REHB1001 Chap.8 Behaviour Change Theory and Motivational Interviewing
Behaviour Change Theory and Motivational Interviewing
Knowing what is healthy rarely changes behaviour, so the Week 4, 8 and 9 lectures teach theories and techniques for change.
This chapter summarises the Health Belief Model, self-determination theory, self-efficacy theory and the Behaviour Change Wheel, explains behavioural, outcome and learning goals with SMART and its limits, and sets out health coaching: its four principles, OARS and the DEARS principles of motivational interviewing, worked through a short conversation with a patient who keeps giving up exercise.
The chapter stays close to the course's own labels, such as past behaviour outcomes for the first source of self-efficacy, because those are the terms the quizzes use.
What this chapter covers
- 01
Why awareness is not enough
- 02
Health Belief Model and cues to action
- 03
Self-determination theory needs
- 04
Four sources of self-efficacy
- 05
Behaviour Change Wheel
- 06
Goal setting and when SMART backfires
- 07
Health coaching, OARS and DEARS
Worked example · free
Choosing a goal type for an inactive patient
- +1A demanding SMART target such as 150 minutes a week can backfire for someone just starting, as Swann and colleagues argue.
- +1A learning goal targets strategies instead: 'Find three ways to add walking to my working day this fortnight.'
- +1Let the patient identify the steps, following the health coaching principle of small, sustainable steps.
- +1Review together and move to a behavioural goal, such as a daily step target, once confidence grows.
Key terms
- Self-efficacy
- A person's confidence that they can carry out a particular behaviour.
- Cue to action
- Anything that activates a person's readiness to change and prompts behaviour change.
- Behaviour change technique
- An observable, measurable and replicable active ingredient of an intervention.
- Motivational interviewing
- A client-centred, directive method for eliciting motivation by resolving ambivalence.
- Learning goal
- A goal that targets strategies to develop, suited to people just starting a behaviour.
- Goal discrepancy
- Drawing attention to the gap between current behaviour and a goal the person has set.
- Ambivalence
- Mixed feelings about changing a behaviour, explored rather than argued with in coaching.
Behaviour Change Theory and Motivational Interviewing FAQ
What are the five principles of motivational interviewing in this course?
The course summarises them as DEARS: developing discrepancy; expressing empathy; amplifying ambivalence; rolling with resistance; and supporting self-efficacy. They are not a sequence; a good conversation uses all five as needed, with the client doing most of the talking, about 80% by the course's guide.
What are the four sources of self-efficacy?
As the lecture prints them: past behaviour outcomes, vicarious experiences, verbal persuasion, and physiological or affective states. Past behaviour outcomes are described as the strongest predictor of future behaviour, which is why reminding a patient of an earlier success, such as quitting smoking, is useful.
Where do the stages of change fit?
The Week 4 page lists a stages-of-change lecture, and the cases and sample viva ask you to identify a patient's stage. The lecture notes are not among the materials available here, so take the stage definitions from the course site and your own lecture notes, and practise matching them to patients' statements.
What are the three needs in self-determination theory?
Autonomy, the wish to be self-directed and choose activities; competence, the wish to feel capable and accomplished; and relatedness, a sense of belonging with others. The Week 9 slide links motivational interviewing to them: autonomy support, structure such as goal setting, and involvement through empathy.
What does OARS stand for?
Open-ended questions, affirmations, reflections and summarising statements. The health coaching lecture gives each with an example, from asking why more activity matters to the person, to summarising how past experiences with exercise have shaped their worries. Together they keep the client talking and the clinician listening.
What are the four core principles of health coaching?
Collaboration over compliance; a strengths-based approach that builds on the client's existing resources; small, sustainable steps that the client identifies rather than the coach prescribes; and long-term self-management built on self-efficacy and resilience. The coach empowers rather than advises, and both coach and client share accountability.
Exam move
Write the four theories on one page with their core constructs and one physiotherapy example each. Practise OARS by recording yourself in a two-minute mock conversation and counting open questions and reflections. Then rehearse each DEARS principle with a line you could say, and check you can match an MI strategy to the self-determination need it serves.
For each tutorial case, decide which theory best explains the patient's behaviour and which technique you would try first, then say both aloud.
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