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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
- “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.
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
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
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
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
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
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
What is a behavior chain?
- Can be used to record patterns of behavior and identify triggers, remember consequences, etc.