How to do brief interventions to maintain the change
Making a change and sticking to it can be a difficult, sometimes lonely, thing to do.
It is important to take opportunities to provide encouragement and support.
What to do:
- ask the person how he or she is going and if the person needs any more help or support
- ask if he or she has been tempted to change his or her mind. If 'yes' then give praise
for sticking to the decision
- give positive feedback - about looking better, sounding better, and when tests or health
checks show improvements in health
- ask whether the person feels better and stronger
- give praise for achieving his or her goals, and for changing
Examples
| Health staff: |
|
I've seen you walking in the afternoons |
| Person: |
|
I've been going for a walk to the airstrip every afternoon for a month
now - feel better already |
| Health staff: |
|
That's great. You're doing really well not to miss even a day, and you're
looking better too. Look, your blood pressure is lower. And you've lost a good amount of
weight with that diet as well as the walking. That heart of yours won't have to work so
hard |
| Person: |
|
Yes, I don't want another heart attack, that's for sure. My clothes are
too big now, I've lost that much! |
| Health staff: |
|
You've done really well. Is it hard to stick to it sometimes? |
| Person: |
|
It's not as hard now it's just what I do every day, and I feel so much
better. I'm just going to keep doing it, and I reckon some of the other ladies will come
with me soon |
| Health staff: |
|
Good for you! May I join you sometimes? |
|
| Health staff: |
|
How are you going with keeping off the smokes? You were going so well
last time I saw you. |
| Person: |
|
I'm going ok. Still off the smokes. |
| Health staff: |
|
Your chest is sounding better. Do you still have your cough? |
| Person: |
|
Yeah - but I'm not coughing so much now. Not getting so out of breath. |
| Health staff: |
|
Do you think about going back to the smoking? |
| Person: |
|
Sometimes…I want to light up when I'm down the club and the others
are smoking. But I feel better since I gave up those cigarettes, so I say "no". |
| Health staff: |
|
Well, if you can cope without lighting up there, you must be strong.
You've done really well to quit those cigarettes. And you're looking better too. |
| Person: |
|
Yeah. I reckon I'll be dangerous on that footy field next season. |
|
How to support people who have lapsed or relapsed
Relapse may be defined as "a return to problem behaviour following some problem
free period." (Wilson 1992:3) Relapse prevention strategies have been considered
within the brief intervention processes described. Maintaining a change in behaviour, such
as giving up smoking, often involves maintaining a change in lifestyle. Therefore relapse
prevention may involve the health professional helping the person to identify high risk
situations, develop coping skills, working out ways to avoid temptation, and working out
what to do if he or she has a lapse in their change of behaviour (Jarvis et al
1995:177-179).
 |
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When a person has a lapse in maintaining his or her change,
is important to: |
- be non-judgemental, not to shame the person
- encourage the person not to feel he or she has failed, but just had a temporary slip
- point out that some people try many times before they change for good, and that this is
a normal part of the change process
- find out what may have led to the lapse, talk about what can be learned
- encourage the person to try again
|
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See also CARPA Standard Treatment Manual, 3rd
edition (1997:123) |
Motivational interviewing as a brief intervention
Brief interventions can include motivational interviews. Motivational interviewing is a
particular method of counselling to help a person recognise and do something about his or
her problem, or potential problem. Some people are ambivalent about changing behaviour -
they both want and don't want to change. Motivational interviewing has been found to help
these people along the path to change. (Miller and Rollnick 1991:52) Like other forms of
brief intervention, motivational interviewing does not try to force the person to make
changes. It supports him or her to explore the good and not so good things, to express his
or her own reasons for concern and the arguments for change (Rollnick, Heather, Bell
1992:25). It has been well researched and developed as an alcohol and other drugs
intervention.