Behavior Change:It’s so very easy!

Ann Rathbun, Ph.D.Associate Professor

Health, Wellness and Human PerformanceMorehead State University

Easy, right??

• Just do it!

• No pain, no gain! • It’s as easy as 1, 2, 3 !• Take this pill and…… in 2 short weeks !• Quick and Easy steps to …..• In as little as 10 minutes a day, you can…….• Just say “no”

© A. Rathbun, 2010

If it WERE easy…..

© A. Rathbun, 2010

Background

• James Prochaska & Carlo DiClemente– The ‘fathers of behavior change’

• Take their cues from psychological theory.• ‘Model’ is a hybrid.• Model is based on 9 major processes of

change.

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

9 major processes of change

1. Awareness raising– Hopefully we can make ‘informed decisions’ about

change2. Social liberation– No smoking restaurants

3. Emotional arousal– Crisis, event, awakening

4. Self re-evaluation– Will my life be ‘better’ if I change this behavior?

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

9 major processes of change

5. Commitment– Accepting responsibility of changing…I am the only

one who can do this!6. Countering– Replacing the existing behavior with something else

(smoking for taking a walk)7. Environmental Control– Cues to motivate, assist, remind

8. Rewards– Extrinsic, non-abstract, ‘I can go do ______’

9. Helping relationships– Social support, listeners

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

Stages of change

• NON-LINEAR !!!– We can go forward and backward

• Tools come in handy• Playing tricks with yourself is OK• Slow and steady• Getting started may be the hardest part• If you can make one change, you can make

others© A. Rathbun, 2010

Stages of Change

• Precontemplation• Contemplation• Preparation• Action• Maintenance• Termination

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

Stages of Change-Defined

• Precontemplation• Not aware that a change should occur• Sometimes individuals might site ‘destiny’ or other factors

that keep them from changing.

• Contemplation• Thinking of making a change in the next 6 months• Plans are indefinite

• Preparation• Will make a change in the next 30 days• Can include gathering behavior patterns though analysis

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

Stages of Change - Defined

• Action• Actually doing something; taking steps to change

behavior• Starting the exercise program, tobacco replacement,

attending programs• Change does NOT end here!!!

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

Stages of Change - Defined

• Maintenance• The behavior change is still in ‘action’ and has now

become a habit.• Need to have a plan for ‘crisis’ periods; backup plan• May last between 6 days and 600 years

• Termination• The ultimate goal• There is no ‘fear’ of relapse; no temptation to return to

the behavior

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

Processes and Stages

Precontemplation Contemplation Preparation Action Maintenance

Consciousness –RaisingSocial Liberation

Emotional ArousalSelf-Reevaluation

Commitment Reward Countering Environmental Control Helping Relationships

© A. Rathbun, 2010

Prochaska, Norcross & DiClemente, 1995

ONE tool: The Contract

• Elements– Choose a GOAL– Choose a BEHAVIOR– Practice…..

VERY DIFFERENT !!!

© A. Rathbun, 2010

Practice• Write 1 simple goal regarding weight loss– Lose 5 pounds by July 1

• Now, what is ONE behavior that goes with that goal?– Behaviors that SUPPORT that goal might be:

• Walking 30 minutes each night• Limiting sugary pop• Running two miles every day• SOMETHING that implies ACTION !!!!

• How did you do???• It is difficult, sometimes. Your clients will need

assistance with this probably.© A. Rathbun, 2010

ONE tool: The Contract

• Elements– Choose a GOAL– Choose a BEHAVIOR

– Practice…..

– Dates– Start date, stop date (?)

– Mini-goals– The small steps…..

» Date» REWARD for accomplishing that mini goal by the date.

VERY DIFFERENT !!!

© A. Rathbun, 2010

Brainstorm a list of 20 things you could

do as a reward*

*Must be ‘free or cheap’, should not involve food, must feel ‘rewarding!’© A. Rathbun, 2010

ONE tool: The Contract

• Elements– Choose a GOAL– Choose a BEHAVIOR

– Practice…..

– Dates– Start date, stop date (?)

– Mini-goals– The small steps…..

» Date» REWARD for accomplishing that mini goal by the date.

VERY DIFFERENT !!!

© A. Rathbun, 2010

BC contract, cont.

• Elements, cont.– How will you keep track?• Weighing in, journaling, biometrics, body

measurements, counting steps/carbs/calories

– Who will support?• Actually SIGNS the contract with the client• Can be YOU, can be loved one, can be a ‘buddy’ in the

class

© A. Rathbun, 2010

Final thoughts• Einstein had it RIGHT……

• Insanity: If you keep doing what you are doing and expecting a different result!

• Nancy Reagan…..not so much• Just saying ‘no’ requires a jump from precontemplation

to action….immediately.

• Clients are their own EXPERT….• This is hard, I have failed before, I am afraid, I want it

FAST…

• You can help !!!• Knowledge, awareness, environmental, support,

professionalism© A. Rathbun, 2010

Questions?Comments?Successes?

Stories?

© A. Rathbun, 2010

Reference

Prochaska, J., Norcross, J., & DiClemente, C.(1995). Changing for good: A revolutionary sixstage program for overcoming bad habits andmoving your life positively forward. New York: Avon Books.

© A. Rathbun, 2010