NBC-HWC Skills and Theories

action

"I am" - have made specific, overt modifications in lifestyle in past ~ 6 months

contemplation

"I may" - intend to change within 6 months --> doubt, delay

maintenance

"I still am" - ~6 months to 5 years --> less likely to relapse, growing more confident

preparation

"I will" - action in ~1 month - strong motivators, knows barriers & has thought through possible solutions - pros > cons

scaling questions

"Why are you at a 6 and not a 2?" LIKELY to invoke change talk- the reasons why change IS important

pre-contemplation

"not ready or I won't -3Ds --> demoralized --> don't know how --> defend - coach--> try to create ambivalence (pros/cons, decisional balance tool)

termination

"this is part of who I am" --> don't risk relapse

MI Skills- CAT

**mobilizing change talk** commitment activation taking steps

MI Skills- DARN

**preparatory change talk** desire ability reason need

4As of MI - Acceptance

- absolute worth - accurate empathy - autonomy support - affirmation

Goal Theory by Lock & Latham

- happiness requires having clear-cut goals in life that give us a sense of purpose and direction - emphasizes the relationship between goals and performance - the most effective performance occurs when goals are specific, challenging, used to access performance & linked to feedback - when a client has success with one goal ---> self-efficacy goes up and increases the potential for success in other areas 4Cs + F - clarity - complexity - challenge - commitment - feedback

Distinctions of NVC

- make observations/not evaluations (limit what can be perceived by the 5 senses) - express feelings/ not thoughts - identify needs - make requests

dimensions of trust & rapport

- unconditional positive regard...being completely accepting toward another person, without reservations - show empathy - be a humble role model - 'walk the talk' - slow-down - under-promise and over-deliver - preserve client autonomy - confidentiality is crucial - be authentic

Components of SDT

-> competence -> relatedness -> autonomy **all 3 = intrinsic motivation **

only about ____ of at-risk people are prepared to take action at any given time

20%

double-sided reflection

Acknowledges the sustain talk and integrates it with previously expressed change talk You can use either "but" or "and" and put the sustain talk either first or second and still have a good double-sided reflection

simple reflection

Add little to nothing more than what the client said, they basically repeat or slightly rephrase the content

Self-Actualization Theory / Hierarchy of Needs

Being a living organism was that our deficiency needs took precedent in our motivation for behavior. When deficiency needs are not met we do not function well, and eventually, become ill or die. needs: - self-actualization - esteem - belonging - safety - physiological

self-compassion

Being kind to ourselves when we suffer, fail, or feel inadequate, recognizing that imperfection is part of the human condition, and accepting rather than denying negative feelings about ourselves a method of processing negative emotions and suffering well

Evocative Questions: DARN

Desire-questions involve want, wish, hope Ability-what a person can do or could do Reason-reasons to consider change Need-expresses urgency to change without. Need questions may evoke reasons.

MI Process

EPEP Engaging Focusing Evoking Planning

Summaries

Essentially reflections that pull together several things that a person has told you Can be affirming because they imply, "I remember what you tell me and want to understand how it fits together"

Components of a vision

Grounded (building on current success) Bold (stretching the status quo) Desired (what people truly want) Palpable (as if they were already true) Participatory (involving many stakeholder)

growth mindset

I can learn anything I want to, more likely to choose/embrace a challenge **greater sense of free-will- it's up to you; you have the ability**

MI Skills: OARS

Open-ended questions Affirmations Reflective listening Summaries

12 Roadblocks to communication

Ordering Warning Moralizing Advising Using Logic Criticizing Praising Labeling Analyzing Reassuring Questioning Avoiding

Spirit of MI

PACE Partnership Acceptance (4As) Compassion Evocation

Stages of Change

Pre-contemplation Contemplation Action Maintenance Termination

MI Guiding Principles

RULE Resist the righting reflex Understand Listen Empower

meaning reflection

Reflective listening forms a reasonable guess as to what the original meaning was, and gives voice to this guess in statement form Hearing → Decoding → Reflection → Encoding

SMART Goals

Specific Measurable Attainable Relevant Time-bound

sustain talk

The individuals own arguments for not changing

amplified reflection

Turns up the volume a bit on the client's statement Acknowledges what the person is saying but takes it up a notch in search of the other side of ambivalence

interrupt and redirect

What specifically would be of value for us to focus on right now?

