A MODEL FOR CHANGE
- A model for change used frequently by health coaches is called the Transtheoretical Model of Change.
- The model provides a format for determining readiness to change.
- The focus is on a person’s intent to make a change and desire to make decisions.
- Most people do not change a habit quickly so determining intent is essential to success.
Stages of Change
- “Ignorance is bliss” – the person may not be aware that the unhealthy behavior could produce a negative consequence.
- A person’s emphasis is on the challenges of changing the behavior rather than the benefits of doing so.
- No action is planned in the next six months.
- A person realizes that a health behavior may lead to negative consequences.
- Investigation into the benefits and challenges associated with changing the behavior occur.
- “Sitting on the fence” – a person has continued uncertainty about changing a behavior but intends to do so in next 6 months.
- “Testing the waters:” – a person is taking small steps toward changing the health behavior including developing a plan to do so.
- There is now a solid belief that changing the behavior will have a positive effect on overall health.
- A plan to take action in next 30 days has been established (see below).
- Things are moving forward with changing a health behavior and there is intent to continue doing so.
- In this stage, a health behavior is sustained for more than six months.
- Efforts are made to prevent relapsing to a previous negative health behavior.
- There is no desire to return to unhealthy behavior.
- Most people remain in the maintenance stage and must sustain efforts to prevent relapse.
- Create a reasonable plan with incremental steps to promote successful changing of a health behavior.
- Establish an overall goal using the S.M.A.R.T. format – specific, measurable, achievable, realistic, and timely.
- Build in mini-S.M.A.R.T. goals and reward milestones along the way.
- Choose an accountability partner.
- Establish a routine interval to review progress.
- Discuss successes and barriers to change.
- Determine strategies to remove barriers and increase likelihood of success.
CHANGING A HEALTH BEHAVIOR - EXAMPLE
- Tom is in the contemplative stage and has learned that drinking too much soda can lead to obesity, diabetes, heart problems and other diseases. After talking with his doctor and confirming his concerns, he moves to the preparation stage.
- Tom attempted to create an overall goal for his behavior change and wrote “I will stop drinking soda every day”.
- Tom’s accountability partner, Mike, discussed his plan with him and encouraged him to re-write his overall goal using the S.M.A.R.T. format. His new goal is “In 60 days I will only drink one 10-ounce soda per week.” The goal is specific, measurable, achievable,
realistic, and timely.
- Tom then created mini-S.MA.R.T. goals with rewards as follows:
- In the first 15 days, I will drink one 10-ounce soda on Monday, Wednesday, Friday, Saturday and Sunday. My reward for doing so will be a premium car wash.
- Between day 16 and 30, I will drink one 10-ounce soda on Monday, Friday and Saturday. My reward for doing so will be a date night with my wife.
- Between day 31 and 45, I will drink one 10-ounce soda on Monday and Saturday. My reward for doing so will be a golf lesson with a pro.
- Between day 46 and 60, I will drink one 10-ounce soda on Saturday. My reward for doing so will be dinner with my wife at our favorite restaurant.
- Tom moved into the action stage and began the process of changing his health behavior. He and Mike talked every Tuesday at 6:30pm to discuss successes and barriers. On the fortieth day Tom confided that he slipped and had a soda at his son’s birthday party that was held on a Sunday. He and Mike discussed purchasing other beverages to have on hand at events.
- Tom successfully moved into the maintenance stage and after six months continued to have one 10-ounce soda a week. He is back in the contemplative stage, deciding whether he wants to give up soda all together!