer you move to one choice, the more disadvantages become clear Desire Ability DARN Reasons Need (preparatory change talk) it's helpful to follow up w other types to see if missing/relevant If you hear DARN talk doesn't always indicate commitment to change mobilising talk commitment activation CATS taking steps (can also occur as sustain talk) using OARS to target change talk (DARN AND CATS) eliciting information can include don't ignore sustain talk respond to change talk with CATS evoking hope increased change talk decrease sustain talk taking steps signs they are ready for planning stage resolution of ambivalence envisioning future w/o behaviour asking about change clients often know what to do next, once you have a plan use CATS encourage troubleshooting how to develop a plan be a support goals need to be graded discuss options 8/9  3005PSY WEEK 3 Study online at https://quizlet.com/_d0ad45 strengthening commitment to and sup- porting change planning process is also about public commitment, social support, self monitoring is useful standalone or to increase engagement in other interventions Therapeutic approach always client focussed 4 processes are layered 9/9