an evidence-based approach to encouraging healthy behaviors john friend, ph.d

An Evidence-based Approach to Encouraging Healthy Behaviors

John Friend, Ph.D.

• Acceptance & Commitment Therapy (ACT)

• Understand patterns of behavior through ACT point of view using “The Matrix.”

• Motivational Interviewing (MI)• Become familiar with the fundamental spirit and

principles of MI.• Become familiar with the four basic skills of MI.

Objectives

What isAcceptance & Commitment Therapy (ACT)?

Psychological Flexibility

The ability to notice what is going on inside and outside of us while we move through the world.

PsychologicalFlexibility

5 Senses Experiencing

Mental Experiencing

TowardAway

Behaviors:that move you toward

the things that are important to you.

Values:Who or what

is important to you?

Behaviors:that you engage in after

unwanted internal experiencesappear

Internal Experiences:Unwanted thoughts, feelings, emotions, urges, memories,

and sensations.

MeNoticing

How do we effectively have a conversation about behavioral change?

Stages of Change Model

A continuum of conversation styles

Directing Guiding Following

The Righting Reflex

Normal Human Reactions to the Righting Reflex

Resistant Disrespected Uncomfortable

Not respected Arguing Disengaged

Not understood Discounting Disliking

Not heard Defensive Inattentive

Angry Oppositional Passive

Ashamed Denying Avoid/Leave

Ambivalence

Making people feel bad doesn’t help them to change

• a collaborative conversation style for strengthening a person’s own motivation and commitment to change.

What is Motivational Interviewing?

The Underlying Spirit of MI

AcceptanceCompassion

The Basic Principles of Motivational Interviewing

Discuss the Discrepancy

Roll with Resistance

Support Self-Efficacy

Develop a DiscrepancyThe Basic Principles of Motivational Interviewing

Disadvantages Advantages

No Change

Change

Roll with ResistanceThe Basic Principles of Motivational Interviewing

Support Self EfficacyThe Basic Principles of Motivational Interviewing

Open-ended Questions

Affirmations

Reflective Listening

Summaries

O.A.R.S.The Core Interviewing Skills of Motivational Interviewing

Open-ended QuestionsThe Core Interviewing Skills of Motivational Interviewing

AffirmationsThe Core Interviewing Skills of Motivational Interviewing

Reflective ListeningThe Core Interviewing Skills of Motivational Interviewing

The Process of Communication(what you think the person means may not be what he or she really

means)

The words the The words the

speaker says listener hears

What the speaker What the listener really means thinks the speaker means

Three Places a Communication Can go Wrong

The words the The words the speaker says listener hears

What the speaker What the listener really means thinks the speaker means

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31

Speaker Listener

The Function of Reflection

The words the The words speaker says listener hears

What the speaker What the listener really means thinks the speaker means

2

31

Speaker Listener

Reflection

SummariesThe Core Interviewing Skills of Motivational Interviewing

Why do people change?

On a scale of 1 to 10……..

• How important is it to you to make this change? (1= Not confident at all; 10 = Extremely confident)

• How confident are you that you can make this change? (1= Not confident at all; 10 = Extremely confident)

• How ready are you to make this change? (1= Not confident at all; 10 = Extremely confident)

Practice : A Taste of MI

• Something about yourself that you– want to change– need to change– should change– have been thinking about changing

But you haven’t changed yet

i.e. – something you’re ambivalent about

Speaker: same topic

• Listen carefully with a goal of understanding the dilemma; Give no advice

• Ask these open questions and listen:– Why would you want to make this change?– How might you go about it, in order to succeed?– What are the three best reasons for you to do it?– On a scale from 0 to 10, how important would you say that it is for

you to make this change?• Follow-up: And why are you at __ and not zero?

• Give a short summary/reflection of the speaker’s motivations for change

• Then ask: “So what do you think you’ll do?” and just listen with interest

Listener

Questions?