Behavior Change Teaching Materials

Table of contents:


The art of supporting patients in making behavioral change can be a challenging one to teach to residents, but is a core skill for them to develop. This relies on accurately assessing readiness for change and then implementing strategies appropriate for the patient's readiness, as well as having the self-awareness to notice when they are in lecture mode and the ability to interrupt the impulse to tell people what they should be doing.

Some Shorthand/dot-phrases that have been useful in our practice include:

.changestage
DESCRIPTION:
Patient counseled re: ___ in motivational interviewing style. Current readiness for change is:
__ Precontemplation phase - Acceptance offered. Also discussed factors that might motivate a change in the future, attempted to plant seeds.
__ Contemplation phase - Discussed the balance sheet of reasons for change and reasons for continuing current behaviors, rulers and hypotheticals used to explore ambivalence.
__ Preparation phase - Discussed resources for assisting with this change, strategies to increase support, timeline.
__ Action phase - Discussed Inspiration, analyzed challenges, discussed rewards and support.
__ Maintenance phase - Discussed rewards, relapse prevention. Discussed role as a role model, creative ideas to keep the inspiration fresh.

.chgruler
Importance of making this change rated as ___ out of 10.
Confidence in ability to make this change rated as out of 10.

.motiv
Motivational interviewing prompts:
You're working on changing . What would be most helpful to talk about today?
DARN - desire, ability, reasons, need (What would you like to see happen, What are you able to do, What would be some benefits of this change, How much do you need to do this?)
What are you already doing to be healthy?
What is good about the way things are now? (To make way for the follow-up question: What is not so good?)
So what do you make of all this now?
What would be a first step for you?
What do you think you'll do?
What might it take for you to make a decision to. . . ?
Suppose that you did decide to. . . .How would you go about it?
Ask permission for informing: (Can I let you know what my concern about this plan is?)
Offer choices where possible. Offer all at once


.action
ACTION PLAN WORKSHEET

Congratulations on deciding to make a positive change in your lifestyle! I have listed your first action plan below.

o Consider making a new action plan weekly for the next month. The changes will add up over time and hopefully they will be a regular part of you daily life.
o The plan should be both important to you and one that you are likely to succeed at completing. Use the scales below to rate the plan. If you cannot give it at least a seven for importance and likeliness to succeed, try to identify why, and make a change in the plan or your life that will allow you to rate it higher.
o After you finish the week, reflect on how you did by answering the questions below.

Week 1

Activity:


Frequency and Duration:


Importance to you on a 1-10 scale:

1---2---3---4---5---6---7---8---9---10
not at all important extremely important

Likeliness that you will be successful on a 1-10 scale:

1---2---3---4---5---6---7---8---9---10
not at all likely extremely likely


Did you accomplish it? (Y/N) _

If you did not accomplish it, can you come up with a plan that might help you succeed by identifying the obstacle and a solution to the obstacle?


Obstacle:


Solution: