Running head: ASSESSMENT METHODS 1 ASSESSMENT METHODS 2 Assessment Methods PSYCH 628 October 20, 2014 Assessment Methods Changing bad behavioral can sometimes be a difficult process. One of the best ways to stay on track is to monitor the behaviors. “Self-monitoring is a systematic observation and recording of target behavior and is the most effective technique of behavioral treatment” (Burgard & Gallagher, 2006). A health behavior other than exercise that can help an individual to lead a better lifestyle is improving nutritional intake. A self-monitoring scale is essential in measuring compliance to the dietary plan. The aim of initiating this desirable health behavior is to help me understand my dietary status in order to identify the possible nature, extent, and occurrence of impaired nutritional status. I believe that understanding my dietary status will aid me in preventing the incidence of some lifestyle diseases such as obesity, hypertension and diabetes. Apart from self-monitoring, other current behavioral assessment techniques include behavioral interviews, self-report behavioral inventories and cognitive behavioral assessment techniques. Articulating my self-monitoring scale for healthy dieting and analyzing some of the behavioral assessment techniques can help to create a better understanding about their effectiveness in promoting the desired health behaviors. Self-Monitoring Scale for Healthy Dieting The self-monitoring will entail observing and recording my eating patterns over a period of three months in order to get concrete feedback that I can use to take corrective measures where I feel there is an impaired nutritional status. Throughout the period, I will use labels found on the food packaging to record and monitor the levels of caloric intake in the beverages or food that I consume. The scale highlights the compulsory dietary requirements that I should consume on a daily or weekly basis, and will serve to complement my daily food diaries. Through the scale, I will be able to increase self-awareness about the target behaviors and realization of outcomes. Compulsory Requirements Action Quantity consumed Time Bread, potatoes and other cereals (at least one of these not cooked in fat or oil) Yes/No Action taken Fruit and fruit juice Yes/No Action taken Vegetables and Salads Yes/No Action taken Milk and dairy foods (did they consist of lower fat options) Yes/ No Action taken Is fish accessible at least twice in a week? (with one serving being oily fish) Yes/No Action taken Is red meat available, for at least three times a week? What type is served? Yes/No Action taken Is safe drinking water accessible free of charge every day? Other beverages consumed throughout the day Yes/No Action taken · Overall comments The ...

1. Running head: ASSESSMENT METHODS
1
ASSESSMENT METHODS
2
Assessment Methods
PSYCH 628
October 20, 2014
Assessment Methods
Changing bad behavioral can sometimes be a difficult process.
One of the best ways to stay on track is to monitor the
behaviors. “Self-monitoring is a systematic observation and
recording of target behavior and is the most effective technique
of behavioral treatment” (Burgard & Gallagher, 2006). A health
behavior other than exercise that can help an individual to lead
a better lifestyle is improving nutritional intake. A self-
monitoring scale is essential in measuring compliance to the
dietary plan. The aim of initiating this desirable health behavior
is to help me understand my dietary status in order to identify
the possible nature, extent, and occurrence of impaired
nutritional status. I believe that understanding my dietary status
will aid me in preventing the incidence of some lifestyle
diseases such as obesity, hypertension and diabetes. Apart from
self-monitoring, other current behavioral assessment techniques
include behavioral interviews, self-report behavioral inventories
and cognitive behavioral assessment techniques. Articulating
my self-monitoring scale for healthy dieting and analyzing some
of the behavioral assessment techniques can help to create a
better understanding about their effectiveness in promoting the
desired health behaviors.
Self-Monitoring Scale for Healthy Dieting
The self-monitoring will entail observing and recording my

2. eating patterns over a period of three months in order to get
concrete feedback that I can use to take corrective measures
where I feel there is an impaired nutritional status. Throughout
the period, I will use labels found on the food packaging to
record and monitor the levels of caloric intake in the beverages
or food that I consume. The scale highlights the compulsory
dietary requirements that I should consume on a daily or weekly
basis, and will serve to complement my daily food diaries.
Through the scale, I will be able to increase self-awareness
about the target behaviors and realization of outcomes.
Compulsory Requirements
Action
Quantity consumed
Time
Bread, potatoes and other cereals (at least one of these not
cooked in fat or oil)
Yes/No
Action taken
Fruit and fruit juice
Yes/No
Action taken
Vegetables and Salads
Yes/No
Action taken
Milk and dairy foods (did they consist of lower fat options)
Yes/ No

