Behavior Change in Primary Care: Assessment

Abstract

This chapter describes an approach to behavioral health assessment designed to engage patients in developing and implementing powerful behavioral change plans. These methods are useful for all clinicians working in primary care, whatever their training background. Assessment begins with a standard introduction that prepares the patient to participate actively in assessment activities. Use of a standardized quality of life survey is an important part of assessment in initial and follow-up visits. Three case examples and clinical dialogues between clinicians and patients illustrate three assessment tools: Contextual Interview Questions, Four-Square Tool and the FACT Pillars Assessment Tool. Use of Contextual Interview Questions promotes a functional approach to assessment and supports development of precise, engaging behavior change plans. The Four-Square Tool aids clinicians in conceptualizing the functions of behaviors identified in the contextual interview. The third tool, the FACT Pillars Assessment Tool, encourages clinicians to identify patient strengths and weaknesses on three pillars of psychological flexibility: open, aware, and engaged. The chapter concludes with a checklist of recommended strategies for readers to use to deliver behavior change assessments that support radical behavior change.