MI Terms & Study Guide: Motivational Interviewing Concepts and Techniques, Exams of Nursing

Download MI Terms & Study Guide: Motivational Interviewing Concepts and Techniques and more Exams Nursing in PDF only on Docsity! MI Terms & Study Guide NBHWC Exam Q&As 4 Central components of MI - Acceptance, compassion, evocation, partnership Activation language - mobilizing change talk towards action, falls short of commitment language. ie. Ready, willing, considering Acceptance - Coach communicates self-worth, accurate empathy, affirmation, and autonomy support. Agenda Mapping - short focusing metaconversation where you step back and client chooses a direction from several options. Agreement with a twist - A reflection, affirmation, or accord followed by a reframe Ambivalence - Simultaneous presence of competing motivations for and against change. Amplified Reflection - Coach reflects with greater intensity than client expressed. A form of response to sustain talk or discord. Assessment Trap - Error of beginning consultation with expert info. gathering at cost of not listening to client's concerns. Autonomy Support - 1 of 4 aspects of acceptance as a component of MI. Interviewer accepts and confirms client's irrevocable right to self- determination and choice. Blaming Trap - The clinical error of focusing on blame or fault-finding rather than change CAT - Acronym for 3 subtypes of client mobilizing change talk: Commitment, Activation, Taking Steps Change Talk - Any client speech that favors movement toward a particular change goal. Chat trap - the clinical error of engaging in excessive small talk and informal chat that does not further the processes of engaging, focusing, evoking, and planning. Coming Alongside - A response to persistent sustain talk or discord in which the interviewer accepts and reflects the client's theme. Commitment Language - Client mobilizing change talk that reflects intention or disposition to carry out change. Verbs: Will, do, going to. Compassion - One of the 4 central components of MI. Coach acts benevolently giving priority to client needs and welfare. Complex Reflection - An interviewer reflection that adds additional or different meaning beyond what the client has just said; a guess as to what the client may have meant. Confidence Talk - Change talk that particularly bespeaks ability to change. Continuing the paragraph - A method of reflective listening in which the counselor offers what might be the next (as yet unspoken) sentence in the client's paragraph. DARN - An acronym for four subtypes of client preparatory change talk: desire, ability, reason, and need Decisional Balance - A choice-focused technique that can be used when counseling with neutrality, devoting equal exploration to the pros and cons of change or of a specific plan. Directing - A natural communication style that involves telling, leading, providing advice, information or instruction. Discord - Dissonance in the working relationship. Sustain talk does not itself constitute discord. Examples are arguing, interrupting, discounting, or ignoring. Double-sided reflection - Reflection that includes both client sustain talk and change talk, usually with the conjunction "and." Elicit-provide-elicit - Info. exchange process that begins and ends with exploring the client's own experience to frame whatever information is being provided to the client. Empathy - The coach communicates accurate understanding of the client's perspectives and experiences, most commonly manifested as reflections. Engaging - The 1st of 4 fundamental processes in MI. Process of establishing a mutually trusting and respectful helping relationship. Equipoise - The coach's decision to counsel with neutrality in a way that consciously avoids guiding a client toward one particular choice or change and instead explores the available options equally. Evocation - 1 of 4 central components of the underlying spirit of MI by which the interviewer elicits the client's own perspectives and motivation. Evocative Questions - Strategic OE questions the natural answer to which is change talk. Evoking - The third of the 4 fundamental processes of MI. Involves eliciting the person's own motivation for a particular change. Stages of Change - Within the transtheoretical model of change, a sequence of steps through which people pass in the change process: precontemplation, contemplation, preparation, action, and maintenance. Sustain Talk - Client speech that favors statue quo rather than movement toward a change goal. Transitional Summary - A special form of reflection to wrap up a task or session by pulling together what seems important and signal a shift to something new. Transtheoretical Model - Complex model of change by Prochaska and DiClemente. Describes stages of change. Undershooting - A reflection that diminishes or understated the intensity of the content or emotion expressed by a client. Self-determination - The