3. Action taken
Is fish accessible at least twice in a week? (with one serving
being oily fish)
Yes/No
Action taken
Is red meat available, for at least three times a week? What type
is served?
Yes/No
Action taken
Is safe drinking water accessible free of charge every day?
Other beverages consumed throughout the day
Yes/No
Action taken
· Overall comments
The scale that I have developed for monitoring my nutritional
intake can serve as an important assessment tool in a behavioral
health intervention. Through recording beverage and food
intake, as well as the providing the description of the amount
and type consumed can help to create an increased sense of self-
awareness and trigger behavior change among other individuals
aspiring to improve their nutritional intake. Self-efficacy beliefs
play a direct role in the decisions I take in conforming to my

4. nutrition plan. Health specific self-efficacy is an individual’s
optimistic self-belief of adopting healthy lifestyle choices and
resisting any temptations that might arise. According to Burke,
Wang & Sevick (2011), self-efficacy is a central component of
any behavioral health intervention since it can influence the
decisions of individuals to select challenging settings, create
new situations and explore their environments. Self-efficacy
also affects adoption or rejection of other health behaviors
including sexually risky behaviors, addictive behaviors,
physical fitness, proper hygiene, sleep as well as stress
reduction. Through formulating similar scales in other
behavioral health interventions, practitioners and researchers
can be able to understand situations that expose individuals to
tempting situations, the internal and social factors that make
compliance difficult, as well as the negative emotional events
that might hinder individuals from adopting healthy behaviors
(Burke et al., 2011).
Current Behavioral Assessment Techniques
Currently, various behavioral assessment techniques can help in
identifying or explaining why individuals act the way they do
and the influences of the environment on their behavior. One of
the techniques is behavioral interviews. In behavioral
interviews, the health practitioner asks questions centered on
the target behaviors (Carducci, 2006). The goal of the
interviews is to aid the practitioner gain a broader perspective
of the variables perpetuating it. Behavioral interviews are
different from traditional interview in focus, but may have the
same format. According to Hersen (2004), the focus of
behavioral interviews is on understanding and describing the
relationships among behaviors, antecedents and consequences in
order to come up with a functional behavior analysis. An
advantage with this technique is that the interviewer is able to
obtain detailed descriptions of the patient’s environment, which
behavioral health practitioners can integrate in the patient’s
treatment plans. Carducci (2006) notes that a common problem-
solving format followed in behavioral interviews begin by

5. problem identification, followed by problem analysis,
assessment planning and finally treatment evaluation.
Behavioral interviews are also more direct than unstructured
clinical interviews.
The other behavioral assessment technique comprises of self-
report behavioral inventories and checklists (Hersen, 2004).
Some of the self-report inventories frequently used by
behavioral clinicians include the fear Survey Schedule, the
Youth Self Report and the Beck Depression Inventory. The
specialists use this technique in identifying perceptions of the
environment and emotional responses that lead to specific
behaviors among individuals. The Child Behavior Checklist
(CBCL) is also another important rating scale for assessing
problem behaviors among adolescents and children in their
natural environments. In self-report inventories and checklists,
parents, peers, teachers or the child rate on a list of behaviors
displayed in a questionnaire format (Carducci, 2006). The
CBCL is advantageous because it usually contains multiple
factors for evaluation such as aggressiveness, anxiousness and
depressed behaviors. The self-report inventories and checklists
are also able to give a quantitative measure of behavior. Other
rating scales developed for assessing problem behaviors among
children and adolescents include the revised behavior problem
checklist and the Teacher Report Form (TRF).
The third technique is cognitive behavioral assessments.
According to Hersen (2004), cognitive events are the activities
that occur in a person’s brain and influence their behavior.
Cognitive behavioral assessment techniques strive to measure
the feelings or thoughts of an individual while in a specific or
challenging situation (Carducci, 2006). The assessments might
ask questions with regard to specific behaviors such as appetite,
sleep patterns and decision-making. The thought sampling
technique, which is central to cognitive assessments, requires an
individual to monitor thoughts experienced in certain situations
that can be useful in explaining the observed behavior. Even
though cognitive assessment methods are successful in

