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January 26, 2011
 
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Bulletin, Progressive, Record, Reporter Wednesday, Jan. 26, 2011 7B Understanding behavior change to meet goals HERE'S TO YOUR HEALTH AURA WHITTAKER Behavior change has come to be understood as a process of identifiable stages through which individuals pass. Understanding this process provides us with tools to help when we are discouraged with our lack of ability to reach our goals. The Stages of Change Mod- el (SCM), originally devel- oped in the late 1970s and early 1980s by James Pro- chaska and Carlo Di- Clemente at the University of Rhode Island, shows that for most people a change in behavior occurs gradually. A person moves from being un- interested, unaware or un- willing to make a change (the pre-c0ntemplation stage) to considering a change (contemplation stage) to deciding and preparing to make a change (action stage). Genuine, determined ac- tion is then taken, and over time, attempts to maintain the new behavior occur. Re- lapses are almost inevitable and become part of the process of working toward lifelong change. The SCM has been validat- ed.and applied to a variety of behaviors including smok- ing cessation, exercise be- havior, weight loss and di- etary behavior, among oth- ers. Simple and effective stage-based approaches de- rived from the SCM demon- strate widespread utility from big changes to small changes. The idea behind the SCM is that behavior change does not happen in one step. Rather, people tend to progress through different stages on their way to suc- cessful change. Also, each of us progresses through the stages at our own rate. So expecting behavior change by simply telling someone who is still in the pre-contemplation stage, for example; that he must lose weight in a cer{ain time peri- od is naive and perhaps counterproductive because the person is not ready to change. People must decide for themselves when a stage is completed and when it is time to move on to the next stage. Moreover, this decision must come from the individ- ual because stable, long-term change cannot be externally imposed. In each of the stages, a per- son has to grapple with a dif- ferent set of issues and tasks that relate to changing be- havior. The stages of change are: Pre-contemplation (not yet acknowledging there is a problem that needs to be changed) Contemplation (acknowl- edging there is a problem but not ready or sure Of wanting to make a change) Prepartion/Determination (getting ready to change) Action/Willpower (chang- ing behavior) Maintenance (maintaining the behavior change) Relapse (returning to old behaviors and abandoning the new changes) During the first state of change, known as the pre- contemplation stage, people are not thinking about changing and are not inter- ested in any kind of help. They may not believe their behavior is a problem or that it will negatively affect them, or they may be re- signed to their unhealthy be- havior because of previous. failed efforts and no longer believe that they have con- trol. People in this stage tend to defend their current bad habit(s) and may be defen- sive in the face of other peo: ple's efforts to pressure them to quit. They do not focus their attention on quitting and tend not to discuss their bad habit with others. In the second stage, or con- templation stage, people struggle with ambivalence, weighin$ the pros and cons of the current behavior with the benefits of and barriers to change. In the contemplation stage people are more aware of the personal consequences of their bad habit and they spend time thinking about their problem. Although they think about the nega- tive aspects of their bad habit and the positives asso- ciated with giving it up (or reducing), they may doubt that the long-term benefits associated with quitting will outweigh the short-term costs. It might take as little as a couple weeks or as long as a lifetime to get through the contemplation stage. Some people think and think and think about giving up their bad habit but never reach their goal. On the plus side, people in the contemplation stage are more open to receiving infor- mation about their bad habit, and more likely to ac- tuaily use educational inter- ventions and reflect on their own feelings and thoughts concerning their bad habit. During the preparation stage, the third phase, people prepare to make a specific change. They may experi- ment with small changes as a determination to change increases. For example, sam- piing low-fat foods may be an experiment with or a move toward greater dietary modi- fication. Switching to a dif- ferent brand of cigarettes or decreasing drinking signals that a person has decided a change is needed. This is sort of a research phase -- people are now tak- ing small steps toward cessa- tion. They are trying to gath- er information about what they will need to do to change the behavior. Also, people may talk.about their problem a lot, trying to find strategies and resources • available to help them in their attempt. Too often, people skip this stage: they try to move