Pic 14: The speech bubble icons representing a Change Talk meter reappear below the “Change Talk” title. Then Danielle reappears on an abstract background.
Guiding patients towards change requires collaboration: listening to what they see as important and what changes they want to make in their lives.
There are some simple tactics you can use to support and invite collaboration:
Pic 15: Screen changes to a gray blue background with the title “OARS”. Underneath, the first letters of the acronym are highlighted and say:
Open ended questions
Affirmations
Reflections
Summaries
DANIELLE: Open ended questions, affirmations, reflections, and summaries, collectively known as the “OARS” techniques.
Pic 16: The title “Elicit Provide Elicit” appears. An icon of three speech bubbles is displayed, the first speech bubble pointing left, the second pointing right, and the third pointing left again.
We’ll also talk about a technique for sharing information called “Elicit Provide Elicit.”
Click on each tactic to learn more and see some examples.
Pic 17: Screen returns to the “OARS” acronym. “Open ended questions” is highlighted. Screen then transitions to display “Open ended questions” as the title, and an icon of a question mark with lines expanding outwards and away from it. Then this icon shifts to the left as Danielle returns on screen.
Open ended questions require more than a yes or no answer and encourage individuals to share their feelings, experiences, and perspectives.
They’re a great way to gather information, build rapport, and elicit change talk.
Pic 18: Screen turns to a dark gray background. Under the title “Open ended questions”, three quotes are displayed:
“What do you like about exercise?”
“How do you enjoy spending your free time?”
“What are some reasons you want to stay healthy and safe?”
Pic 19: Then the header “Ask one question at a time” emerges on the top with the icon of a head and puzzle piece inside. The top quotation, “What do you like about exercise?” is highlighted.
Pic 20: Then the screen fades back to the “OARS” acronym, now with the word “Affirmations” highlighted. Then, the title changes to “Affirmations” on the top, and an icon of three speech bubbles with check marks within each are displayed. This icon shifts to the left and Danielle reappears on screen.
DANIELLE: Affirmations highlight an individual’s specific strengths and values that may lead them to make positive changes.
Pic 21: The screen returns to a dark gray background with the title “Affirmations”. Three quotes are displayed:
“You’re not the kind of person who gives up easily.”
“You really have a clear understanding of how important this change is for your health.”
“You have a lot of supportive people in your life who care about your health.”
DANIELLE: You can also affirm past efforts, good intentions, and patients’ ability to make decisions for themselves.
Pic 22: The quotes are replaced with three new ones, now with highlighted notations in parentheses.
“You’ve really been working hard at this!” (past effort)
“Your family is important to you, and you don’t want your health to get in the way of your time with them.” (good intentions)
“Choosing foods and how much to eat are decisions that only you can make.” (autonomy)
Pic 23: A red band appears in the middle with an example negative quote crossed out, saying: “You’re doing great!”
DANIELLE: Avoid phrasing affirmations as positive judgments, like “You’re doing great!” which suggests that you are in a place of authority to determine what is good and bad.
Pic 24: Red band disappears, and the header “Use positive reinforcement” appears on top with the icon of a head and puzzle piece inside. The quotation is replaced with: “You have a lot of supportive people in your life who care about your health.”
Pic 25: Screen returns to the “OARS” acronym, now with the word “Reflections” highlighted. Then the title “Reflections” appear on top, with the icon of two arrows stacked on top each other appearing at the center. The top arrow is pointing to the right, while the bottom arrow is pointing to the left. This icon shifts to the left an Danielle reappears on screen.
DANIELLE: Reflections are statements that summarize what the patient is saying without judgment.
Pic 26: Under the title “Reflections”, two quotes appear:
“I feel winded when I walk upstairs or try to keep up with my sister’s kids. I’m not okay with that.”
“You want to do the activities that are important to you without feeling so drained.”
Pic 27: The second quotation is highlighted in a speech bubble, spoken by a doctor icon appearing. A patient icon appears along with the reply, “Yeah, I’d like to have more energy.” attached to it.
DANIELLE: Whatever sentiment you choose to reflect will gain prominence in the conversation and the patient is likely to respond with more of the same. That’s why you want to listen for change talk and reflect it.
Pic 28: A red title “Sustain Talk” appears, with a red rectangle bordering the example quote: “I don’t think I can change because”. On the very top, the header “Deemphasize sustain talk” appears along with the icon of a head and a puzzle piece within.
Patients are likely to voice reasons to continue with an unhealthy behavior. Empathize with them and acknowledge their challenges, but do your best to reflect change talk and deemphasize sustain talk.’’
Pic 29: The title “Reflections” reemerges along with a person icon. Two speech bubbles are shown coming from it:
“I miss playing with the kids.”
“I feel winded when I walk upstairs or try to keep up with my sister’s kids, I’m not okay with that.”
DANIELLE: Reflections are most effective when they get at the feelings and motivations behind the patient’s words. So listen for implied desires or reasons for change.
Pic 30: The title “Simple Reflections” appear with two speech bubble icons appearing. The first speech bubble is empty and pointing to the left, while the second speech bubble is pointing to the right with a quotation mark inside. Two arrows connect the two speech bubbles in a circular fashion.
A simple reflection is a slight rephrase or paraphrase of what the person said.
Pic 31: Below the title “Simple Reflections”, three quotations emerge with people icons.
PATIENT: “But quitting smoking would be hard. I mean, everyone I know smokes.”
DOCTOR: “Most of your friends smoke too.”
PATIENT: “I don’t smoke that much except when I’m with them.”