6. measuring the behaviors, threats to validity can occur because
of observing one’s own behavior (Hersen, 2004). It is also
worth noting that different assessment methods can be
applicable concurrently.
Conclusion
Behavioral assessment methods can be important for helping
individuals to adopt healthy lifestyles because they identify the
underlying influences behind a particular behavior. My scale for
self-monitoring nutritional intake enables me to identify the
possible nature, extent and occurrence of impaired nutritional
status, after which I can be able to initiate the desired corrective
measures to lead a healthier lifestyle. This scale can also find
application in other behavioral health interventions especially
those targeting sexually risky behaviors, addictive behaviors,
physical fitness, proper hygiene, sleep and stress reduction.
This is especially true considering the role of self-efficacy in
promoting adherence to the preferred healthy behaviors. In
addition, other behavioral assessment techniques including
behavioral interviews, self-report inventories and checklists as
well as cognitive assessment techniques also serve a critical
role in underscoring the relationships between behavioral
patterns and environmental influences.
References
Burgard, M. & Gallagher, K. (2006). Self-monitoring:
Influencing effective behavior change in your clients. ACSM’S
Health & Fitness Journal 10(1) 14-19. Retrieved from
http://ovidsp.tx.ovid.com.ezproxy.apollolibrary.com/sp-
3.13.0b/ovidweb.cgi?WebLinkFrameset=1&S=BEIMFPNMKGD
DLLBKNCLKJDFBIALNAA00&returnUrl=ovidweb.cgi%3fMai
n%2bSearch%2bPage%3d1%26S%3dBEIMFPNMKGDDLLBKN
CLKJDFBIALNAA00&directlink=http%3a%2f%2fgraphics.tx.o
vid.com%2fovftpdfs%2fFPDDNCFBJDBKKG00%2ffs046%2fov
ft%2flive%2fgv023%2f00135124%2f00135124-200601000-
00007.pdf&filename=Self-
Monitoring%3a+Influencing+Effective+Behavior+Change+in+Y

7. our+Clients.&link_from=S.sh.22%7c1&pdf_key=FPDDNCFBJD
BKKG00&pdf_index=/fs046/ovft/live/gv023/00135124/0013512
4-200601000-00007&D=ovft
Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-
Monitoring in Weight Loss: A Systematic Review of the
Literature. Journal of the American Dietetic Association, 111
(1), 92-102
Carducci, B. J. (2006). The psychology of personality (2 ed.).
Oxford: Blackwell
Hersen, M. (2004). Psychological Assessment in Clinical
Practice: A Pragmatic Guide. New York: Routledge
Enhancing motivation presentation
PSYCH/628
October 27, 2014
Week 2 Team B assignment
1
introduction
Current Issues with Treatment Adherence
Causes of Patient Non-Adherence
Effectiveness of Using Motivational Interviewing to
Increase Adherence
“Motivational interviewing (MI) is a collaborative, goal-
oriented method of communication with particular attention to
the language of change. It is intended to strengthen personal
motivation for and commitment to a change goal by eliciting

