1. © 2011 McGraw-Hill Higher Education. All rights reserved. Chapter 2 Changing Behavior A Wellness Way of Life Ninth Edition Robbins/Powers/Burgess

2. Chapter 2 Objectives After reading this chapter you will be able to: 1. Explain what self-efficacy is and how it affects behavior change. 2. Explain why willpower alone is not enough to change a behavior permanently. 3. Identify and describe the five stages of change in the transtheoretical model of behavior change. 4. Name the nine processes of change and relate them to the stages of change in the transtheoretical model. 5. Describe the elements of a well-designed behavior change plan/contract. 6. Describe the components SMART goal setting. 7. Name the two components of motivation and identify ways to sustain motivation. 8. Identify the top three contributors to relapses during attempted behavior changes. 9. Explain ways to prevent or recover from relapses during behavior change. © 2011 McGraw-Hill Higher Education. All rights reserved.

3. Behavior Change Behavior change takes more than knowledge and willpower. Desire must be present, but skills, self-efficacy, resources, a plan, and rewards will increase the chances of success. Learning a new behavior takes practice and persistence. Only you can initiate change in yourself. © 2011 McGraw-Hill Higher Education. All rights reserved.

4. What is Self-Efficacy? The amount of confidence an individual has in his or her own ability to carry out a desired behavior. A person can have high, moderate, or low levels of self efficacy. It is behavior specific—could be high for one behavior and low for another. Having high self-efficacy can lead to making positive health choices consistently. © 2011 McGraw-Hill Higher Education. All rights reserved.

5. The Transtheoretical Model of Behavior Change Model of intentional change focused on personal decision making. Individuals progress through five stages: –Precontemplation –Contemplation –Preparation –Action –Maintenance The key to successful behavior change is identifying current stage and applying the processes of change that fit that particular stage. © 2011 McGraw-Hill Higher Education. All rights reserved.

6. Precontemplation – stage 1 Individuals are not even considering a change in behavior. Individuals are either uninformed about the consequences or demoralized about the chances of change. Denial is very common at this stage. © 2011 McGraw-Hill Higher Education. All rights reserved.

7. Contemplation – stage 2 Individuals have a sense of awareness about their problem behavior. Individuals may intend to take action or are seriously thinking about it but have not made a commitment to change. The barriers override the benefits. © 2011 McGraw-Hill Higher Education. All rights reserved.

8. Preparation – stage 3 Key transition from considering change to beginning a plan for action. Individuals are making a commitment to the change effort. May begin some small steps toward change. © 2011 McGraw-Hill Higher Education. All rights reserved.

9. Action – stage 4 Individuals take overt action to change a behavior. Individuals use strategies to resist temptation, cope with everyday challenges, and prevent relapse. Self-efficacy is a key element in this stage. Small attainable goals are important. © 2011 McGraw-Hill Higher Education. All rights reserved.

10. Maintenance – stage 5 Individual sustains new changed behavior for at least 6 months. New patterns become automatic. Long-term change creates strong efficacy. Increased internal reward system. © 2011 McGraw-Hill Higher Education. All rights reserved.

11. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Can you think of other behavior change questions? Figure 2-1 © 2011 McGraw-Hill Higher Education. All rights reserved.

12. Processes of Change Consciousness-raising (learn about it.) Social liberation (Is there help out there?) Emotional arousal (I don’t want that to happen to me!) Self-reevaluation (Is change really worth it?) Self-liberation (I can do it!) Reward (How can I reward myself along the way?) Countering (What can I do instead?) Environment control (My surroundings make it easy.) Helping relationships (Will you help me stick with this?) © 2011 McGraw-Hill Higher Education. All rights reserved.

13. Consciousness-Raising Learn About It. Getting information regarding the nature and risk of an unsafe behavior. Gaining awareness and feedback about a problem behavior. Learning about the benefits of changing a problem behavior. © 2011 McGraw-Hill Higher Education. All rights reserved.

14. Social Liberation Is There Help Out There? Understanding and changing the contingencies that control or maintain the problem behavior. Accepting and using new alternatives provided by the external environment. Seeking social opportunities that support change. © 2011 McGraw-Hill Higher Education. All rights reserved.

