Effective Communication in Counseling: MI Techniques and Traps to Avoid, Quizzes of Public Health

Download Effective Communication in Counseling: MI Techniques and Traps to Avoid and more Quizzes Public Health in PDF only on Docsity! TERM 1 Define Engaging DEFINITION 1 The process of establishing a helpful connection and working relationship. Involves: buying in two-way street partnership TERM 2 5 factors that influence (dis)engagement DEFINITION 2 D.I.P.E.HDesire or goalsImportance - to them, family, parent, etc.PositivityExpectationsHope TERM 3 Traps to avoid when trying to engage clients (6) DEFINITION 3 Assessment: asking too many A's for the sake of collecting infoExpert: the client is the expert on themselves Premature Focus: focusing on initial problem when there could be an underlying problem Labeling: making early assumptions about the type of patient they areBlaming: blaming the patient for the situation they're in Chat: don't linger too long in small talk TERM 4 Provide examples of roadblocks to reflective listening DEFINITION 4 Ordering, commanding Warning, threatening Giving advice, suggestions, providing solutions Persuading with logic, arguing, lecturing Telling what to do Disagreeing, judging, blaming Agreeing, approving Shaming, ridiculing Analyzing Sympathizing, consoling Withdrawing, distracting, humoring, changing subject TERM 5 Importance of non-verbal listening DEFINITION 5 Provide undivided attention and minimizing distractions Making eye contact Considering spatial rrangements Be aware of facial expressions TERM 6 Communication process DEFINITION 6 Encoding: relationship b/w what the speaker says and what the speaker meansHearing: rel b/w what the speaker says and what the listener hears Decoding: rel b/w what the listener hears and what they think the heard words mean Reflection: rel b/w what the speaker means and what the listener thinks the words mean TERM 7 Reflections - Voice Inflection DEFINITION 7 Tone: Voice tone goes up at the end of a question Gently down at the end of a statement Reflective listening: Gently down at the end of the statement TERM 8 4 A's of Listening DEFINITION 8 Absolute WorthAutonomyAffirmationAccurate Empathy = active listening = reflective listening- feeling "with" people TERM 9 Accurate Empathy DEFINITION 9 Feeling WITH people - acceptance for where the person is in the process Sympathy drives disconnection TERM 10 Factors of Reflections DEFINITION 10 Forming reflections Depth of reflection (simple and complex) Overshoot and understanding Length Direction TERM 21 Open-ended Values Interview DEFINITION 21 Tell me what you most care about in life. What matters most to you? How do you hope your life will be different a few years from now? What would you say are some rules you live by? What would you say are you 5 most important values? TERM 22 Integrity DEFINITION 22 "To live with integrity is to behave in a manner that is consistent with and fulfills one's core values."MI can be used to: Help people clarify their core values Help people consider how to live in greater consistency with their core values TERM 23 Exploring Discrepancy DEFINITION 23 Change is motivated by a perceived discrepancy b/w present behavior and important personal goals or values Discrepancy has to do with the importance of this change: not the behavioral gap Helping client "create and amplify" the gap Help client realize why the change is important TERM 24 Define process of focusing DEFINITION 24 The process of becoming more clear about the goals and direction of MI TERM 25 3 sources to derive focus and attention DEFINITION 25 Client Setting Clinician TERM 26 Characteristics of Guiding DEFINITION 26 Assist Collaborate Encourage Inspire Motivate Offer Support TERM 27 Tolerating Uncertainty DEFINITION 27 Hold back from solving client's problems Unhurried and uncluttered state of mind "Slow is fast" Interviewer's felt state of urgency TERM 28 Sharing Control DEFINITION 28 Concern about losing control of consultation Despite uncertainty, clarity can and will emerge Give clients space to explore the direction of the interview TERM 29 Searching for strengths/openings for change DEFINITION 29 A small glimmer of change talk can become the fuel to change Listen for your client's strengths, values, and aspirations for change TERM 30 1. The focus is CLEAR DEFINITION 30 If the direction is clear, no need to spend much time focusing acknowledge client's autonomy and expertise TERM 31 2. There are options to choose from DEFINITION 31 Multiple options to choose from Involve the client in the choice of direction! Agenda mapping Provides relief to clients who are overwhelmed with problems Sequence Starts with structuring and a list of options Move towards an agreed-upon focus Zooming in Summarizing! Ask for client's response TERM 32 When to use agenda mapping with a client DEFINITION 32 Changing direction Activating clients before you meet them Getting "unstuck" Raising a difficult topic Fitting in an assessment Clarifying your roles TERM 33 3. The focus is unclear DEFINITION 33 Orienting: moving from general to specific Solid engagement is critical Utilize OARS Eagle view vs. mouse view Higher level of clinician expertise TERM 34 Ethical Extremes b/w counselor and client DEFINITION 34 Box A - hopefully where you spend most of your time your goals align with your client's Box B - you may have some aspirations that your client does not shareBox C - your hope for your client doesn't align with their goals Client's aspirations might fall out of your expertise You're unwilling to help a client pursue a goal (ethically) Box D - Object is not a goal of yours OR your client's Client might need to come back when they're ready to change TERM 35 4 Ethical Principles DEFINITION 35 Non-maleficence: Do no harm Beneficence: provide benefitAutonomy: respect of human freedom and dignity People are the expert on themselves Justice: Fairness, Equitable access of benefits of treatment and freedom against risk TERM 46 Avoidance-Avoidance