DHSA –Engaging Individuals in
Behavior Change
ELIZABETH ORSEGA-SMITH, PHD
ASSOCIATE PROFESSOR
UNIVERSITY OF DELAWARE
Mountain guides do not climb mountains for people
 As a guide.. I will help you plan the climb. We will assess your readiness
for the climb, examine what you have and what you need in equipment
and resources. Together we will determine a route to take. We will plan
how long the journey will take and allow elements we can’t control. We
will examine your personal goals.
 Mountain guides do not make people climb mountains . The motivation
must be within the climber. During times of discouragement, I will lend
support, or challenge you to reach a little deeper for strength that I
know you have. Chance for success are higher if your motivation is
internal.
 I will hold you accountable to yourself to do what you say. I know that
you retain your freedom, and if you turn back, you will not be criticized
for it. When we reach the summit, it is your flag that is planted for this
was your journey..
Engaging Individuals …Empowering them with
Skills to Change
 Empowerment
 Enabling process through which individuals or communities
take control of their lives.
 Latin roots:
 Power
 Freedom
Initial Session Can Set the Tone
 How to start working with a Client
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Agenda setting
A typical day
Normalizing the Behavior
Offering concern
Why some change and others do not
 Readiness
 Influenced by importance
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(value of change)
Influenced by confidence
Mastery of necessary skills
 Ease of changing behavior
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 Dependent on the BEHAVIOR
 (think back to menu to choose behavior)
Scaling Questions…rapport matters
 “How ready do feel that you could make this
behavior change? On a scale of 1 to 10 if 1 is not at all
ready and 10 is completely ready what score would
you give yourself?”
 Follow-up.
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Why are you at a 5 and not a 1? (why a little ready)
What would need to happen to move to a higher number?
Follow-up suggestions
 Question why not further to the left..elicits
motivational statements
 Question why not further to the right ( elicits
perceived barriers)
 Ways to overcome barriers actions that can be taken.
Advice Vs Information
 Advice:
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Prof-Recommends a particular course of action
Client-Contributes own pt of view
Prof- disputes client’s pt of view and goes back to his view
 Suggest using the word “if” so client can turn down
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advice…
Ask permission
Offer ideas
Be concise
Use a menu of suggestions
Solicit what client thinks
Information sharing
 EPE
 Asking clients what they want to know (elicit)
 Professional can add to the information stated (provide)
 Ask client about their view on what is offered (elicit)
 Chunk check chunk
 Provide a chuck of information
 Check with the client about information
 Chunk of information
Goal Setting
SMART Goal Setting
 Specific
 Measurable
 Attainable
 Realistic
 Time-limited
How Goal Setting Works
 Focuses an individual’s attention and effort on
outcome
 Specific goals>general goals
 Considers factors such as:
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Level of complexity
Designated time frame
 Intrinsic factors impact(self-efficacy motivation)
 Extrinsic factors impact (feedback & social support)
Steps for Action Planning
 Steps to achieve goal
 List barriers
 List benefits
 Track progress
 Reward self for meeting goals