ENS 434 test 2
process of investigation
identify their readienss to change, understand their core values and then complete a decisional balance worksheet to understand their mindset or attitude towards change
Labeling
identifying with negative traits behaviors.
the strongest behavioral predictors in TPB are
intention and perceived control
TPB limitiation
intention does not necessarily imply behavioral action
attitudes towards behavior, subjective norms and perceived control of actions collectively influence
intention(s) which in turn governs behaviors (actions)
latent pain
is defined as the resistance one demonstrates where they believe that the behavior cannot be shaped or that the challenge cannot be resolved.
self efficacy
is defined as the strength of the belief one has in their own capabilities to organize and execute the actions required to attain a given outcome
The Hot system
is impulsive and emotional; responsible for quick, reflexive responses to certain triggers like eating without consideration of consequences.
The Cool system
is the cognitive; reflective, thinking system incorporating knowledge about sensations, feelings, actions and goals and reminds us why we should delay gratification
normative social influence
making decisions in effort to belong to a group, proactive
precontemplation stage
no intention of taking action in the near future(6 months),uninformed on behavioral consequences, avoidance and resistance
4 components to health belief model
perceived severity, perceived benefits, perceived barriers, percieved susceptibility
5 levels of Maslow's Hierarchy of Needs
physiological, safety, love and belonging, self-esteem, self-actualization
TTM stages of change
precontemplation, contemplation, preparation, action, maintenance,termination
instrumental social influence
providing practical resources (ie data/statistics)
what has a more immediate impact importance or relevance
relevance
rule accronym
resist righting reflex,understand patients intentions and motivations,listen with empathy,empower change
informative social influence
seeking information from other sources to make appropriate decisions, retroactive
willpower is viewed as a
system that becomes depleted or exhausted like muscles do after repetitive work
relevance
the combination of what is important and what appeals to them in the 'now.' For example, telling a young lady that resistance training builds bone density to starve off osteoporosis is important, but it is not relevant. Informing her that resistance training builds muscle to burn more calories and drop a dress size is relevant.
Conscious Competence
the individual is actively learning how to go about change and experiencing success. A coach provides immeasurable value by providing the KSAs that empower the change process.
Decisional Balance
the process we all use to evaluate the benefits (or gains) associated with changing behavior against the risks (or losses) of making that change
To create discrepancy, practitioners must first identify
the type of ambivalence that the person might be experiencing
4 stages of competence model
unconscious incompetence,Conscious Incompetence, conscious competence,unconscious competence
Emotional Reasoning
where feelings influence thinking (e.g., feeling a fool - therefore I am an fool) - what does a fool feel like
a hot-cool system is used to explain
why willpower sometimes succeeds, yet sometimes fails
From a scientific perspective, psychological scientists define willpower as:
(1) Ability to delay gratification/short-term temptations to meet long-term goals. (2) Capacity to override unwanted thoughts, feelings or impulses. (3) Ability to employ the 'cool' cognitive system v. the 'hot' emotional system. (4) Conscious, effortful regulation of self by thyself. (5) Limited resource capable of being depleted (i.e., like a muscle).
Other ideas to preserve willpower include
(1) Avoiding temptation because this helps maintain self-control (i.e., 'out of sight-out of mind.') (2) Making willpower less vulnerable to depletion. Like training a muscle (i.e., building endurance), practice at exercising self-control on a regular basis strengthens willpower. (3) 'Implementation Intention.' This takes the form of 'if-then' statements that help in situations that could likely foil resolve (e.g., if someone offers me a drink, I will take a soda). In other words, proactive planning allows us to make decisions in the moment without relying upon willpower to avoid temptation. Keep in mind, we always maintain a small willpower reservoir for special circumstances, but using this when willpower is depleted requires high levels of motivation and is only effective to a point. (4) Depletion in one area reduces willpower in other spheres, therefore it is best to focus upon one single goal at a time as opposed to tackling many simultaneously (this will be examined later in the BJ Fogg Model). A formed habit relies less upon willpower to maintain the desired behavior.
For sustainable change to occur, the person undergoing the change process needs to experience several events that include:
(1) Changing current negative emotions and cognitive thoughts. (2) Seeing the reasons for change as both important (long-term) and relevant ((immediate). (3) Possessing some level of motivation and willpower to maintain positive attitudes. (4) Believing they have the ability to make and sustain change (i.e., self-efficacy). (5) Experiencing positive outcomes (overall impressions).
