Summary: <p>Addressing Treatment Noncompliance<br> Instructor: Dr. Dawn-Elise Snipes</p> <p>CEUs for this presentation can be found at <a href="https://www.allceus.com/member/cart/index/search?q=noncompliance">https://www.allceus.com/member/cart/index/search?q=noncompliance</a></p> <p>Objectives<br> ~ Examine some of the reasons for treatment noncompliance including<br> ~ Learning vs. Performance<br> ~ Low motivation<br> ~ Not feeling heard / White-Coat Syndrome<br> ~ Roll with Resistance<br> ~ Tipping the Scales<br> Questions<br> ~ In what ways are your clients noncompliant?<br> ~ What things are your clients often resistant about?<br> Noncompliance<br> ~ Is NOT a respect issue<br> ~ Can result from<br> ~ Lack of knowledge<br> ~ Lack of ability<br> ~ Lack of effective skills for that person<br> ~ Lack of motivation<br> ~ No buy-in to new skill or behavior<br> ~ New skill or behavior less effective than old skill or behavior</p> <p>Types of Resistance<br> ~ Issue resistance<br> ~ Related to a specific issue such as smoking cessation, changing a dietary pattern, physical activity, etc.<br> ~ Relational resistance<br> ~ Has to do with the relationship between you and the client.<br> ~ There is discord in the interactions.<br> ~ Comments may include<br> ~ You don’t understand<br> ~ You can’t help me</p> <p>Learning vs. Performance<br> ~ Client is motivated but not following through<br> ~ Do they know it?<br> ~ Can they do it?<br> ~ Do they have confidence that they can do it?<br> ~ How do you teach adult learners: ABCD<br> ~ Acquisition: Auditory, Visual, Kinesthetic<br> ~ Buy In (Why do I care?)<br> ~ Connected to current/prior situations<br> ~ Divided into manageable parts</p> <p>Learning vs. Performance<br> ~ How do you teach performance?<br> ~ Role play<br> ~ Hypothesizing<br> ~ Systematic exposure/experience<br> ~ Example: Distress Tolerance for Anxiety<br> ~ Have client develop distress tolerance plan<br> ~ Remember a time last week when you were distressed and explain how you could have applied the plan<br> ~ Role play a situation that often causes you distress and use the new skills<br> ~ Envision yourself successfully navigating a stressful situation using new skills<br> Learning vs. Performance<br> ~ Systematic exposure/experience<br> ~ Example: Distress Tolerance for Anxiety<br> ~ IRL: Practice using the skill at least once a day on things that cause you anxiety.<br> ~ Identify how successful it was<br> ~ Identify what parts worked<br> ~ Identify what you could do differently next time</p> <p>Tipping The Scales of Motivation<br> ~ Stages of Readiness for Change<br> ~ Precontemplation<br> ~ Contemplation<br> ~ Preparation<br> ~ Action<br> ~ Pain Withdrawal Romanticize/minimize drawbacks to old behavior<br> ~ Motivation<br> ~ Stages are NOT linear<br> Motivation<br> ~ Why is the new behavior less motivating?<br> ~ Benefits of old behavior (Drinking, Eating, Cutting, Screaming, Sleeping)<br> ~ How can you meet those needs now<br> ~ Drawbacks to new behavior (Less immediately effective, less enjoyable, hard to remember to use them)<br> ~ How can you minimize those<br> ~ Benefits of the new behavior<br> ~ How can you maximize those<br> ~ Drawbacks to the old behavior<br> ~ How can you magnify/remember these<br> Motivation<br> ~ What about the new behavior is less motivating<br> ~ No buy in<br> ~ Too hard/complicated/theoretical<br> ~ Assumes skills not available (i.e. need to pause before DT; Need self awareness before communicating needs)<br> ~ Not individualized<br> ~ Meditation/PTSD/ADHD<br> ~ Writing and reading for Extroverts<br> ~ Support group and social gatherings for Introverts, cultures that prefer privacy<br> ~ Tried and failed</p> <p> </p> <p>Motivation Maintenance<br> ~ Regularly review and add to the<br> ~ Benefits of change<br> ~ Drawbacks to st</p>
