CBC Behavioral Modification Strategies 3 — Questions and Answers
Question 1: In the Transtheoretical Model, a patient who plans to start a food diary within the next month but has not begun is in which stage of change?
- Preparation (Correct answer)
- Precontemplation
- Action
- Maintenance
Correct answer: Preparation
Preparation is characterized by intending to take action soon, typically within the next month.
Question 2: Which counselor response best reflects motivational interviewing when a patient expresses ambivalence about exercise?
- 'What would be different in your life if you became more active?' (Correct answer)
- 'You need to exercise or the surgery will fail.'
- 'Most patients who don't exercise regain their weight.'
- 'Let me give you a mandatory workout schedule.'
Correct answer: 'What would be different in your life if you became more active?'
Open-ended questions that evoke the patient's own change talk are central to motivational interviewing.
Question 3: A patient sets a goal to 'eat better.' Applying SMART goal criteria, which revision is most appropriate?
- 'Eat one cup of vegetables at dinner five nights this week' (Correct answer)
- 'Try to eat healthy whenever possible'
- 'Never eat junk food again'
- 'Lose 50 pounds as fast as possible'
Correct answer: 'Eat one cup of vegetables at dinner five nights this week'
The revised goal is specific, measurable, achievable, relevant, and time-bound.
Question 4: Behavioral chaining analysis with a patient who binge eats at night would primarily focus on:
- Identifying the sequence of events and triggers leading up to the binge (Correct answer)
- Measuring resting metabolic rate
- Reviewing surgical anatomy changes
- Calculating daily protein requirements
Correct answer: Identifying the sequence of events and triggers leading up to the binge
Chain analysis maps the linked antecedents, thoughts, and behaviors that culminate in the binge episode.
Question 5: A patient who regained 10 pounds says, 'I'm a total failure.' The counselor's best cognitive restructuring response is to:
- Help the patient examine evidence for and against that belief (Correct answer)
- Agree that regain indicates failure to motivate change
- Ignore the statement and change topics
- Recommend immediate revision surgery
Correct answer: Help the patient examine evidence for and against that belief
Cognitive restructuring guides patients to test distorted beliefs against objective evidence.
Question 6: Which strategy best applies the behavioral principle of shaping to physical activity?
- Starting with 5-minute walks and gradually increasing duration weekly (Correct answer)
- Requiring a 60-minute gym session from day one
- Waiting until motivation is high to begin exercise
- Punishing missed workouts with extra sessions
Correct answer: Starting with 5-minute walks and gradually increasing duration weekly
Shaping reinforces successive approximations toward the target behavior through gradual progression.
Question 7: A patient reports skipping planned meals, then overeating late at night. The first behavioral recommendation should be:
- Establishing a structured, regular eating schedule (Correct answer)
- Fasting until noon to reduce calories
- Removing all evening meals permanently
- Doubling breakfast portion sizes
Correct answer: Establishing a structured, regular eating schedule
Regular structured meals prevent excessive hunger that drives compensatory nighttime overeating.
CBC Behavioral Modification Strategies 3
In the Transtheoretical Model, a patient who plans to start a food diary within the next month but has not begun is in which stage of change?