Ambivalence DEFINITION 46 Have to choose b/w 2 bad choices Lesser of 2 evils Less easily resolved TERM 47 Double Approach-Avoidance DEFINITION 47 2 very enticing and very negative choices 2 goals, both with positive and negative aspects Most difficult type of ambivalence Most difficult to resolve TERM 48 Preparatory Change Talk (DARN) DEFINITION 48 Desire: I want to lose weightAbility: I would be able to stop at the gym after workReasons: It would help to have more energyNeed: I need to start feeling better TERM 49 Mobilizing Change Talk (CAT) DEFINITION 49 Commitment: I promise to go to the gym weekly Activation: I am prepared to go weekly to the gymTaking Steps: I started going to the gym last week TERM 50 Sustain Talk (DARN) DEFINITION 50 Signals the "con" side of ambivalence (favors status quo)Desire: I like the way I am Ability: I don't think I can afford the gymReasons: I just don't have the time Need: I need to focus on work and not my weight TERM 51 Sustain Talk (CAT) DEFINITION 51 Resolution of ambivalence towards staying the sameCommitment: I'm going to stay the same Activation: I'm not willing to put the time in Taking steps: I went back to working late hours TERM 52 Evoking Change Talk (DARN) DEFINITION 52 Desire: How would you like for things to changeAbility: What do you think you might be able to change?Reasons: Why do you want to get more exercise?Need: What needs to happen for you to exercise more? TERM 53 The Wrong Questions DEFINITION 53 Why haven't you changed? What keeps you doing this? How could you want to go back to...? What were you thinking when you messed up? TERM 54 5 Ways to Evoke Change Talk DEFINITION 54 Asking open-ended questions Using the importance ruler Querying extremes (worst/best case scenario) Looking back vs. looking forward (past vs. future) Exploring goals and values (provides reference points) TERM 55 OARS in response to change talk DEFINITION 55 Open-ended Q's: ask more about it Affirmation recognize and prize what they're saying about change Reflection When you reflect change talk, they're more like to continue Summary Strategic, conscious effort towards change TERM 56 Strategies to respond to change talk DEFINITION 56 Emphasize Autonomy make the obvious, obvious w/o sarcasm Reframe Places a client's statement in a new light or perspective Agree w/ a twist Reflect on a statement of agreement, followed by a reframe Running head start (for tough clients) Gaining access to CT by hearing out motivations for status quo Coming alongside (for an incredibly difficult client) Acknowledges that it might be the right time for change TERM 57 Smoke Signals of Discord DEFINITION 57 Defending Squaring Off Interrupting Disengagement TERM 58 Responding to Discord DEFINITION 58 Apologizing Acknowledges collaborative relationship Affirming helps heal tension ("you are very capable") Shifting Focus to an area that may be more helpful TERM 59 Strengthening confidence DEFINITION 59 Confidence Talk Confidence ruler Giving info and Advice ID and affirm strengths Review past successes Brainstorming Reframing Hypothetical thinking Radical Change TERM 60 Directive Approach to MI DEFINITION 60 Encouraging clients in a certain direction Counselor judges what is desirable TERM 71 The Change Plan outlines the: DEFINITION 71 Behavior to be changed Reminders of the motivational factors Change goals Action plan Doable steps towards change potential barriers Steps to overcome barriers TERM 72 Strengthening Commitment DEFINITION 72 Listen for mobilizing language (CAT) Implementation intentions Evoking intentions Covert commitment Public commitment Social support Self-monitoring TERM 73 MI in supporting persistence DEFINITION 73 Emphasize ability to keep moving forward towards behavior change goal Counselor should avoid "directing" style when difficulty arises TERM 74 Integration of MI w/ other approaches (3) DEFINITION 74 Prelude - offer MI as strategy initially Permeating style - incorporating MI w/ other strategies Fall-back option - MI not be as appropriate in every situation TERM 75 Regulation of nicotine receptors for tobacco users DEFINITION 75 Nicotine binds to brain cells and releases dopamine Brain UP-REGULATES to develop more receptors The brain NEVER FORGETS what it feels like Not a good idea for them to start smoke again TERM 76 Cancer risks for tobacco users DEFINITION 76 Leading cause of death in US 30% of all cancer deaths are related to smoking "When use as directed will cause cancer, death" Cancer levels are similar across brands Second hand smoke is equally detrimental TERM 77 1 cigarette = ? DEFINITION 77 1 mg of nicotine delivered to the blood TERM 78 Nicotine Replacement Therapy (NRT) DEFINITION 78 Seeing a tobacco cessation specialist (counseling) + pharmacotherapy offers most effective outcomes! TERM 79 The Patch DEFINITION 79 No Rx needed Doses: 21, 14, and 7 mg Some stop the patch prematurely TERM 80 Nicotine Gum DEFINITION 80 Plan to use before times of craving Don't swallow juices Works well in combo with the patch TERM 81 Other Pharmacotherapies DEFINITION 81 Smoky Mountain Herbal Dip Wellbutrin - mild anti-depressant TERM 82 Health Literacy DEFINITION 82 "The degree to which individuals have the capacity to obtin, process, and understand basic health info and services needed to make appropriate health decisions." -Healthy People 2010 TERM 83 Healthy People 2020 - Health Literacy Objectives DEFINITION 83 Increase # who report they always understand their HCP Increase # who report their HCP always asked them to repeat instructions back to them Increase # who report the office helped w/ paperwork Improve health literacy persons with inadequate or marginal literacy skills Who do the goals focus on?? Health Care providers TERM 84 Red Flags for Low Literacy DEFINITION 84 Frequently missed appointments Incomplete registration forms Non-compliance w/ meds Unable to name meds or explain what they do Unable to give coherent story Ask fewer questions Lack of follow-through on tests/referrals