ELIZABETH ORSEGA-SMITH, PHD ASSOCIATE PROFESSOR UNIVERSITY OF DELAWARE DHSA –Engaging Individuals in Behavior Change

Mountain guides do not climb mountains for people As a guide.. I will help you plan the climb. We will assess your readiness for the climb, examine what you have and what you need in equipment and resources. Together we will determine a route to take. We will plan how long the journey will take and allow elements we can’t control. We will examine your personal goals. Mountain guides do not make people climb mountains. The motivation must be within the climber. During times of discouragement, I will lend support, or challenge you to reach a little deeper for strength that I know you have. Chance for success are higher if your motivation is internal. I will hold you accountable to yourself to do what you say. I know that you retain your freedom, and if you turn back, you will not be criticized for it. When we reach the summit, it is your flag that is planted for this was your journey..

Engaging Individuals …Empowering them with Skills to Change Empowerment  Enabling process through which individuals or communities take control of their lives.  Latin roots:  Power  Freedom

Initial Session Can Set the Tone How to start working with a Client  Agenda setting  A typical day  Normalizing the Behavior  Offering concern

Why some change and others do not Readiness  Influenced by importance  (value of change)  Influenced by confidence  Mastery of necessary skills  Ease of changing behavior Dependent on the BEHAVIOR  (think back to menu to choose behavior)

Scaling Questions…rapport matters “How ready do feel that you could make this behavior change? On a scale of 1 to 10 if 1 is not at all ready and 10 is completely ready what score would you give yourself?” Follow-up.  Why are you at a 5 and not a 1? (why a little ready)  What would need to happen to move to a higher number?

Follow-up suggestions Question why not further to the left..elicits motivational statements Question why not further to the right ( elicits perceived barriers) Ways to overcome barriers actions that can be taken.

Advice Vs Information Advice:  Prof-Recommends a particular course of action  Client-Contributes own pt of view  Prof- disputes client’s pt of view and goes back to his view Suggest using the word “if” so client can turn down advice… Ask permission Offer ideas Be concise Use a menu of suggestions Solicit what client thinks

Information sharing EPE  Asking clients what they want to know (elicit)  Professional can add to the information stated (provide)  Ask client about their view on what is offered (elicit) Chunk check chunk  Provide a chuck of information  Check with the client about information  Chunk of information

Goal Setting

SMART Goal Setting Specific Measurable Attainable Realistic Time-limited

How Goal Setting Works Focuses an individual’s attention and effort on outcome Specific goals>general goals Considers factors such as:  Level of complexity  Designated time frame Intrinsic factors impact(self-efficacy motivation) Extrinsic factors impact (feedback & social support)

Steps for Action Planning Steps to achieve goal List barriers List benefits Track progress Reward self for meeting goals