Transtheoretical Model of Change

a behavior change model that describes how, for most people, behavior change occurs gradually as they move through identifiable stages a model that explains how/when new behaviors can be adopted & sustained

self-efficacy theory

a client's perceived ability to successfully achieve a particular task ** describes the circular relationship between belief and action

positive psychology

a domain of psychology focusing not on what ails the human mind but toward the conditions that enable people to flourish, feel engaged, fulfilled & authentically, meaningfully happy *strengths-based*

Non-violent communication (NVC)

a model for expressing empathy, understanding/respecting where someone is coming from; recognizing the emotion for what it is...and appreciate what is has to reach us

values

a person's core goals or standards that provide meaning + direction in life

Motivational Interviewing (MI)

a person-centered counseling style for addressing the common problem of ambivalence about change --> a collaborative conversation style for strengthening a person's own motivation to change --> designed to help people resolve ambivalence and strengthen motivation for change

change is...

a process that occurs overtime, not a singular event

empathy

a respectful understanding of another person's experience, including his or her feelings, needs, and desires. **has transformative power**

Vision Statement

a target that beckons identifies what people want not what they don't want **Connect their vision with consideration for their best experiences, core values, and generative conditions

appreciative inquiry

an approach for motivating change & enhancing well-being that focuses on exploring/amplifying the best in a person or situation key points: * does not focus on weaknesses * highlights strengths to imagine possibilities * uncover/celebrate the best of what is and what could be 5D Cycle of AI * Define * Discover * Dream * Design * Destiny

self-defeating perceptions

any negative views you hold about yourself and the world around you

evocative questions

asking open-ended questions in which change talk is the answer

self-monitoring

being attuned to the way one presents oneself in social situations and adjusting one's performance to create the desired impression

outcome goal

centered on end result

behavioral goal

centered on the actions/behaviors that you take

brainstorming

coming up with as many solutions to a problem as possible in a short period of time with no censoring of ideas "The generation of possibilities without censor"

extrinsic motivation

done because doing so will yield a "reward"

intrinsic motivation

done for pure enjoyment (deeper engagement, learning, persistence)

bottom-lining

getting to the point of what a client says

pity

grieving someone's experience, usually because of circumstantial hardships **not useful in coaching**

fixed mindet

i'm either good at it or i'm not; avoid challenge **deterministic view of the world- how you're born is how you're set**

sympathy

identifying with someone's experience primarily on an emotional level. it is not a prelude to the work of coaching, it is the work of coaching. means, "I feel your pain" or "I share your joy"

patient engagement

interventions designed to increase activation; and patients' resulting behavior, such as obtaining preventative care or engaging in regular exercise

components of self-compassion

kindness, common humanity, mindfulness

4 sources of self-efficacy

mastery experiences, vicarious learning, social or verbal persuasion, physiological and affective states

metaphors

positive actions and outcomes stem from positive energy and emotion; words create worlds; it's all invented!

PERMA

positive emotions engagement relationships meaning achievement

open-ended questions

questions that allow respondents to answer however they want

feeling reflection

repeating back, acknowledging, focusing on the client's expressed emotions Add some meaning or emphasis to what the person has said, making a guess about the unspoken content or what might come next

SDT & SET Theory states

self-efficacy is needed for self-determination

change talk

statements regarding one's desires, abilities, and reasons for change

affirmations

statements that seek and acknowledge the person's strengths and efforts

The Coach Approach

states that coaches look to collaborate & partner; a personalized learning system which enables clients to find their own answers and achieve exceptional results even in the face of challenges **it is not showing up as an expert principles: - ask questions with a beginner's mind - no decision/judgement calls - listen - WAIT - reading, respecting, and working with emotions - not rushing - not being on auto-pilot

Broaden & Build Theory

states that positive emotions widen people's outlook's in ways that, little by little, shape who they are * people's daily experiences of positive emotions compound overtime to build a variety of consequential personal resources and the increase in personal 'resources' predicts an increase in life satisfaction and depressive symptoms

Emotional Intelligence

the ability to recognize our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships principles: used for positive outcomes, an essential part of the empathy that contributes to relational flow

self-efficacy

the belief that you can

self-determination

the belief that you will

negative self-talk

the critical inner voice that focuses on negativity, low self-esteem, and statements of doubt

Reframing

the process of redefining events and experiences from a different point of view

self-determination theory (SDT)

theory of human motivation in which the social context of an action has an effect on the type of motivation existing for the action (intrinsic or extrinsic) - 3 innate psychological needs: -> competence -> relatedness -> autonomy if all 3 are met, people will grow and function optimally

Patient Activation Measure (PAM)

valid, highly reliable, unidimensional scale that reflects a developmental model of activation

patient activation

willingness and ability to manage one's health and healthcare; understanding one's role in the healthcare process and having the knowledge, skills, and confidence to manage one's health and healthcare

establish trust & rapport

willingness to be vulnerable to another based on the confidence that the other is benevolent, honest, open, reliable, and competent