In 1983, Prochaska and DiClemente developed the TranstheoreticalModel which is also known as the Stages of Change Model. The study and evidencewere based on changes in smokers’ behaviour. The model emphases on thedecision-making of the individual and is a model of premeditated change. Thestages of change Model functions on the assumption that people do not changebehaviours rapidly and decisively.
Instead, change in behaviour, particularlyhabitual behaviour, happens continuously through a cyclical process. · Precontemplation: this when an individualdoes not believe their behaviour is challenging with No intent to take anyaction anytime soon.· Contemplation: This when an individualpossibly understands the cost of their behaviour, and has the intention oftaking action soon.· Determination: this is when an Individualhas made the decision to change their behaviour. This stage is significant asit can easily lead to relapse if the individual does not plan cautiously.· Action: this is when anindividual putstheir plan into action.
· Maintenance: The individualneeds to sustain the change in behaviour with an intent to maintain thechange in behaviour going forward. · Relapse: An individualRelapsing within the cycle of change considered as normal. It’s good to learnfrom the relapse, e.g. what was the trigger; why the plan was ineffective. E.
t.cConcordanceConcordance appliesto a consultation process that occurs between a health care professional and apatient. The process of concordance improves power-shaping inprofessional-patient collaboration, patient’sviewpoint is valued; as well as recognizing that the patient has knowledge abouthis or her illness and how well their body response to treatment. Patient’s personalexpertise is not the same as the professional’s scientific knowledge when itcomes to in medication treatment selection however both knowledges relevant andvalued when it comes to deciding on the best treatment available. It has been researchedthat concordance can impr9ove care satisfaction, knowledge of the condition andtreatment, treatment adherence and lots more. Motivational Interviewing Motivational interviewingis a therapeutic tactic that was initiallydeveloped by W. Miller & S. Rollnick in 1991, the therapeutic tactic focuseson person-centred counselling, which attempts to encourage an individual tomove through the stages of change and enabling an individual to go through thestages of change, as well as make positive decisions and achieving establishedgoals along the way.
Key Elements ofMotivational Interviewing The key elements of motivational interviewing whichis also known as the spirit of motivational interviewing refers to how thistechnique is applied, there are 3 key elements which are;· Collaboration: is the alliance that is formed between a healthcare professionaland the patient. The healthcare professional will try to understand thesituation from the patient’s point of view and experiences. This is differentfrom some other approaches to counseling or treatment, which are based on healthcareprofessionals taking the “expert” role, which can sometimes result tochallenging patients or imposing their own viewpoint on the patient’s unhealthybehaviour, the suitable course of treatment and the outcome. Collaboration helpbuilds bond and enables trust in the relationship between the healthcareprofessional and the patient. this does not mean that the healthcareprofessional agrees with the patient automatically, about the complexion of theproblem or the appropriate changes that may be required. While they possiblywill see things inversely, the therapeutic procedure is focused on jointunderstanding, not the healthcare professional or the patient being right. · Evocation: in motivational interviewing approachthe healthcare professional draws out the patient’s own thoughts and ideas, insteadof the healthcare professional imposing their own thoughts.
This means,the patient will be more interested in changing and maintaining the change fora longer period. In other types of counselling, like cognitive behavioraltherapy, patients are given information by healthcare professionals as encouragementfor them to change their ways of thinking, beliefs, or behaviours. sometimes,this approach can lead to the patient becoming defensive.· Autonomy: Motivationalinterviewing gives all power to the patient. The healthcare professional shouldrespect the patient’s responsibility and the ability to make decisions abouttheir care. Some other therapy approach seeshealthcare professionals as authority figure, Motivational Interviewing empowerspatients, but also allows them take responsibility for their actions.
The principles of Motivational Interviewing · Express Empathy: This principle focuses onperson-centered treatment, the healthcare professional sees the world throughthe patient’s eyes, feels things the way the patient feels them, as well asthink about things like the way the patient thinks about them. By doing this,the patient will feel that he or she is being understood, leading to themopening up and sharing their experience accurately. When a patient opens up andshare their experiences accurately, it enables the healthcare professional toassess as to when, where and how the patient can be supported. Patients alsobecome a lot more comfortable, with assessment, more certainty about change andless likely to be defensive. Healthcareprofessionals can be trained to have Empathy skills, on how to understand thefeelings of patients over the use of reflective listening. Empathy helps builds bonds and trust, leadingto a successful collaborative relationship with the patient after which thehealthcare professional can offer support for the anticipated change.
· Develop discrepancy: with this principle the healthcare professionals mustallow patients point out the difference between what their current situation isand their goals for the future.The healthcareprofessional role is to support the patient with focusing their attention onhow their current behaviour varies from the anticipated behaviour. The healthcareprofessional uses interventions that are not based in confrontation to generatethis information. The healthcare professional asks a sequence of questions tolead the patient to a natural conclusion.·