To help individuals attain those changes, professionals need to fulfill several objectives which include:
(1) Driving positive cognitive and emotional attitudes. (2) Demonstrating both importance and relevance to promote and sustain the motivation for change. (3) Understanding the causes or reasons for any ambivalence or resistance to change. (4) Amplifying any current level(s) of discontent or discomfort (i.e., dissatisfaction) with the existing non-desirable behavior(s). (5) Promoting ability (self-efficacy) and confidence. (6) Creating positive experiences whenever possible. (7) Understanding how to use motivation to help foster sustainable reasons for adherence.
founding principles of motivational interviewing
(1) Expressing empathy - using reflective listening to accept and understand what the individuals says or believes. (2) Developing discrepancy - to amplify differences, discomfort or discontent between the existing and the desired behaviors which serves as a source of motivation. to create and amplify differences (positive, negative) between current and desired ideals (3) Avoid being argumentative and confrontational throughout the process. (4) While striving to help the individual overcome any ambivalence to the change process, the practitioner needs to be capable of recognizing and adjusting to any encountered resistance rather than trying to oppose it (i.e., avoid pressuring or coercing change which can trigger psychological reactance). Don't oppose, but respect resistance and use this to invite opinions and self-exploration from the problems they identify. (5) Supporting or building self-efficacy and optimism which enhance the individual's belief in their own ability to change. Instill within them the idea or belief that that there is no right or wrong way, just their way, and draw upon past successes as a driver of self-efficacy.
TPB specifies that 4 psychological variables may influence behavior:
(1) Intention (willingness)* - whether to engage or not engage in a particular behavior. (2) Attitude - a positive or negative evaluation of performing a behavior. (3) Subjective norm - the perceived social pressures felt from doing or not doing a behavior. (4) Perceived control* - the ease or difficulty of performing a behavior.
Signals that an individual is ready to commit to making changes include
(1) Offering decreased resistance - seem open to ideas and suggestions. (2) Decreased discussion about the problem, how they are victims, or how the problem is overwhelming or bigger than them. (3) Resolved (more peaceful, relaxed, calm, and settled over the problem). (4) Change talk - engage in discussion about the change process and outcomes. (5) Questions about changes - clarifying expectations, and seeking solutions to bring about change. (6) Envisioning and experimenting (i.e., trying ideas).
EAP three components
(1) Social connection - having a well-established support system or ecosystem to lean on during times when temptation appears overwhelming. (2) Reflection with gratitude (thinking to what you are thankful for) - this generates more positive attitudes and optimism which is important because positive moods can mitigate willpower depletion (as illustrated below). (3) Social engagement - shifting your focus to another person (i.e., a distraction), but be certain that the focus is on something other than your temptation. For example, if late night snacking is the temptation, shifting to help another person is great, but it should not be about their late night snacking.
TTM model is comprised of several constructs
(a) the individual stages of change, (b) the processes of change, (c) decisional balance, (d) self-efficacy and (e) temptations
True / False: The idea of participating in a behavior that distracts you from negative thoughts defines schema maintenance (select one word answer only please).
False - This is a schema compensation.
limitations to the social influence theory
-Social Bias: Possessing a prejudicial attitude towards an individual or group of people (e.g., attitude that older adults should be less active, that heavier people are less active) which distorts the potentially positive influence of this model. -Peer Pressure: A social influence occurring among members of a similar age or peer group - that makes a person/people adopt certain behaviors, values, and attitudes (e.g., teenagers using social media to be cool, which TV shows to watch).
contemplation stage
-aware of consequences and thinking about problem, usually with a 6 month plan to change -ambivalent lack KSA's, low self efficacy
strategies to use with action stage
-connect process goals to core values desires/goals -adopt a systematic approach to change, avoid all or nothing mindset -ensure self efficacy continues building through measurable success -provide appropriate instruction and feedback -evaluate programs -establish and examine support systems,build connectivity -re iterate long term benefits of change
strategies to use with maintenance stage
-connect to new challenges, new desirable behaviors or new motivators -provide options, variety -continued self management and evaluation of support systems
limitations to health belief model
-habitual health related behaviors may be independent of conscious health related decision making processes(ie buckling seat belt) -social and environmental factors may be beyond individual control that may present barriers (ie weather) -participation may be related for reasons other than health(ie aesthetic)
action stage
-have made specific modifications to lifestyle and behavior within past 6 months, observed by behavioral action, may include some but not all desirable changes -less than 6 months consistent participation, changing perceptions -high risk of lapse/relapse
strategies to use for preparers
-help establish structured plan, vision and documented goals -consider structured supportive programs, recruit into action oritented programs (weightloss programs) -validate possessions of skill sets, assist with simple coping strategies -attain small victories, connect with positive experiences and outcomes -explore support systems
maintenance stage
-individuals make specific modifications to lifestyle and behavior and working to prevent relapse -empowered and self sufficient with good coping ability exert more self control with greater self efficacy growing increasingly more confident -generally occurs after 6 months but may take up to 5 years to attain level -potential boredom/burn out
preparation stage
-intention to take action in immediate future (next month) with some steps towards initation -includes sporadic particpation within last year -have framework of a plan of action but not structured -recognize barriers but limited capacity to cope/overcome -stage is often skipped (contemplation to action) due to lack of research and commitment to change
termination stage
-once a behavior has been maintained for 5 years, fear of relapse is eliminated -ultimate goal
strategies to use with precontemplators
-show empathy be non judgemental -validate lack of readiness to change -decrease any emotional responses connected to change
strategies to use with contemplators
-show empathy be non judgemental -validate lack of readiness to change -focus on building self efficacy and motivation -identify new positive outcomes and show how they are tied to core values, encourage continued evaluation of risks vs benefits using imagery -offer invitations to try something
True / False: A social influence whereby useful resources like tools and maps are made available to you is an example of informational support (select one word answer only please).
