Final Exam Review Monday: 5:30 – 7:30 p.m.Final Exam will cover:- CBASP (PowerPoint)- Eating Disorders Overview (PowerPoint)- Motivation Interviewing (PowerPoint)- Gold PowerPoints 1-3- YouTube Videos:Judith Beck and CBT for Dieting:1. Beck Interview: (3:57)https://www.youtube.com/watch?v=EgF0mShiouY2. Beck Role Play (6:24) https://www.youtube.com/watch?v=yJxCnoR3Cc83. Beck Diet Solution: (4:50)https://www.youtube.com/watch?v=_RCzEtdSt98Motivational Interview:1. Motivational Interviewing: (15 minutes)https://www.youtube.com/watch?v=cPd1aLOfwF42. MI: Role-play (No Closed captioning) (9:28) https://www.youtube.com/watch?v=sWc0g2K9LAIFINAL EXAM REVIEW POINTS- few questions on CBAS- few questions on eating disorders, Miss America contest, anorexia, bulimia, binge eating- few questions on how MI differs from regular therapy- CBAS - know steps of CBAS- Eating Disorders - know the 3 eating disorders and the main difference between them - anorexia, bulimia, binge eating- Motivational Interviewing - questions come directly from slides- Gold PowerPoint - examples of CB? - controlling environment- CBT for Eating Disorder - 1-2 questions from Beck/Role-playing videos- CBT - “restructuring” on testMotivational interviewing: What are the defining characteristics of Motivational Interviewing (MI)?- Motivational interviewing is helpful for those who want to change, those who don’t want to change, those who are ambivalent (unsure of change), and those with motivational problems- Collaboration between the therapist and client- The therapist evokes, but doesn’t instill motivation (listen reflectively)- The client is responsible for change (maintains autonomy)How does it differ from other therapies?- Differs from other therapies because client is the one responsible for change, not therapist. After all, it’s their life, change can only occur if they are motivated to do so.What are the best situations for MI?- People who use drugs and want to stop- People who are in situations in which they want to change but are unsure and have problems with motivationWhat techniques work for MI?- Use a client’s resistance or argumentative tendencies against them (roll with resistance)What techniques do not work for MI?- Pushing a client when they don’t want to goWhat type of patient was it developed for?- Good for patients who are ready or not ready for change, but especially good for those who are ambivalent about changing.- Those who believe they don’t need therapy or therapy doesn’t workDefine:- Rolls with Resistanceo Simple reflection i.e. “My P.O. is always on my back.” Response: “It must be frustrating always having someone looking over your shoulders.”o Double-sided reflection i.e. “I may have some gambling problems but it’s not like I’m an addict who lost my house.” Response: “On one hand gambling has caused some problems, but it’s important you aren’t viewed as an addict.”o Reframing i.e. “I’ve tried to quit smoking many times before but I just can’t.” Response: “You’re pretty persistent.” o Agreeing with a twist “You can’t tell me how to raise my kids, you don’t live in my house.” Response: “Truth is, you’re in the best position to decide the best way to raise your kids and figure out what does and doesn’t work, so you need to be a full partner in this process.”o Emphasize personal controlo Coming alongside- Change Talko What worries you about current behavior?o Do you remember a time when things were going well for you?o Where do you see yourself in 10 years if you don’t change? If you do?- Amplified Reflectiono i.e. “My wife is upset about my gambling but I don’t have a problem.” Response: “It seems to you that she doesn’t have a reason to be concerned.”Describe in one-sentence each of the two phases of MI?- Phase one consists of using different methods to gather motivation from within the client by determining what reason they have to change, and changing versus not changing.- Phase two consists of developing a change plan and actually enacting the change plan inorder for change to really occur, using the motivation from phase one.Describe the Five General Principles of Motivational Interviewing: (e.g. express empathy)1. Express empathya. i.e. “I can see how that would be difficult”2. Develop discrepancya. Current behaviors interfere with life goals 3. Avoid argumentation4. Roll with resistance5. Support self-efficacya. Client responsible for changeb. Must hold the belief that change is possible, and have confidence and optimismc. Dynamic rather than staticWhat is Self-Efficacy?- The belief that changing oneself is possible, and the person has the confidence and optimism to accomplish tasks- The “able” in “ready, willing, and able”Describe the ways a therapist can help patient to evoke ‘change talk’ about the disadvantages of status quo? (e.g. what concerns you about your current situation?).- Get the client to acknowledge how the current behavior is not as good as the change behavior- i.e. “Picture yourself in five years if you do not…”- Recognize the disadvantages of the status quo while recognizing the advantages of change, holding optimism about the change with an intention and commitment to change- i.e. “I never really thought about how…”; “I have not taken this serious enough”; I can see if I don’t lose some weight I could die sooner”How does MI differ from Traditional Therapies?- In MI, the therapist collaborates with the client rather than being the authority- In MI, the client is responsible for change instead of the therapist determining the change that should occur- In MI, motivation should come from within the client instead of the motivation being instilled into the clientCBASPWhat is the procedure for filling out a CBASP homework?1. Describe the situationa. Pick a discrete slice of time (approx. 15 min.) and describe what happened (no editorializing)b. Description should be short (couple sentences) and have beginning, middle, end2. Interpretations of the situationsa. The patient’s opinions about what the event meant (what does the situation mean to you?)b. Thoughts that occurred during the situation3. Identify behaviors in the situationa. Words and actionsb. Body language c. i.e. eye contact, posture, gestures, tone of voice, timing, etc.4. Identify the Desired Outcome (DO)a. How did the patient want the
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