model of change

  1. Nurse can help out during the precontemplation stage by...
    • Acknowledge lack of readiness
    • Clarify- decision is theirs
    • Encourage re-evaluation of current behavior
    • Personalize the risk
    • Raise awareness is the goal not action
    • Explore how the problem or behavior is manifested?
    • When and how do they do it?  
    • How is it getting in the way?
    • Be specific and use behavioral terms
    • Goal of Stage:  Help to move --> contemplation
  2. Contemplation stage
    • “Sitting on the fence”
    • Not considering a change in the next month
    • Ambivalent about change 
    • Goes back and forth—to change or not to change?
    • “Maybe I have a problem.  Maybe I don’t.”
    • This is often where we can start with them.
    • Discuss pros and cons about change
    • How will they benefit?
    • How will this harm them if they don’t?
    • Help to identify & promote new, positive outcomes
    • Goal:  Begin to consider problem exists.
  3. Helping during determination...
    • Complement their commitment to change
    • Assess the strength of commitment
    • Help find an appropriate change strategy
    • Acceptable, accessible, appropriate & effective
    • Do they have the skills to make the change
  4. What happens in the action stage?
    • "I am striving to do something different.”
    • Make a plan and practice new behavior
    • Implement change (Three to six months)
    • Discuss what to do with triggers?
    • Find social supports
    • Combat sense of loss
    • Keep goal in mind
    • Benefits of change
    • Detriments 
  5. Helper actions during the action stage?
    • Helps to reaffirm commitment
    • Facilitate planned change
    • What would change be like?  
    • How will you know?
    • What would it look like? 
    • What would it feel like?
    • Give positive feedback for positive changes
    • Help them modify plan as needed
  6. What happens in the maintenance stage
    • “My behavior is different”
    • “Who I am is different.”
    • After six months and beyond
    • Maintain behavior change-replace  old with new
    • May require a different set of skills to maintain rather than obtain
  7. Helper tasks during the maintenance stage.
    • Provide continued support for change
    • Provide periodic review of plan and success
    • Foster continued development
    • Reinforce rewards
    • Help recognize signs of potential behavioral relapse or setback
  8. Helper tasks if/when relapse?
    • Evaluate triggers for setback
    • Assess what happened
    • Avoid scolding or “You were doing so well.”
    • Help deal with discouragement
    • Review consequences
    • Reaffirm commitment to change
    • Assess motivation and barriers
    • Help plan stronger coping strategies

    • Identify supportive people
    • Support efforts to change behavior again
    • --Contemplation
    • --Determination
    • --Action
    • --Maintenance
  9. What is a behavior chain?
    • Image Upload 1
    • Can be used to record patterns of behavior and identify triggers, remember consequences, etc.
Card Set
model of change
mental health