15. Emotional Arousal I Don’t Want That to Happen to Me! Experiencing emotions related to the problem behavior. Acknowledging emotions. Reflecting on emotions. © 2011 McGraw-Hill Higher Education. All rights reserved.

16. Self-Reevaluation Is Change Really Worth It? Determining consequences and impact on personal life with and without a particular habit. Reevaluating values, sacrifices, and level of commitment. Weighing pros and cons. © 2011 McGraw-Hill Higher Education. All rights reserved.

17. Self-Liberation I Can Do It! Accepting personal responsibility for changing, especially the belief that it can be done. Committing and recommitting to act on that belief. Creating a specific plan for change with goals and a time line. © 2011 McGraw-Hill Higher Education. All rights reserved.

18. Reward How Can I Reward Myself? Receiving rewards or reinforcements from others for positive change. Rewards should be meaningful to the particular person and should encourage and/or support the changed behavior. Using positive self-talk. Avoid rewards that are contrary to the changed behavior, e.g., a big bowl of ice cream as a reward for weight loss. © 2011 McGraw-Hill Higher Education. All rights reserved.

19. Countering What Can I Do Instead? Substituting alternative behavior for problem behaviors. Choosing alternative behaviors that will support healthy behavior. Choose alternative behaviors that are convenient and that you enjoy if possible. © 2011 McGraw-Hill Higher Education. All rights reserved.

20. Environment Control My Surroundings Make Change Convenient and Easy Restructuring the environment to reduce temptations. Avoiding or controlling the situations that trigger the problem behavior. Post positive signs and reminders. © 2011 McGraw-Hill Higher Education. All rights reserved.

21. Helping Relationships Will You Help Me Stick With This? Trusting, accepting, and using the support of others during attempts to change the problem behavior. Surrounding yourself with relationships that will support your new behavior. Writing a contract with yourself or another supportive person. © 2011 McGraw-Hill Higher Education. All rights reserved.

22. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Figure 2-2 © 2011 McGraw-Hill Higher Education. All rights reserved.

23. Making a Plan Identify your goals List pros and cons Identify your stage of change Identify processes with accompanying behavioral strategies Create an action plan Prevent relapse Engage positive rewards Develop internal motivation © Getty Images/SW Productions © 2011 McGraw-Hill Higher Education. All rights reserved.

24. Writing SMART goals S = Specific M = Measurable A = Achievable R = Reward T = Time-defined Ex: By the end of the semester, I will attend at least 95% of my classes. © 2011 McGraw-Hill Higher Education. All rights reserved.

25. Listing the Pros and Cons The decision to move from one stage to the next is based on the weight given to the pros and cons of behavior change. Seriously ask yourself how your life will be affected by your changed behavior. As the pros of change outweigh the cons, movement in the stages will occur. © 2011 McGraw-Hill Higher Education. All rights reserved.

26. Top Three Factors That Contribute to Relapse Stressors. Tempting social situations. Cravings – emotional and physiological. © 2011 McGraw-Hill Higher Education. All rights reserved.

27. Tips for Getting Back on Track After a Setback Cut yourself some slack—don’t beat yourself up, just get back on track. Review your goals and plan. Review your pros for change. Anticipate and plan for obstacles. Look for role models. For cravings: Delay at least 10 minutes, distract yourself, distance yourself. © 2011 McGraw-Hill Higher Education. All rights reserved.

28. Rx for Action Keep a log/journal of a habit you are thinking about changing. Write a specific, measurable behavior-change goal and post it in a prominent place. Identify two specific things your can and will do today to help you reach your goals. State one source of support that could assist you in changing a habit. Identify one way you can modify your environment to help contribute to a successful behavior change. © 2011 McGraw-Hill Higher Education. All rights reserved.

29. What Do You Think? Is there any behavior you would like to change? What is your current stage of change? Can you write a SMART goal? What would it be? What is your biggest challenge with change? What process of change would help you the most? © 2011 McGraw-Hill Higher Education. All rights reserved.

30. Questions? © 2011 McGraw-Hill Higher Education. All rights reserved.