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