Remotivation Therapy PDF Print E-mail
Written by John Bierma   
Thursday, 30 December 2010 20:52

Why Behavioral Intervention?

Traditional patient education in the form of clinician advice and information is NOT adequate in many clinical cases,  as documented by the U.S Prevention Services Task Force in its paper Evidenced-Based Methods for Evaluating Behavioral Counseling Interventions found at this link:

http://www.uspreventiveservicestaskforce.org/3rduspstf/behavior/behsum2.htm

 

I quote form this paper to illustrate why remotivation methods are clinically indicated for MANY patients and populations when advice and information do not produce behavior change.

 

Advise: As discussed above, clinician advice establishes behavioral issues as an important part of health care and enhances the patient's motivation to change. Such advice is most powerful when personalized by specifically linking the behavior change to the patient's health concerns, past experiences, family, or social situation,119 and tempering it with the individual's level of health literacy.120 Clinician advice primarily gives the cue to action, while other health professionals and media provide the details.29,56 In this scenario, the clinician is a uniquely influential catalyst for patient behavior change69 and is best supported by a coordinated system to accomplish and maintain that change... 

 

Futher, it is important to apply motivational internventions BROADLY for the impact on individuals and populations to be stastically signifcant.  I quote again from the U.S Prevention Services Task Force.

 

Assist: In providing assistance, the primary care clinician or other health care staff offers additional treatment to address barriers to changes, increase the patient's motivation and self-help skills, and/or help the patient secure the needed supports for successful behavior change. Effective primary care interventions seek to teach self-management and engage problem-solving/coping skills, thereby enabling the patient to undertake the next immediate step(s) in the targeted behavior change.70

Those not ready to commit to making a specific behavior change in the near future often benefit from assistance strategies that explore ambivalence and enhance motivation.59 As emphasized earlier, additional assistance through effective behavior-change techniques need not be provided directly by the primary clinician solely within the context of a primary care visit. Clinicians may provide assistance through referral to other health care staff within the clinic or outside in the larger health care system or community. Importantly, such approaches typically involve multiple communication channels and intervention methods, which also improve intervention outcomes.

 

Theories and Models of Behavior Change

Behavior change theories and models from the social and behavioral sciences explain the biological, cognitive, behavioral, and psychosocial/environmental determinants of health-related behaviors. Thus, they also define interventions to produce changes in knowledge, attitudes, motivations, self-confidence, skills, and social supports required for behavior change and maintenance.39 The application of relevant theoretical models to behavioral counseling interventions is an important contribution to strengthening health research in this area.40

 

...The Potential Impact of Health Behavior-Change Programs in Clinical Care

Appreciating behavioral counseling interventions requires a true population-based medicine perspective (i.e., intervening with individuals, but recognizing that the health benefits may not be as clinically visible individually as they are clinically meaningful when considered for the whole). Individually, brief behavioral counseling interventions that are feasible in health care settings often have only modest behavior change impacts. For example, only 5 percent to 15 percent of those receiving an intervention make clinically significant changes, such as quitting smoking12 or reducing heavy drinking.11 Even at a population level, overall risk factors typically change only 1 percent to 20 percent.16,17,19,20,22,61 However, these "modest" impacts translate to significant benefits to the health of the population (and to multiple individuals) when systematically applied to a large proportion of those in need.48,62-65 This opportunity for substantial public health benefit comes about only when behavior change interventions are applied broadly to entire populations of patients. Given this, population-based behavioral interventions generally offer a range of intervention options including motivational strategies designed for people not ready to change.64

 

Remotivation therapy is an evidence based, time tested method of group work that began in the 1940s as part of the care of veterans from WWII with post traumatic stress disorder (PTSD) and the chronically mentally ill.

  • It has been shown to be one the BEST and most EFFECTIVE forms of small group facilitation currently available.
  • The fundamentals of adult education incorporated into its methods and its unique techniques developed out of many years of clinical experience have been shown in research to produce superior outcomes to traditional lecture/discussion forms of patient education.  See review of literature of the effectiveness of psychoeducation and remotivation therapy:

http://www.remotivation.com/Research.asp

Remotivation Consultation Services staff is certified therapists and trainers in remotivation therapy by the National Remotivation Therapy Organization Inc.  We provide training and certification to our customer’s staff in leading shared medical appointments in a remotivation therapy format.

Some of the unique qualities employed in remotivation therapy are:

  • A climate of acceptance
  • Methods to overcome denial
  • Use of story, poetry and art to motivate
  • The design of each session to the literacy skill level of the patient/client(s)
  • Application of the topics of discussion to activities of daily living and to rehabilitation
  • A climate of appreciation

For more information on Remotivation Therapy see http://www.remotivation.com

In summary, it is well and good to use various method to increase access to care, including telemedicine.  But, if the patients/clients are NOT MOTIVATED to participate, comply with the advice and plan of care of the provider, change their behavior and engage in self care, the increased access will not result in better health outcomes!!!
Last Updated on Sunday, 02 January 2011 18:16