di- rectly from contemplation into action and fall flat on their.faces because they haven't adequately re- searched or accepted the work it is going to take to make a major lifestyle change. The fourth stage, action, is the one that most people are eager to reach. Many failed New Year's resolutions pro- vide evidence that if the pri- or stages have been glossed over, action itself is often not enough to create change. This is the stage where people believe they have the ability to change their be- havior and are actively in- volved in taking steps to change their behavior by us- ing a variety of different techniques. This tends to be the shortest of all the stages. The amount of time spent in action varies: it can last six months or more, or as little as one hour. This is a stage when peo- ple most depend on their own willpower. Whey are making overt efforts to quit or change the behavior and are at greatest risk for re- lapse. Mentally, they review their commitment to them- selves and develop plans to deal with both personal and external pressures that may lead to slips. Some use short- term rewards to sustain their motivation and analyze their behavior change efforts in a way that enhances their serf-confidence. People in this Stage also tend to be open to receiving help and are also likely to seek support from others. If successful at this stage, they move into the maintenance stage. The maintenance stage, the fifth stage, and relapse prevention involve incorpo- rating the new behavior over the long haul. Mainte- nance means being able to successfully avoid any temp- tations to return to the bad habit. People in this stage tend to remind themselves of how much progress they ,have made. Individuals in mainte- nance constantly reformu- late the rules of their lives and are acquiring new skills to deal with life and avoid re- lapse. They are able to antic- ipate the situations in which a relapse could occur and prepare coping strategies in advance. They remain aware that what they are striving for is personally worthwhile and meaningful. They are patient and recognize that it often takes a while to let go of old behavior patterns and practice new ones before they are second nature. Even though they may have thoughts of returning to old bad habits, they resist the temptation and stay on track. There is a real risk that people who relapse will expe- rience an immediate sense of failure that can seriously un- dermine.their serf-confi- dence and ultimate success. The important thing is that • if someone does slip and eat a whole package of cookies, she shouldn't see herself as having failed. Rather, she should analyze how the slip happened and use it as an op- portunity to learn how to cope differently. In fact, re- lapses can be important op- portunities for learning and becoming stronger. As you progress through your own stages of change, it can be helpful to re-evaluate your progress in moving up and down through these stages. Even in the course of one day, you may go through several different stages of change. And remember that it is natural to regress: to at- tain one stage only to fall back to a previous stage. This is just a normal part of making changes in your life. Relapsing is like falling off a horse -- the best thing you can do is get right back on again. However, if you do fall off the horse and relapse, it is important that you do not fall all the way back to the pre-contemplation or contemplation stages. Rather, restart the process again at preparation, action or even the maintenance stages: People who have relapsed may need to anticipate high- risk situations (such as be- ing with family) more effec- tively, control environmen- tal cues that tempt them to engage in their bad habits (such as being around drink- ing buddies) or learn how to handle unexpected episodes of stress without returning to the bad habit. This gives a stronger sense of serf-control and the ability to get back on track. EventuaLly, ffpeople main- tain long enough, they will reach a point where they will be able to work with their emotions, understand their own behavior and view the behavior in a new iight. This is the stage of transcen- dence transcendence to a new life. In this stage, not only is a bad habit no longer an inte- gral part of a person's life, but a return to it seems atyp- ical, abnormal and even weird tO the person. When you reach this point in the process of change, you know you have transcended the old bad habits and are truly becoming a new person who no longer needs your old be- haviors to sustain you. Aura Whittaker has a Bachelor of Science degree in kinesiology, which is the study of the principles of me- chanics and anatomy in rela- tion to human movement. She has more than 15years expe- rience in nutritional consult- ing and personal training. With comments and ques- tions, e-mail Ictimes@lassennews.com, or send mail to Lassen County Times, 100 Grand Ave., Su- sanville, CA 96130. Bequette & Kimmel Accountancy Corporation John A. Kimmel C.P.A. & Roberta Allen C.P.A. CPATM The CPA. Never Underestimate The Value. 307 W. 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