What is Behaviour <br />Behaviour is the result of the interaction between what we believe and how we feel.<br />If we want to assist our clients in changing we need to help them change their underlying beliefs and feelings related to the behaviour. <br />Behaviour change can be difficult to achieve and even more challenging to maintain.<br />
Influencing Factors on Behaviour Change <br />Motivation<br />Beliefs underlying the Behaviour<br />The value of the behaviour e.g. How does the behaviour serve me?<br />Perceived costs and benefits of changing<br />Barriers to changing <br />Self-belief in our ability to change the behaviour<br />Support and reinforcement from others<br />
Behaviour Change & Chronic Illness<br />Many assume that with a diagnosis of a health problem this would motivate people to change- this is not always the case.<br />Only 50% of heart attack patients quit smoking and only 40% of patients take medication appropriately (Ley et al 1974)<br />The level of psychological issues with chronic illness is approximately 30%<br />The combination of psychological factors and managing a medical condition does not make the ideal conditions for sustaining behaviour change.<br />
What is Motivational Interviewing (MI)?<br />Motivation is a state of readiness or eagerness to change (Miller& al. 1991)<br />Motivational Interviewing (MI) is a cognitive behaviour technique that helps patients to identify and change behaviours to improve the quality of their lives.<br />Evidence-based talk therapy based on four principles to help patients.<br />
Principles<br />1. To help understand your thought process in regards to your problem behaviour.<br />2. To identify and measure the emotional reactions of the problem behaviour. <br />3. To identify how thoughts and feelings interact to produce the patterns in behaviour.<br />4. To challenge your thought patterns and implement alternative behaviours.<br />
Stages of Change (Prochanska and DiClemente)<br />1.) Precontemplation: Not thinking of changing<br />2.) Contemplation: Start thinking about changing in the next 6 months <br />3.) Preparation: Get ready to change in the next month;<br />4.) Action: Change occurs<br />5.) Maintenance: Continuing change after the first goals have been reached.<br />6.) Relapse: May occur during this process at any stage and this is where your support network including your Employment Consultant can assist you<br />
Creating the Conditions for Change<br />Express Empathy: Active listening, and reflection<br />Avoid Argument: If we actively challenge the client they will defend their position even more.<br />Supporting Self-Efficacy: Belief in one’s ability to change is fundamental to success.<br />Rolling With Resistance: Gently challenge your thought processes that underlie the problem behaviour.<br />Developing Discrepancy: You need to be aware that your current situation has consequences and you need to set obtainable goals.<br />
How To Do It<br />Establish Rapport: Support, encouragement, be genuine.<br />Setting the Agenda: Let the client set the agenda for change and assist by giving feedback. What would you like to change?<br />Assessing Readiness for Change: “On a scale of 1 to 10, how committed are you to change?” <br />Sharpening The Focus: Breaking down goal into small goals-more achievable. Make self-contract. “I am willing to change my behaviours as necessary to reach my goal I have chosen.....”<br />Identifying Ambivalence: The behaviour is occurring because there are positive and negatives for this behaviour. Assist the client with writing pros and cons list for changing the behaviour.<br />Eliciting Self-Motivating Statements: Encourage the client to use positive statements about themselves ad their progress.<br />Handling Resistance: Use reflection <br />Shifting focus: Assisting clients around barriers to behaviour change.<br />
Other Strategies<br />Anticipating Obstacles:<br />Avoid tempting situations<br />Ask your friends not to tempt you<br />Minimize the tempting quality <br />If in the situation, distract yourself.<br />When tempted, remind yourself of your goal<br />Ask other people to remind you of your goal<br />
Strategies Continued<br />Self Monitoring; Keep a diary<br />Identify triggers to unwanted behaviours <br />Who?<br />What Situation?<br />Where?<br />Consequences?<br />
Improving Self-Efficacy Beliefs<br />Pick a target you feel there is some chance of reaching.<br />Focus on the process of change, not on the final goal.<br />Distinguish between past performance and the present situation<br />Pay close attention to small successes.<br />Don't let old emotions hold you back <br />Be aware that a depressed mood can hold you back from achieving your goals<br />Begin with the easiest situation and work your way to the most difficult situation.<br />
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