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Counselling Skills 3: Facilitating behaviour change
Transcript of Counselling Skills 3: Facilitating behaviour change
Promoting behaviour change to facilitate self-management
Trans Theoretical Model
Explains how people change
5 stages of change
How do we assess readiness to change?
Ask the right questions to get the right answer (Eg: Using Motivational Interviewing techniques)
Recognizing motivational statements used by the client
Using the Ruler of Change
Helping clients make changes
People are ambivalent
Counselor/Clinician’s advocacy for change evokes “resistance” for the patient and resistance predicts lack of change
Evoking the patient’s own change talk will enhance behavior change
MI is a directive, collaborative, person-centred approach to elicit and strengthen motivation to change
How to achieve?
Understand how people change
List and describe the stages through which clients pass in the course of changing behaviour with nutrition counselling.
Know how to assess client's mindset
Explain the skills used to assess the client’s motivation, confidence and readiness-to-change in a variety of nutrition situations where adherence may be a problem.
Know how to extract motivation
Describe common motivational strategies to promote and maintain behaviour change.
Understanding the patient notes
Nutrition Counselling 2 slides
Extra reading material on TTM
Four type of motivational statements - change talk:
Cognitive Recognition of the problem
"I guess this is more serious than I thought."
Affective Expression of concern about the perceived problem
"I'm really worried about what is happening to me."
Direct or Implicit Intention to change behavior
"I've got to do something about this."
Optimism about one's ability to change
"I know that if I try, I can really do it."
Sustain Talk: Any speech that favors status quo rather than movement toward a change goal
Change Talk: Any speech that favors movement toward a specific change goal
4 principles provide a conceptual foundation for the practice of MI:
Rolling with resistance
How do we achieve this?
Ruler of Change
4 principles of MI document
Practice these principles during Tutorial 5role-play
Information gathering backbone
Sets non-judgemental, collaborative tone
Answer with 1 or 2 reflections for every question
Communicate understanding & appreciation of positive behaviour, competence, personal strength, competence
Used to express interest, acceptance, understanding, empathy
Can be used to develop discrepancy
Simple and complex reflections
Used to help client organize thoughts and experiences
Enhances understanding of client
Can be used to guide conversation to 'change talk'
Practice using OARS during SCL
Elicit or draw out what the client wants to know
Provide information in neutral manner
Elicit what the client thinks about the provided information
Aim to evoke 'change talk' --> this will resolve ambivalence
What worries you about your current situation?
Eliciting change talk
Using the ruler of change
Could you tell me more about your decision to choose the number 5 and not 8 or 3?
Exploring decisional balance
What do you like about your present diet? What concerns you about it?
Can you tell me more about / describe exactly what happened the last time this occured?
What concerns you most about?
What are the best results you could imagine if you made a change?
What were things like before you...? What has changed?
How would you like things to be different a year / three years from now?
Exploring goals and values
What things are most important to you?