end game of coaching. Autonomy - self regulating behavior, rather than controlled. Competence - feel confident and effective. Related - having social support and connection that are autonomy supporting. (quality of relationships and the perception that significant others are invested and understand the person. Autonomy - coach encourages client to initiate behaviors based on client's own values and desires, not those of an outside source/influence. Neuroplasticity - the brain's ability to grow, adapt and change. Neurons forge new connections, creating new pathways and networks in the brain. Robust neural networks require months or a year or more of client neuroplasticity. Being skills coach - mindfulness, empathy, authenticity, affirmation, courage, zest, calm, playfulness, and warmth. Help coaches build and sustain a close relationship and partnership with clients. Unconditional Positive Regard - Being completely accepting toward another person, without reservations. Essential for establishing rapport and trust. Empathy - The feeling that you understand and share another person's experiences and emotions, feelings. Usually with a reflection. Understands and appreciates the experience. Acknolwledges the person's right to feel and experience the situation however he or she chooses without needing pity, sadness or disappointment from the coach. Helps build trust and rapport. Sympathy - Person identifies with another's experience. HIPAA - Health Insurance Portability and Accountability Act - protects the privacy and security of health information. positive reframing - framing a client's experience in positive terms, making it easier to engage in brainstorming, action planning, and forward movement. Flow Zone - Speed of coaching that is comfortable yet challenging, and enables clients to achieve their goals. Being skills - Coaches use these to build growth-promoting relationships with clients. Ie. mindfulness, empathy, warmth, affirmation, calm, zest, playfulness, courage and authenticity. (qualities that can be chosen) An empathetic coach..... - understands and connects wit the clients without sharing the. experiences, getting hooked, or being hijacked by emotions emerging from within or from the client. The core relational dynamic that leads to movement and growth in coaching. Autonomous Motivation - People control their own choices and act in ways they find interesting/important. 4 strategies of MI - Engaging, focusing, evoking, planning Rolling with resistance - Instead of pushing back with clients, coaches should avoid the 'righting reflex' and roll with the client's ideas instead of trying to change them. (could cause more resistance and for clients to move backwards) Righting reflex - Coaches should avoid this. When a coach confronts resistance directly by arguing, diagnosing, fixing or anything that fosters resistance. Decisional balance - Developing discrepancy. evaluates the pros and cons of change. Social Cognitive Theory - Beh. is determined by 3 factors which interact. 1. Personal factors (what one believes and how one feels about what one can do) 2.Environmental factors - support networks and role models) 3.Behavioral Factors - what one experiences and accomplishes. Flow - When the challenge of the task and the skills to accomplish it are high and close to equal. Wheel of life - focuses on self-care and balance. When are assessments given? - At the beginning of a coaching relationship b/c they inform coaches and help clients gain self-awareness, insights, and a sense of their priorities for coaching. Six Dimensions of Wellness assessment - Occupational, physical, social, intellectual, spiritual, emotional. First Sesson - Confirm expectations, review assessments, gather info, create vision and design goals. (3 month and 1st several week goals) SMART - Specific, measurable, action-based, realistic, time-bound Behavioral goals - Must be tailored to a person's stage of change. Generative Moment - The peak of a coaching session. could be high energy from being ready to do something new, or a peaceful calm of a new way of thinking. Happens when clients are aroused by the path of change and growth. Moments that inspire clients to generate new ideas, perspectives, or insights, uncover capacities, which can lead to bold actions that might alter a client's future. Relational Flow - Another way to define generative moments - when coaches and clients perceive themselves as being in sync and engaged in generative, interdependent, collaborative dialogue. An intuitive dance between coaches and clients when they enter a zone where they are fully challenged at a high level of skill and awareness. Social Cognitive Theory - Human behavior is determined by 3 factors which interact with each other. 1. Personal (what someone believes) 2. environmental (support networks and role models) 3. behavioral (what one experiences and accomplishes). Principles of MI (4) - Showing empathy, identify discrepancies, roll with resistance, assist self-efficacy. 