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