ON Chiropractic perfect solution . There are three steps :
1 . Ask permission to offer some ideas . This demonstrates respect for the patient ’ s autonomy .
2 . Offer two or three general and varied ideas all at once . People love to get ideas from people who are like them , so other patients ’ experiences can be very helpful . By offering different kinds of ideas and not getting too specific , you can avoid assuming too much about your patient ’ s preferences or leading them to reject a specific idea .
3 . Ask if any of the ideas seem appealing or if they trigger other ideas the patient may have .
“
I Have an Idea
” Most patients will come up with ideas that are quite directly related to your care . But sometimes a patient may surprise you . For example , a patient who has been resisting regular exercise may tell you they are depressed and that they want to find a therapist . A patient who has been putting off gardening may set a goal to clean their garage so their tools are more accessible . Other patients may come up with goals that bear no connection to their health so far as you can tell .
It is important to support every patient in their goals , no matter how relevant they seem . Every successful plan will help to build the patient ’ s confidence and self-efficacy , leading to a greater ability to make behaviour changes in the future .
Once a patient identifies a goal , it ’ s time to create a specific action plan and elicit a commitment statement .
Skill : SMART Planning
Behaviour change is about just that : behaviour . For this reason , it ’ s important to help your patients develop a specific action plan rather than a goal . For example , a patient ’ s goal may be to lose weight . Action plans that could help them accomplish this include portion control , a specific diet or increased exercise .
BAP focuses on helping patients create Specific , Measurable , Achievable , Relevant and Time-bound ( SMART ) goals . You can do this by asking them for specific details : what , where , how long , how often , how much and when to start . A SMART plan might be “ I will do two sets of ten squats and five pushups at home every Tuesday and Friday morning and I will start tomorrow .”
Skill : Eliciting a Commitment Statement
Once your patient has a SMART action plan , ask them to tell their plan back to you . This helps the patient solidify the details in their mind and it increases their sense of ownership over the plan . “ People are more likely to believe what they hear themselves say , and are more likely to resist what they hear others tell them to do .” 8
The commitment statement also “ predicts subsequent behaviour change , and the strength of the commitment
Dr . Smith : Some of my patients do exercises and stretches at home or join a class at a gym . Others have worked on reducing stress or improving the quality of their sleep . Do any of those ideas seem like something that would work for you ? Or maybe something else comes to mind ?
Ms . Ng : Well , I would like to do more exercise . I keep hearing about how bad it is to sit all day at work .
Dr . Smith : Would it help to make a specific plan around exercise ?
Ms . Ng : That could help .
Dr . Smith : Okay , what would you like to do ?
Ms . Ng : Well , I think I would rather exercise at a gym . I tried those stretches you gave me , but I have so many other things I need to do at home and I get distracted .
Dr . Smith : Is there a particular gym you are thinking of ?
Ms . Ng : Actually , there is a gym near my office that some of my coworkers go to at lunch . They have a yoga class I could join .
www .. chiropractic . on . ca 23