3 purposes of goal setting - Way to direct client's attention, positively affects persistence, goals are energizing 5 principles of appreciative inquiry - Define Discover Dream Desig n Destin y Which session is best to establish SMART goals - Second Session Diastolic BP - Lower number tells pressure in the arteries when heart is at rest between beats. Systolic BP - Top number. Tells pressure in arteries when heart beats. At Risk BP 2003 - 120-139/80-89 At Risk BP 2017 - 120-129/-80 Physcial determinants Healthy People - Natural environments buildings, sidewalks, roads, worksites, schools, rec centers housing & community exposure to toxins physical barriers for people with disabilities aesthetic - good lighting, tress etc. My Plate - Replaced food pyramid. Lean proteins. 30% grains, 40% vegetables, 10% fruit, 20% protein, small dairy Harvard Healthy Eating Plan - Plant based diet. Limits potatoes/white rice. DASH diet - Lowers sodium and BP. Sodium less than 2300mg/day. American Heart Assoc. recommends sodium less than 1500mg/day. Ethics of NBHWC Conflict of Interest - Where coach has a personal or private interest which could influence the objective as a coach and his/her professional role. Rolling with Resistance (Motivational Interviewing) - Roll with client don't try to change them. HIPAA Privacy Rule - Protects medical records and personal info. applies to health care professionals. HIPAA acronym - Health Insurance Portability and Accountability Act HIPAA Security Rule - -protects electronic personal health info Scope of Practice Rule - can only give info/help if licensed in other area. Minimun Necessary Rule - Minimum necessary to satisfy purpose honoring autonomy - Acknowledging that clients have the decision-making capacity and right to make their own decisions. Process Outcome - Measures progress results and determines when intended outcomes were achieved. Biometric Outcome - BMI, cholesterol, blood glucose, BP and nicotene Double-sided reflection - Shows both sides of ambivalence - you feel 2 ways about this. Amplified Reflection - Extreme or exaggerated way of reflecting in a matter of fact manner with empathy Ambivalence - Mixed feelings or contradictory ideas. Evoking Dissonance - Conflicting beliefs. ie. Smokers know that smoking is bad for health. Being skills - Mindfulness Empathy Warmth Affirmation Calm Zest Playfulness Courage + authenticity Most significant change is between which stages? - Precontemplation to contemplation Pre-contemplation - No intention of changing behavior. I won't/can't within the next 6 months. Contemplation - I may in the next 6 months. Preparation - I will in the next month. Action - I'm doing it now. Maintenance - I've been doing it for at least 6 months. Rulers used in MI - Readiness and Confidence Self-determination - Building around supporting autonomy, competence and social support connections. Decisional balance - Pros and cons of making or not making a change. Explores ambivalence. Rulers used here. Change Talk - Helps client increase motivation and progress toward goal. MI used. Bottom lining - Skill of berevity and succinctness on part of coach and client. Having client get to the essence of their communication rather than engaging in long descriptive stories. Willingness/Importance Ruler - How imp. to change. Conf. ruler - How confident to change. Readiness ruler - How ready to change Social Cognitive - Influence of others' experinece, the actions of others, environmental factors on individual health behaviors. Observational learning - watching and observing outcomes of others performing desired behavior. Non-violent communication 3 focuses - 1. Self-empathy 2.Receiving empathetically 3.Expressing honestly 3 parts of NVC - Express feelings not thoughts Make requests, not demands Identify needs not strategies Growth mindset - The belief that abilities can be developed through commitment and hard work Sustain talk - Desire to stay the same discord - disagreement Elicit-Provoke-Elicit - Find out what client already knows, fill in gaps and gives knowledge, and then explore how will fit into client's life. Validates client's knowledge and allows time to address barriers. Reframing - Changing the meaning of an event, different way of looking at situation. 6 dimensions of wellness - emotional, occupational, physical, social, intellectual, spiritual Doubt & Delay - Drs. Prochaska - Contemplation stage Most appropriate time to assess readiness to change - At the beginning of a session Positive Psychology must include (Seligman) - 1. Pleasant life 2.Engaged life 3.Meaningful life 3 Domains of Social Intelligence - 1. Self-Awareness 2.Self-Management 3.Social Awareness Flow - Skill and Challenge are matched Goal Setting Theory - a theory that says that specific and difficult goals, with feedback, lead to higher performance 1.Directed Attention