False - This is an example of instrumental support.
Which form of ambivalence is Mary experiencing if she wants to drop 10 pounds so that she will feel healthier and sexier, but hates the notion of having to go on a diet or exercise to attain that weight loss?
Approach-avoidance conflict,C - Her ambivalence is focused upon the desired behavior where she has a love-hate relationship with it.
Which Motivational Interviewing principle focuses upon helping an individual identify more reasons for hating their existing behavior(s) while simultaneously reducing any resistance towards the desired behavior?
Developing discrepancy,Creating greater differences between the desired and undesired behaviors
Which of the following irrational thoughts defines the action where you might downplay the significance of your accomplishment - for example earning a B on an exam where the class average was a C-
Discounting,Discounting is the action of diminishing your positive accomplishments.
In which stage of Maslow's Hierarchy does the need to be valued and respected exist?
Esteem
True / False: One should emphasize the removal of a bad habit like smoking, rather than implementing a healthy habit to replace it (e.g., chewing gum when the desire to smoke arises). Select one word answer only please).
False - Emphasize desirable behaviors that will supplant the undesirable actions.
True / False: To help people overcome their ambivalence or perhaps resistance, sometimes the practitioner needs to adopt a more confrontational approach to change the individual's mindset (select one word answer only please).
False - Practitioners should never be argumentative or confrontational when working with individuals demonstrating resistance - this may drive greater levels of resistance.
True / False: If you believe an individual is ready to commit to a behavioral change process, you should then proceed to conducting a health risk assessment before completing the decisional balance worksheet (select one word answer only please).
False - Some behavioral information should always precede physiological assessments to first understand the person's mindset and readiness to change behavior.
True / False: It is estimated that at any given time, only 40% of individuals are actually ready to initiate some action-orientated behavioral change process (select one word answer only please).
False - That statistic is < 20%.
True / False: A person who is defensive and continues to talk about the problem rather than exploring solutions is most likely in contemplation stage of change (select one word answer only please).
False - This person is exhibiting latent pain and most likely in the pre-contemplation stage of change.
True / False: According to Walter Mishel, the 'hot' system of willpower is reflective and incorporates an understanding of sensations and feelings (select one word answer only please.)
False - this defines the cool system.
what is preferred Implementing new (desirable) behaviors or removing undesirable behaviors
Implementing new (desirable) behaviors is favored over removing undesirable behaviors as it avoids the process of formulating negative associations with performed actions or behaviors.
Motivational Interviewing (MI)
Motivational Interviewing (MI) is a collaborative (client- or patient-centered) conversational style of coaching that aims to help individuals overcome their own ambivalence and resistance to change.
health belief model
People's beliefs about their own health problems, the perceived benefits of taking action, and any perceived barriers to taking action can explain participation or a lack of participation in healthy behavior, perceived susceptibility to a health problem or the perceived severity of the consequence of this health problem both contribute to our overall perception of the threat. Then it is the perceived barriers to taking action as well as the perceived benefits derived from such action that determine the likelihood of actually taking action and participating in that healthy behavior
Which stage reflects an individual who is not aware of their problem and most likely not even thinking about change?
Pre-contemplation stage,Pre-contemplators are unaware or underaware of the problem
Which stage would define the sporadic behavior of a person who does not perform a desirable behavior consistently?
Preparation,Refer to illustrations presented above.
Which of the following is NOT needed for sustainable behavioral change?
Rewards, This may drive short-term compliance, but not a sustainable, long-term behavior.
Which process of change reflects the action of an individual who examines their own actions, then imagines how better things would be if they engaged in healthier behaviors?
Self-evaluation
Behavioral Processes (BP)
Set of processes through which relevant information for change is gathered on a basis of physical or environmental events
Which construct of this theory explains the pressure one might feel from friends and relatives for engaging or not engaging in a particular behavior?
Subjective norm,The social pressure one might feel from family and friends is subjective norm.
the stages of competence model says that
Successful behavioral change will always first require some kind of awareness of the existing (undesirable) behavior as this is needed to drive any intention for change
True / False: Willpower can be defined as the capacity to override unwanted thoughts, feelings or impulses (select one word answer only please).