8. and exploring an individual’s own arguments for change”
(Miller & Rollnick, 2012). MI is one style of helping others
make changes in their current behaviors. It contrasts with the
more typical directing helping style where the health care
provider tries to install knowledge or motivation with their
patients. “MI is neither a discrete nor entirely new intervention
paradigm but an amalgam of principles and techniques drawn
from existing models of psychotherapy and behavior change
theories” (Resnicow et al, 2002). This presentation will address
the current issues with treatment adherence, causes of patients
non-adherence to prescribed treatment, and the effectiveness of
using motivational interviewing to increase adherences in
patients.
2
Current issues with treatment adherence
Measuring Adherence
Direct Adherence Measures
Indirect Adherence Measures
There has not been an actual degree of adherence by patients on
community-based DOT . Measuring adherence is difficult
because due to the available direct and indirect measures have
limitations. Direct adherence measures, for example tests to
measure drug levels in plasma or urine, cover brief medication
intake periods only. Indirect measures, for example, pill counts
and self-report questionnaires, cover longer periods but assume
rather not prove the patient’s actual medication intake ( World
Health Education, 2011).
3

9. Current issues conti.
Effect Health Care Outcomes
Threat to health and Wellbeing
Financial Burden
Quality health depends on individuals (patients) adherence to
recommended treatment plans. When patients do not adhere to
their health regimen it can pose a huge threat to health,
wellbeing, and causes financial issues. For example
government agencies providing medical supplement when
patients are showing to doctors appointment, taking medical
transportation, and not taking medication which can lead to
frequent emergency room visits, and hospitalization; which in
turn becomes extremely costly. With certain diseases and
conditions, more than 40% of patients have severe risk by
misunderstanding, forgetting, or ignoring healthcare advice
(PMC, US National Library Medicine, 2005).
4
Cause of patient non-adherence
Age
Culture
Social Background
Values

10. Attitudes
Emotions
Some studies have shown that many patients are non-adherence
because they are not able to follow through with their
appointments and or recommendations that are made by a
medical professional. Many individuals tend to “cheat” or not
follow the recommendations whether it is a diet for weight
loss, stopping medications because they think that they feel
better, and also some patients get on prescribed painkillers and
abuse them.
There are many different causes for non-adherence. Some of the
issues to adherence would be dealing with the individuals
behavior and attitude. Depending on the age of the individuals
their attitude and behavior to taking on the advice coming from
the health professional recommendations is one factor. Being
able to follow and adhere to the instructions turns into lack of
adherence because they are refusing to follow the
recommendations to the fullest. Understanding the patients
culture, what their backgrounds foods, behaviors, health
statistics etc. Understanding the patients social background, for
example someone trying to stop drinking doctor/therapist
recommends to change the crowd of coworker you hangout with
for drinks to a twenty three year old who loves going out for
drinks is probably going to have a hard time and if the
coworkers invite her and she decides okay one more time and it
doesn’t happen. Understanding the patients values in life and
understanding the emotions that the individual is going through.
5
Cause of patient non-adherence

11. Relationship amongst Doctor and patient
Family and Friend support
Health education
Another thing that the individuals have a hard time adhering to
these recommendation. Relationship with the doctor and the
patient is highly important. If the patient does not follow the
recommendations then it is probably because they don’t believe
in it and they do not feel as if their provider listens and set up
a plan that takes their personal characteristics. If the provider
rushes them out of the office, doesn’t ask a lot of questions etc
it can affect the patients adherence to their doctors
recommendation. If the patient does not have family and friend
support the patient Is going to be lacking encouragement and
would have a hard time sticking to the recommendations due to
lack of motivation and encouragement to stick to something that
can be difficult.
Understanding the health education and the information that is
out there regarding the different recommendations and
understanding the different illnesses it would add to the non-
adherence because they would not understand the information
that given to them. There maybe lack of understanding and time
where the information is given that can contribute to the
patients commitment and adherence to what the medical
professional has stated.
6
Effectiveness of using Mi
Positive connection between

