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Targetting the Discussion

The role of the practitioner is different depending on the person's readiness to change. 

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Not ready:

Practitioner Roles Use statements like:
Raise doubts about patient behaviour                            “Why do you think it's important to...?"
Normalise behaviour "Lots of people find it difficult to...for a variety of reasons. What are some of the things that get in the way for you?"
Provide information “Are there any questions you would like to ask me?"

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Thinking about it:

Practitioner Roles Use statements like:

Normalise ambivalence                         

 

 "Some people don't like...yet they know it's important

Consider the 'pros'

 

 "What would be some reasons to start doing it?"

Encourage self re- evaluation

 

 "How much does your family know about...? How do you think it affects them?"         

Examine options

 

If you were to start...,what do you think you would do?"

 

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 Ready to change in the near future:

Practitioner Roles Use statements like:

Clarify the patient's own goals and strategies for change

 

 “Tell me what changes you are planning about…” .Ask for specifics such as how often, when, how long etc.

Lower barriers to change

 

 “What do you need to do so that it is not going to get in your way?”                                                                           

Encourage self re- evaluation

 

 “Who do you need to help you achieve your goal?”

 

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 Ready to change - already started:

Practitioner Roles Use statements like:
Engage patient in discussion about changes               “Undertaking…. will have a positive impact in your heath. What has changed for you since you began?”           
Assess strengths and social support “Who helps you to keep up with…? How does that person help you?”

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 Already doing it:

Practitioner Roles Use statements like:
Affirm commitment                                  “What motivates you to ….?”
Incorporate positive rewards “How can you celebrate your success
Review long-term goals “What will success look like in 6 months time? What do you see as you long term goal?”

 

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