Summary of "ENTREVISTA MOTIVACIONAL - Parte I"

Summary of Key Wellness Strategies, Self-Care Techniques, and Productivity Tips from "ENTREVISTA MOTIVACIONAL - Parte I"

This video provides an in-depth introduction to Motivational Interviewing (MI) as a clinical approach to support behavior change in patients, especially for managing chronic diseases and harmful habits. It contrasts MI with traditional directive or fear-based approaches and explains how MI fosters patient autonomy and sustainable change through respectful communication.

Key Wellness and Behavior Change Strategies

Motivational Interviewing (MI) Overview:
- A patient-centered, collaborative communication style.
- Helps patients explore and resolve ambivalence about change.
- Strengthens internal motivation rather than imposing change.
- Originated in the 1980s to treat alcoholism; now applied broadly (diabetes, obesity, hypertension, psychiatric disorders).
- Supported by over 160 clinical trials demonstrating effectiveness.
Core Principles of Motivational Interviewing:
- Collaboration: Cooperative relationship between clinician and patient.
- Evocation: Drawing out patient’s own reasons and values for change.
- Autonomy: Respecting patient’s control over their own change process.
Common Mistakes in Behavior Change Counseling:
- Assuming lack of adherence equals lack of motivation.
- Using fear, threats, or confrontation to force change.
- Imposing directives without understanding patient’s readiness.
- These approaches often increase resistance and reduce engagement.
Stages of Change Model (Prochaska & DiClemente):
Change is a cyclical, non-linear process with six stages:
1. Pre-contemplation: Patient unaware or denies need for change.
2. Contemplation: Patient ambivalent, weighs pros and cons.
3. Determination (Preparation): Patient commits and plans change.
4. Action: Patient actively implements change.
5. Maintenance: Sustaining change and preventing relapse.
6. Relapse: Return to old behavior; viewed as part of the process, not failure.
Each stage requires tailored communication and support strategies.
Strategies for Each Stage:

Pre-contemplation:

Build trust and empathy; patient sees clinician as ally.
Avoid unsolicited advice; raise awareness gently.
Use reflective questions to highlight discrepancy between values and behavior.
Example: Linking smoking fatigue to playing with grandchildren.

Contemplation:

Encourage patient narrative to express doubts and ambivalence.
Use tools like a Health Diary to increase self-awareness of behavior patterns.
Employ a Balance Sheet to weigh pros and cons of change.
Support without pressuring immediate decisions.

Determination:

Help patient set realistic, achievable goals and timelines.
Assess commitment and anticipate barriers.
Encourage setting a specific, near-term start date for change.
Develop a detailed action plan (when, where, how, support systems).

Action:

Provide practical and emotional support.
Identify and plan for triggers that may cause relapse.
Share success stories to boost confidence and motivation.

Maintenance:

Help patient develop coping strategies for high-risk situations.
Reinforce benefits gained from change to sustain motivation.
Normalize occasional slip-ups and encourage resumption of positive habits.

Relapse:

Avoid judgment or punishment.
Frame relapse as a learning opportunity.
Explore triggers and plan alternative responses.
Reinforce patient’s progress and encourage continued effort.

Additional Tips:
- Small, consistent interventions over time are more effective than aggressive, one-time attempts.
- Respect the patient’s pace; do not rush stages of change.
- Motivational Interviewing complements other consultation methods (seven-step consultation, person-centered clinical method) and should be integrated, not replace them.
- Recognize that motivation fluctuates; patients may cycle through stages multiple times.

Practical Tools and Techniques

Health Diary: Patient logs frequency, context, feelings, and consequences of the behavior.
Balance Sheet: Patient lists pros and cons of continuing vs. changing the behavior.
Narrative Technique: Encourage patient to verbalize thoughts and feelings about change.
Reflective Questioning: Connect behaviors to personal values and goals.
Coping Plans: Prepare strategies for handling triggers and temptations.
Success Stories: Use peer examples to inspire and normalize the change process.

Summary of Differences: Motivational Interviewing vs. Traditional Informational Model

Aspect Informational Model Motivational Interviewing Role of Professional Authority, directive, persuading Collaborator, facilitator Communication Style One-way, advice-giving Two-way, evocative, patient-centered Patient Role