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Choices and Changes: Motivating Healthy Behaviours is appropriate for a wide range of clinicians, at every stage of their careers. Physicians, nurses, nurse practitioners, physician assistants, case managers, diabetes educators, social workers, psychologists, pharmacists, physiotherapists, addiction counselors, health coaches, health educators and dieticians have benefitted from the program.

The workshop can accommodate 6 to 20 participants to ensure optimal experiential learning in small and large group exercises.


The Choices and Changes workshop is based on theories and models of change, communication and education. Guiding models and theories include the conviction and confidence model, motivational interviewing, social cognitive theory, self-determination theory, and the transtheoretical model of health behavior change, of which the stages of change model is a key component.  Participants learn specific strategies and skills to apply these models in the setting of brief office visits. Choices and Changes teaches skills that are consistent with motivational interviewing; it is not affiliated with the Motivational Interviewing Network of Trainers (MINT).

The workshop is divided into three parts:

  1. Summary of research about health behavior change. There is now a large body of evidence that indicates that clinicians can have a positive impact on the health behaviors of our patients.

We can influence a wide variety of behaviors that include:

  • Self-management strategies that enhance chronic illness outcomes (e.g., self-monitoring, diet and exercise)
  • Adherence to specific treatment recommendations (e.g., medication use)
  • Avoidance, reduction or cessation of unhealthy behaviors (e.g., smoking or excessive drinking)
  • Adoption of healthy behaviors (e.g., stress management techniques)

2.  Clinicians’ roles and ideas and beliefs about change.

3.  Focus on patients. Change models, skills and specific strategies are applied to our work with our patients
to help patients change their health behaviors and improve their ability to self-manage their conditions.

The optional expanded full-day workshop includes more in-depth subject matter content and additional practice opportunities via small group exercises using video cases.

The one-hour Grand Rounds presentation provides a brief overview of key concepts and an abbreviated video case study and discussion opportunity.

Learning Objectives

The Choices and Changes workshop provides clinicians with opportunities to reflect on their role as facilitators of change and practice specific skills. By the end of the workshop participants will be able to:

  1. Describe two theoretical models of behavior change that can guide conversations with patients;
  2. Demonstrate three motivational interviewing core skills;
  3. Describe the four key elements of the visit with a patient/client; and
  4. Put into practice two techniques to use in clinical settings to influence change.


Choices and Changes workshop consists of brief lectures, interactive exercises, videotaped case studies and skills practice with peers to build participant awareness, knowledge, skills and confidence regarding health behavior counseling. Case examples frame realistic issues involving patients with diabetes, hypertension, asthma and cardiovascular disease; patients who smoke or use alcohol problematically; and patients reluctant to follow through with plans for screening or treatment. Workshop materials include an extensive annotated bibliography.

At the end of the workshop, participants are asked to commit to trying out one or two new motivational/behavior change counseling strategies for several weeks and then to evaluate the outcomes associated with these approaches.

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