12. Client and professional
Adequate information
Proper presentation
(Bing, 2014)
Motivational interviewing (MI) varies from person to person,
and professional to professional. Depending on the person and
how he or she want to make a life change with the negative
behavior, the MI may or may not be effective. The
effectiveness depends on the delivery of the needed materials
and presentation by the professional (doctor or psychologist).
If the professional does not give effective data or does not
present information effectively the client may not take the
professional seriously (or may not understand the consequences
of the change). Follow-up interviewing with the client is
important for effective MI (Resnicow, DiIorio, Soet, Borrelli,
Hecht, & Ernst, 2002). Improper client follow-up of the
treatment, or “inadequate length of follow-up” (Resnicow,
DiIorio, Soet, Borrelli, Hecht, & Ernst, 2002, p. 448) may result
in negative results of the MI.
7
Effectiveness of using mi conti-
MI STUDY:
Diet and Physical Activity:
22 overweight women (41% African American) with non-
insulin-dependent diabetes mellitus (Resnicow, DiIorio, Soet,
Borrelli, Hecht, & Ernst, 2002, p. 446) (Smith, et al (1997).
“16 weeks group behavioral weight control and intervention or

13. the same intervention with the addition of three individual MI
sessions” (Resnicow, DiIorio, Soet, Borrelli, Hecht, & Ernst,
2002, p. 446)
The MI intervention was given by experienced psychologists,
MI were given before initial group treatment, mid treatment,
and this included individual MI feedback on glycemic control
(Resnicow, DiIorio, Soet, Borrelli, Hecht, & Ernst, 2002, p.
446) .
At the four month mark, 16 of the 22 women with follow-up
data, showed significant improvement with glycemic control,
more likely to monitor blood glucose, and increased session
attendance with motivational interviewing.
(Bing, 2014)
Positive patient and provider relationships can help with MI and
adherence. A client may be more focused to follow the
instructions of a provider (professional) who listens, helps, and
provides adequate information (a person he or she gets along
with). MI can be helpful with positive outcome in many
situations when presented with “nonjudgmental, empathetic, and
encouraging” (Resnicow, DiIorio, Soet, Borrelli, Hecht, &
Ernst, 2002, p. 444) words from a professional (doctor or
psychologist). “Within MI, information is presented in a more
neutral manner, and the client is asked to do the work of
interpretation” (Resnicow, DiIorio, Soet, Borrelli, Hecht, &
Ernst, 2002, p. 445). The professional should allow the client to
speak of concerns, thoughts, and give time for the client to
process the information (Resnicow, DiIorio, Soet, Borrelli,
Hecht, & Ernst, 2002, p. 445). This can help give positive
feedback for MI and increase adherence.

14. 8
conclusion
Who benefits from Motivational Interviewing:
Psychologist/Psychiatrists
Healthcare providers
Substance abuse and Mental Health professionals
Social workers
Peer and family support staff
Law enforcement
Clinical supervisors
“MI can be thought of as an egalitarian interpersonal
orientation, a client-centered counseling style that manifests
through specific techniques and strategies” (Resnicow et al.,
2002). With its main goal as helping persons maneuver through
ones ambivalence in regards to behavior change. This method is
most effective for those persons that may be in the
precontemplation stage in terms of readiness to change.
Motivational Interviewing attempts to tip the balance of this
ambivalence into the change direction. The motivation comes
from seeing both sides of the story and seeing what the barriers
to change might be. As a person realizes the reasons for his or
her current behavior, he or she can also see why it has been so
difficult to change. This realization takes away some of the
pressure, as there is often guilt associated with unhealthy
behaviors.
9
References
ASU.edu (2014). What is motivational interviewing? Retrieved
from http://cabhp.asu.edu/professional-

15. development/motivational-interviewing
Resnicow, K., Dilorio, C., Soet, J., Borrelli, B., Hecht, J. &
Ernst, D. (2002). Motivational interviewing in health
promotion: It sounds like something is changing. Health
Psychology, 21(4) 444-451 doi:10.1037/0278-6133.21.5.444
Martin, L., Williams, S., Haskard, K. & Dimatteo, M. (2005).
The challenges to patient adherence. Retrieved from
http://www.ncbi.nlm.nih.gove/pubmed/18360559
World Health Organization (2011). Boogaard, J. , Lyimo, R.,
Boeree, M., Kibiki, G. & Aarnoutse, R. Electronic monitoring
of treatment adherence and validation of alternative adherence
measures in tuberculosis patients: A pilot study. Retrieved from
http://www.who.int//bulletin
Clip art: Bing, 2014
10