Pre-contemplation
Stage
"Ignorance
is bliss"
"Weight is not a concern for me"
Goals:
1.
Help patient develop a reason for changing
2. Validate the patient’s experience
3. Encourage further self-exploration
4. Leave the door open for future conversations
1. Validate
the patient’s experience:
"I
can understand why you feel that way"
2. Acknowledge
the patient’s control of the decision:
"I
don’t want to preach to you; I know that you’re an adult and you will
be the one
to decide if and when you are ready to lose weight."
3. Repeat
a simple, direct statement about your stand on the medical benefits of
weight loss for this patient:
"I
believe, based upon my training and experience, that this extra weight
is putting you at serious risk for heart disease, and that losing 10
pounds is the most important thing you could do for your health."
4. Explore
potential concerns:
"Has
your weight ever caused you a problem?" "Can you imagine how
your weight might cause problems in the future?"
5. Acknowledge
possible feelings of being pressured:
"I
know that it might feel as though I’ve been pressuring you, and I want
to thank you for talking with me anyway."
6. Validate
that they are not ready:
"I
hear you saying that you are nowhere near ready to lose weight right
now."
7. Restate
your position that it is up to them:
"It’s
totally up to you to decide if this is right for you right now."
8. Encourage
reframing of current state of change - the potential beginning of a change
rather than a decision never to change:
"Everyone
who’s ever lost weight starts right where you are now; they start by
seeing the reasons where they might want to lose weight. And that’s
what I’ve been talking to you about."
Motivational
Interviewing Algorithm
Prochaska
and DiClemente’s Stages of Change Model
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