FEATURE STORY / BEHAVIOUR CHANGE WITH BRIEF ACTION PLANNING
efficacy and ultimately change patients ’ behaviours by helping patients set an action plan that they feel confident in their ability to achieve .” 7
Below , we will describe the three questions and five skills used in Brief Action Planning . These questions and skills are demonstrated in the acase scenario below .
Is There Anything You Would Like to Do for Your Health in the Next Week or Two ?
Brief Action Planning begins with Question One : “ Is there anything you would like to do for your health in the next week or two ?” This question brings the patient ’ s focus to their health and wellness and asks them to talk about their personal goals and preferences .
Depending on the conversation you ’ ve had with the patient so far , it may be appropriate to make this question more general ( e . g . “ for your current situation ”) or more specific ( e . g . “ for your headaches or anything else ”).
Question One intentionally focuses on the next week or two . This relatively short time frame helps patients create smaller goals that lead to quick wins . After all , to run a 5K it ’ s necessary to get off the couch and begin with short walks and runs . It is these early confidence-building successes that BAP seeks to unlock for your patients .
Responses to Question One generally fall in three categories : I have an idea , I ’ m not sure or I ’ m not interested .
“
I ’ m Not Interested
”
Some patients aren ’ t ready to make a plan . Since BAP and MI
encourage and respect the patient ’ s autonomy , allow your patients to choose not to make a change if they do not wish to . Patients have a variety of reasons for resisting making plans , and for some it ’ s simply not the right time .
If you try to push forward when a patient is not ready , they may feel uncomfortable . What ’ s more , if these plans fail , the patient ’ s confidence will be damaged . Allowing a patient to say no demonstrates respect and enables you to support them in the future .
To leave the door open to action plans , you can ask these patients if it would be okay if you asked them about making a plan at a future visit .
“
I ’ m Not Sure
”
If a patient is open to creating an action plan but is having
trouble coming up with ideas , you can help them think of ideas by offering a behavioural menu .
Skill : Behavioural Menus
The goal of a behavioural menu is to help the patient generate their own ideas , not for the practitioner to come up with a
CASE SCENARIO
Ms . Ng is a 45 year old office worker who has chronic low back pain . Her chiropractor , Dr . Smith , has suggested stretches and exercises but Ms . Ng rarely does them . In this scenario , Dr . Smith works with Ms . Ng using BAP as a form of self-management support . His CHA , Alicia , provides additional support and follow-up .
Dr . Smith : Now that I ’ ve adjusted your back , I was wondering if there is anything you ’ d like to do for your back health in the next week or two ?
Ms . Ng : Well , I ’ m not really sure what I can do . It helps when I come here , but it always seems to come back .
Dr . Smith : That must be frustrating . Would it be okay if I shared with you some examples of what some of my other patients have done for their health ?
Ms . Ng : Sure , that might help .
22 SPRING 2016