II. Technique: Five Rs Counseling (using Tobacco as an example)

  1. Relevance
    1. Encourage the patient to identify Tobacco Cessation reasons that are relevant to them
    2. Examples: Erectile Dysfunction, COPD or Asthma, Coronary Artery Disease
  2. Risks
    1. Discuss with the patient the harmful effects of continued Tobacco use on their families and themselves
    2. Examples: Spirometry to estimate "lung age", attributing a typical age for their actual lung function
      1. Parkes (2008) BMJ 336(7644): 598-600 [PubMed]
  3. Rewards
    1. Ask the patient what benefits they would foresee from Tobacco Cessation
    2. Examples: Financial savings, eliminating the Tobacco odor
  4. Roadblocks
    1. What are the barriers to Tobacco Cessation
    2. Examples: Stress, Weight gain, other smokers in same household
  5. Repeat
    1. Readdress at each visit with an unmotivated Tobacco user

III. Technique: Five Rs Counseling (using Eating Disorders as an example)

  1. Relevance
    1. Encourage the patient to identify why Eating Disorder effects are relevant to them
    2. How would your life be different if you spent less time thinking about eating?
  2. Risks
    1. Discuss the consequences of disordered eating (decreased concentration, Fatigue, weakness)
  3. Rewards
    1. Ask the patient what benefits they would foresee from overcoming disordered eating habits
    2. Examples: Improved energy, clothes fit, not hiding intentional weight loss behaviors
  4. Roadblocks
    1. What would be the downside of changing the way you eat?
  5. Repeat
    1. Readdress at each visit with an unmotivated patient

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