Change Plan. A Preparation/Determination Stage Tool
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- Melanie Greer
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1 Change Plan A Preparation/Determination Stage Tool 1
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4 Change Plan 1. The changes I want to make (or continue making) are: 2. The reasons why I want to make these changes are: 3. The steps I plan to take in changing are: 4. The ways other people can help me are: 5. I will know that my plan is working if: 6. Some things that could interfere with my plan are: 7. What I will do if my plan isn t working: 4
5 Decisional Balance A Contemplation Stage Tool Thomas E. Broffman, PhD, LICSW, LCDP, LCDS, CEAP Broffman Training & Consulting PO Box Providence, RI broffmat@bc.edu 1
6 Understanding Ambivalence Costs of Status Quo Benefits of Change Costs of Change Benefits of Status Quo Contemplation: cost-benefit balance 2
7 Ambivalence is the Issue -- Decisional Balance is the Intervention To change Not to Change 3
8 DECISIONAL WORKSHEET THINGS I LIKE ABOUT SMOKING THINGS I DON'T LIKE ABOUT SMOKING THINGS I WOULD DISLIKE ABOUT QUITTING THINGS I WOULD LIKE ABOUT QUITTING REASONS TO STAY THE SAME REASONS FOR MAKING A CHANGE 4
9 Decisional Balance Decisional Balance Worksheet (Fill in what you are considering changing) Good things about behavior: Not so good things about behavior: Not so good things about changing behavior: Good things about changing behavior 5
10 Decisional Balance Sheet Reasons for staying the same Reasons for making a change Good things about: Not so good things about: Not so good things about changing: Good things about changing:
11 Conducting a Decisional Balance Discussion Accept all answers. (Don t argue with answers given by client.) Explore answers. Be sure to note both the benefits and costs of current behavior and change. Explore costs/benefits with respect to client s goals and values. Review the costs and benefits. 7
12 Imagine Extremes What is the worst that can happen if you continued? What do you think would have to happen to make you decide to tell yourself, ok that s enough? 8
13 Looking Back When was the last time things were going well for you and what was it like for you? What do you think could have prevented this setback? Before you used, what was your life like? As you step back and look at all this, what do you make of it? 9
14 Looking Forward What would you like your life to be like in 2 years? How does what you are doing now make that difficult? What would it be like if you continue with the way things are now? Suppose things don t change, how do think your life will look? 10
15 Readiness Rulers A Precontemplation Stage Tool Thomas E. Broffman, PhD, LICSW, LCDP, LCDS, CEAP Broffman Training & Consulting PO Box Providence, RI broffmat@bc.edu 1
16 Readiness Rulers: I-C-R Importance: The willingness to change Confidence: In one s ability to change Readiness: A matter of priorities Confidence 2
17 Importance Ruler On a scale of 1 to 10, how important is it for you to make a change? Not at all important Somewhat important Extremely Important 3
18 Importance to Change Readiness Ruler We show the client the Importance readiness (willingness)ruler & ask: On a scale of 1 to 10, how important is it to you to make a change in...? Example, If you are a 5, why are you a 5 and not a 3? Or if you are a 5, what need to happen for you to go to a 7? How could I assist you in getting to a 7? 4
19 Confidence Ruler On a scale of 1 to 10, how confident are you that you could make a change if you wanted to? Not at all confident Somewhat confident Extremely confident 5
20 Confidence to Change Readiness Ruler We show the client the Confidence (ability) readiness ruler & ask: On a scale of 1 to 10, how confident are you to make a change in...? Example, If you are a 5, why are you a 5 and not a 3? Or if you are a 5, what need to happen for you to go to a 7? How could I assist you in getting to a 7? 6
21 Building Confidence Review past successes Define small steps that can lead to success Problem solve to address barriers Provide tools- strategies, resources, teach skills Attend to the progress and use slips as occasions to further problem solve rather than failure 7