True - Refer to bullet #2 above.
True / False: Medical issues or a lack of support from family are good examples of external barriers that may lead to lapses (select one word answer only please).
True - Refer to the content provided table.
True / False: Providing unsolicited advice, suggestions or even premature solutions, or interpreting problems based off perception should be avoided when expressing empathy (select one word answer only please).
True - Refer to the table above.
Unconscious Incompetence
The individual does not understand nor recognize the deficits or problems, or may deny any need for change. However, once they become aware, the hope is that they see value in making a change (i.e., intention)
Unconscious Competence
The individual has developed autonomy in performing the desirable behavior (i.e., formed habit). In this stage complacency can occur, so be mindful and carefu
Conscious Incompetence
The individual recognizes a deficit or problem, and identifies a need for change, but has no effective means for accomplishing this change (i.e., no knowledge, skills or abilities - KSAs). This stage is often marked by trial-and-error efforts, perhaps relying upon previous experiences or what is read or heard. Inevitably this leads to frustration over the failed attempts, but hopefully not to a point of completely quitting.
Cognitive Processes (CP)
The set of processes through which relevant information for change is gathered on a basis of personal experience
Theory of Planned Behavior (TPB)
This theory focuses upon the link between attitudes and behaviors and assumes that individuals are capable of forethought and making rationale decisions about their actions (behaviors) while also considering the consequences. But, the belief is that they have perceived control over their intentions and their actions. This theory specifies that 4 psychological variables may influence behavio
Negative Thinking
focusing upon negative aspects of a behavior to be decreased and not emphasizing positive thoughts.
True / False: A person who recognizes that they need to make a change and tries a series of unsuccessful diets to no success appears to be consciously incompetent (select one word answer only).
True - The person lacks the KSAs, but is conscious of a need to change.
Rational emotional Behavior
a cognitive behavioral method developed by Albert Ellis that helps shift people's cognitions (i.e., how people think - aka cognitive restructuring) to decrease those irrational beliefs that sometimes plague them. The outcomes or consequences are improved moods and actions. According to Ellis, we experience positive, neutral and negative activating events (A), that we interpret (our thoughts (B)), which subsequently lead to feelings and actions (consequences - C)
MRI scans of their brains showed more anterior cingulate cortex activity in those with
higher self-control when faced with temptations.
Transtheoretical Model of Change (TTM) or Stages of Change Model is
a model stating that behavioral change requires readiness and it assumes that change unfolds through a series of stages, incorporating different change processes that people utilize at different stages. It also postulates that people progress through these stages of change at varying rates. Change equals a progression or a regression though the individual's stages (i.e., in both directions - progression or relapse).
Resistance differs from ambivalence
ambivalence is a willingness to change accompanied by some hesitancy, resistance is a belief that the behavior or the challenge cannot be resolved, therefore the person is not actively thinking about change
Willpower governs our decision-making process within the
anterior cingulate cortex in the brain;
schema
any persistent irrational belief that resists change even though that belief makes the individual unhappy. Irrational thoughts sustain a schema
Maslow's Hierarchy of Needs
behavior is driven in part, by a need to fulfill specific essentials and desires
__________should precede any and all__________assesments
behavioral components (e.g., thoughts, emotions) should precede any and all physiological assessments
Dichotomous Reasoning
believing in only two (all-or-nothing) sides to an issue (good/bad, right/wrong) and nothing in between
Action-oriented strategies are only effective or appropriate for those
committed or prepared for change
practioners will offer greatest value to people in
contemplation and preparation stages
Over-generalization
creating general rules/assumptions from single incidents/isolated behaviors.
loss of willpower is attributed to
decreased activity within the anterior cingulate cortex, our cognitive center, which lowers our drive.
to help manage willpower
develop an Emergency Action Plan (EAP)
Discounting
diminishing the significance of positive accomplishments
Cognitive Deficiency
disregarding important life situations that might impact behavioral responses (e.g., APT = I'm sick, but angry because I played so poorly)
Arbitrary Inferences
drawing conclusions when evidence fails to support conclusion or is lacking
when we demonstrate willpower, our cool system
drives the cognitive process and dominates whereas when willpower lacks, the hot system drives the impulse, and the emotional process dominates.
processes of change
epresent the driving forces associated with changing behavior and are divided into two categories; cognitive processes (CP) and behavioral processes (BP)
Catastrophizing
exaggerating problems/events to make them seem hopeless/impossible to change
Over-socialization
failing to recognize and challenge arbitrariness of certain cultural ideals (e.g., APT = I need to look thin to win contest; T = judges might favor thin bodies, but too thin is ineffective).