Open-ended quesions
questions asked where the response has more than a yes or no. usually start with, what, how, tell me, why. asked after the reflection
Affrimations
-Builds rapport
-Demonstrates understanding
-Demonstrates appreciation
-Builds client confidence
like complements, but without judgement.
EX: Thanks for coming in today.
-That's a great suggestion.
-You clearly want to do as much as you can for your healt
What are Reflections?
-Repeat a few words that sound key
-Reflect back meaning/values/feeling
-Recommended ratio of reflective listening to questions: 2:1
Summary
-Reinforces what has been said
-Shows that you are listening
-Prepares the way for further exploration or for next steps
-Often done several times during an appointment
-Allows client to hear change talk again (pick the flowers)
Why Reflect?
-Clarify meaning
-Express interest
-Demonstrates empathy
-Demonstrates understanding of clients
-The counselor can express acceptance
Types of reflections
-Simple and complex
-stabilizing vs. forward moving
What are simple reflections?
close to what the client said originally
-sometimes just includes a piece of what the client said.
What are complex reflections?
-Sometimes includes an emotion
-Metaphor
-Amplified
-Reframe
-Double-sided
-Continuing the paragraph
What does it mean to reframe?
-place problem in a different context
-Seeing things a different way
-Reframe a negative into a positive
Example: A mother who pressures her child to eat
"You really care about your child's health.
Change talk
refers to the clients mention and discussion of his or her desire, ability, reason, and need to change behavior and commitment to changing.
Sustain talk
talking about the change, but mainly talking about why they cant do it. helps to move the client forward to talking about making a change.
What are the 4 phases of an MI appointment?
engage, focus, evoke, and planning
Engage
-the connection
-Make initial contact with the client and build rapport
-Establish the reason for the visit
-Let client know what to expect
Focus
-the funnel
-Provide an overview of nutrition and/or fitness changes your clients typically make (related to the client's medical diagnosis)
-Allow the client to select one change (if any) they'd like to work on
-Ask, "What are you hoping to get out of ou
Evoke
-the "why to"
-The main purpose
-Get the client to use change talk
-Understand it ALL (Go deep)
-Unpack
-Explore Reasons to Change
-Assess Readiness
What are some evoking questions?
-Tell me more about that.
-Why do you think that is?
-How does that make you feel?
-What was that like?
Plan
the "how to"
-Elicit, provide, elicit
-asking permission
-menu options
-behavioral experiments
-client determines action goals
-assess confidence
-assess barriers
What is "the key question" that transitions the client from the evoking process to the planning process?
How will you go about making that change?
Menu options
-Give clients a list (menu) of strategies that have worked for "some people"
-Ask the client if any of the ideas on the list would work for them
-You can make the menu option the P of an E-P-E
Example: E-P (menu)-E(Which of these options would you like to
Scaling question
1-10, how confident are you at making this change?
What does GAB stand for?
Goals: get the client to verbalize action goals
Assess: assess the clients confidence in ability to following through; scale 1-10
Barriers: Assess potential barriers
-Happens before the client leaves
What are the four categories of the eating competence model?
eating attitudes, food acceptance, internal regulations, and contextual skills
Eating attitudes
-To establish and maintain
positive and flexible attitudes about
eating
-build relationships, emphasize providing not depriving, enhancing the dignity and importance of eating, addressing feelings
Food acceptance
-being open to trying new foods
-supported by variety,
which in turn is supported by enjoyment
and learned food preference.
-address food acceptance skills, address picky eating
Internal Regulations
...
What are the basic concepts of the intuitive eating book?
...
What is the division of responsibility?
-The parent is responsible for the what, when, and where of feeding
-The child is responsible for how much and whether of eating
Intrinsic Motivation
the behavior that is driven by internal rewards. positive body image, euphoric feeling after, increase energy & sleep...etc. (the most powerful motivation)
Extrinsic Motivation
the behavior that is driven by external rewards, such as money, fame, grades, praise. (the lease powerful motivation)