Behavior Changes for Better Health

Vicki:

Hi, welcome to an HMC Health Works podcast. I’m Vicki Putnam, and we’re joined by certified wellness coach Elizabeth DuPont. Welcome, Elizabeth.

Elizabeth:

Yes. Thank you. Greetings. Thanks for having me.

Vicki:

Elizabeth, today, we will discuss some behavior change. And as a wellness coach, your primary goal is to facilitate an individual’s growth and change. In the arena of health, fitness and wellness, you focus on behavioral changes that support a higher level of health and wellbeing.

Elizabeth:

Yes. Today, I will discuss the trans theoretical model of behavior change. It is developed by Dr. James Prochaska. And the model is based on more than 25 years of research, measuring behavior change for a wide variety of health behaviors, and is one of the models that we do use while coaching our individuals here at HMC.

Vicki:

Interesting. I know research has shown that self-change is a staged process and that there are five stages of change. Can you tell me a little bit more about these stages?

Elizabeth:

Sure. There are stages and we move from not thinking about changing behavior, to thinking about it, to planning to change and to testing out ways to do it before we actually start. It is really important to recognize that the individual may move forward toward action or may slip back to inactive during the time that you are working together. And when a coach is aware of the stage, we can apply techniques for assisting change that are specific and effective for the stage they are in. Application of specific techniques at each stage will help the participant reach their health, fitness and wellness goals more quickly and effectively, and will be able to maintain them.

Vicki:

Interesting information. Elizabeth, tell me about the first stage, pre-contemplation.

Elizabeth:

This is the, ‘I won’t’ or ‘I can’t’ stage. When someone is not even thinking about adopting a healthy behavior, it’s usually because they fall into one or two categories. The ‘I won’t’ or the ‘I can’t’ people. The ‘I won’t’ people are not interested in changing because they do not feel they have a problem. Family and friends may feel otherwise and may be nagging them about it, but they refuse to see the problem. The ‘I won’t’ people would like to change, but they don’t believe it is even possible. For very different reasons, both kinds of people are not even thinking about making a change when it comes to that area in their lives.

Vicki:

As a coach, how do you assist these individuals?

Elizabeth:

Well, in the ‘I won’t’ people, we leave it open. We provide our contact information and let them think about it more. For the ‘I can’t’ people, I provide sincere empathy we use reflections to show understanding and respect for their feelings and needs, discuss and sort through their barriers in a positive and rational way, so they can learn from them rather than being overwhelmed by the negative emotions of ignoring it or even perhaps the past failure.

Vicki:

Yeah, that’s definitely a lot to think about. Elizabeth, what is the next stage after that?

Elizabeth:

The next stage is contemplation, or the ‘I may’ stage. Individuals are thinking about changing an unhealthy behavior or adopting a healthy behavior and are considering taking action within the next six months. They are more aware of the benefits inherent in changing and less satisfied with their present health and wellbeing than the pre-contemplators. So I would really assist them in connecting them with their strengths, identifying their reasons for change, the why’s, the payoff, what would be the benefit. And connecting them with others for support. Weighing out the pros and cons to making a change and coming up with small, realistic thinking and feeling goals.

Vicki:

Wow. It really sounds like the coach can play a huge role with nurturing change in that contemplation stage. After that contemplation stage, what’s next?

Elizabeth:

Preparation or the ‘I will’ stage. In this stage, ambivalent feelings have been largely overcome and individuals have strengthened their motivation and they are planning to take some action within the next month. This includes assisting them with their specific plan for change, brainstorming and coming up with a lot of small steps that are actionable and realistic, and discussing any barriers that might arise and strategies to overcome.

Vicki:

You know what, as you’re explaining these stages, I can see actually how they’re relevant even in my own everyday habits. Even something as simple as me trying to pay attention to my plate and how much of it is filled with fruit and vegetables in a meal. I’m ready to go to the action stage, aren’t I?

Elizabeth:

Exactly. This is used in everyday life and eventually leads to a change in action, which is our next stage. The action stage, the ‘I am’ stage. In this stage individuals have identified the new behavior that they want to establish and are doing it consistently. Building up to a target level. For example, they may be working toward meeting the American Heart Association definition of cardiovascular exercise. Or in your case, by noticing the plate portions, you move to the ‘I am’ stage and are having half of your plate filled with fruits and vegetables for meals.

Vicki:

Yeah. What else do you do in that stage?

Elizabeth:

We continue help assisting them connect the new behaviors with their strengths, values and preferred environments. We target gradual change, small achievable steps that really assist clients to feel successful early. Learning from setbacks and coming up with strategies to increase success and discuss the situations that could be problematic and develop a strategy to cope with the situation before it actually arises. The support is continued into the maintenance stage, which is the next stage. That is the ‘I still am’ stage.

Elizabeth:

When the new behavior has become a habit and it’s done automatically, which usually takes about six months after the initial behavior has changed. There are different sets of risks and maintenance, including boredom and the danger of gradually slipping back into old, less helpful habits. So it really is important to reconnect and appreciate the value of new behaviors in serving their vision and goals. Challenge them to keep growing by setting new behavioral goals that are both interesting and attainable. The environment, mental support is really important, and connecting with those motivators. If we have early recognition and rapid response to get back on track is very important.

Vicki:

Wow. This multi-stage process that you shared for behavior change, it actually reminds me of a quote from Dorothy Corkville Briggs. I don’t know if you or any of the listeners have heard of her, but what she says is, “Growth is not steady forward, upward progression. It is instead a switchback trail, three steps forward, two back, one around the bushes and a few simply standing before another leap.” And this really is so true. Elizabeth, thank you so much for all this fascinating information.

Elizabeth:

You’re welcome. Thanks for having me.

Vicki:

And I wanted to remind everyone to stay tuned for future HMC Health Works podcasts.