22 Simplified Motivational Categories Confidence in Ability Importance of Change Low High Low High Group 1 Little interest in change; don t think they could even if they wanted to. Group 3 Believe they could change, but not interested right now. Group 2 Want to change, but don t think they are able. Group 4 Want to change and believe they have the ability. 8
23 Readiness Ruler On a scale of 1 to 10, how ready are you to make a change? Not at all ready Somewhat ready Extremely Rready 9
24 Readiness to Change Readiness Ruler We show the client the Readiness (specific commitment) ruler & ask: On a scale of 1 to 10, how ready are you to make a change in...? Example, If you are a 5, why are you a 5 and not a 3? Or if you are a 5, what need to happen for you to go to a 7? How could I assist you in getting to a 7? 10
25 Readiness to Change Ruler Not Prepared to Change 0 Already Changing 10 11
26 Let s Try Using Readiness Rulers 1. How important is it for you to learn about motivational interviewing? 2. How confident are you that you can learn motivational interviewing? 3. How ready are you at this point to do some of these things in your practice? 12
27 Project Cope s BSP Utilizing OEQs Thomas E. Broffman, PhD, LICSW, LCDP, LCDS, CEAP Broffman Training & Consulting PO Box Providence, RI broffmat@bc.edu 1
28 1. What Brings You To Project Cope And How Do You Think We Can Help You? 2
29 2. If Mandated, Who Mandated You And What Would They Like To See Come Out Of This Experience? 3
30 3. What Do You See As Your Strengths And Limitations? 4
31 Substance Abuse History 4. Tell Us About How You First Began Using Alcohol/Other Drugs And The Ways In Which They Have Most Effected Your Life? 5
32 Prior Treatment History 5. What Kinds Of Treatment Experiences Have You Had (Please Include Treatment For Substance Use As Well As For Mental Health Issues) Which Were Most Helpful And Which Were Least Helpful? 6
33 6. If The Client Has Been On Prescribed Medication, In What Ways To You Think Your Use Of Medication Has Either Helped You Or Not Helped You? 7
34 7. What Kinds Of Experiences Have You Had With Self-help Programs Like AA Or NA? 8
35 8. Describe Any Periods Of Recovery You Have Had. 9
36 9. What Do You Think Was Most Helpful For You In Maintaining Your Recovery? Which People/Persons Were Most Helpful During Your Recovery? 10
37 Education/Employment History 10. Tell Us About Your Experiences In School As A Child? 11
38 11. What Type Of Work Interests You The Most? 12
39 12. What Support Do You Think You Might Need To Be Able To Support Yourself Financially? 13
40 Family History 13. Tell Me What It Was Like Growing Up In Your Family? 14
41 14. How Would You Describe Your Relationship With Your Family Now? (Include Family Of Origin, Current Partner, And Children) 15
42 15. What Types Of Traumas Or Upsetting Events Do You Remember Experiencing As A Child Or As An Adult? 16
43 16. If The Client Has Children, What Do You See As Your Biggest Challenge In Raising Your Children? 17
44 17. Which Friends Or Family Members Are Available To You To Support You While You Are In Treatment And During Your Recovery After You Leave This Program? 18
45 18. What Types Of Interests Or Hobbies Do You Have? How Do You Like To Spend Your Free Time? 19
46 TREATMENT PLANNING 19. What Are The Most Important Issues That You Want To Get Help With While You Are In This Program? 20
47 SOCS, OARS & DARNC Thomas E. Broffman, PhD, LICSW, LCDP, LCDS, CEAP Assistant Professor Eastern CT State University, BSW Program Willimantic, CT
48 Stages of Change Maintenance Precontemplation Relapse Contemplation Action Preparation - Determination 2
49 What Are OARS? Open Ended Questions Affirmations Reflective Listening Summarizing 3
50 Listen For Change Talk D A R N C Change Desire: I want/wish/prefer to Ability: I can, could, able, possible Reason: why do it? what would be good? Need: important, have to, matter, got to Commitment: I will/am going to signals behavior change 4
51 Stages of Change Maintenance Precontemplation Relapse Contemplation Action Preparation - Determination
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