1. Kenneth W. Phelps, MS, MFTA Medical Family Therapy East Carolina University

2. Social Psycho- logical Biological Spiritual

3. Who? What? When? Where? Why? How?

4.  Who can be my partner or support person? Emotional support- empathy, love, trust, caring  Example: providing comfort and encouragement Instrumental support- tangible aid or service  Example: transportation, chores, healthy cooking Informational support- advise or information  Example: facts on nutrition, weight, or coping Appraisal support- information used for self-evaluation  Example: progress reports, reflection, constructive criticism Adapted from House's (1981) types of social support

5.  What am I thinking, feeling, or doing?  We make the change… THOUGHTEMOTIONBEHAVIOR

6.  Identify the thought  “What is running through my mind right now?”  Weigh the evidence for the thought  “What information supports this thought?”  Weigh the evidence against the thought  “What information disproves this thought?”  Create an alternative explanation  “Taking a balanced strategy, I can see both sides and create a reasonable, thoughtful perspective.” Adapted from Beck's Cognitive Therapy: Basics and Beyond

7. Automatic thought: “I feel so low today. Today is just another day of the same old, same old.” Emotion: Sadness Behavior: Sleeping more, snacking, crying Evidence for: My body hurts. I’m still in the same job I hate. My husband and I yelled this morning Evidence against: I usually feel better after I get moving. I may be able to apply for other jobs. My husband did call to apologize. Revised automatic thought: “Yes, I feel low. However, if I get moving, I might feel better. Maybe I should look at my job as a stepping stone to something better for myself.” Emotion: Hopeful Behavior: Active, taking care of self, goal-directed

8.  Place  Home  Work  Environment  Time  Early Morning  Daytime  Night  People  Family  Friends  Coworkers  Events  Parties  Stores  Holidays When do your thoughts become a problem?

9.  Using the STOP sign Post a picture of a stop sign in challenging thought areas Picture a stop sign in your mind and say “stop” After saying “stop” to the thought, try to find a balanced perspective…go slow Use your supports and resources (spirituality, distraction, etc.) to move forward

10.  Where you see yourself in the future? In shape Successful Happy Content In a relationship Running a 5K Etc.

11.  Scaling From 1-10 where are you at being at your goal How can you move from a “3” to a “4”?  Visualization Imagine yourself and what you would be doing  Pictures Post photographs of where you see yourself  Motivating Statements “Yes, I can do this!” “Look how much progress I have made so far!” “Don’t get discouraged. Keep taking small steps!” Adapted from de Shazer's Keys to Solutions in Brief Therapy

12.  Why are you making these changes? Health Children Family Being a role model Energy Strength Accomplishment NOT because a doctor, therapist, educator, or dietician told you to do so. This has to be YOUR reason for making this change.

13.  Make a list of reasons to change Example: The reason I would like to make a change is to 1) decrease my high blood pressure, 2) be a good role model for my children, 3) get more restful sleep, 4) show myself I can do things if I put my mind to it. Read this list often to generate motivation.

14.  How can we set ourselves up for success?  Set goals that are SMART: Specific Measurable Attainable Realistic Time Bound

16.  Lose weight  Exercise  Better control my diabetes  Take more me-time  Rewriting these goals…

17.  Lose 1-3 lbs. per week (total of at least 20 lbs. by July) by cooking healthy at home for 75% of meals. Reward: Go to favorite restaurant once per month  Walk 3 times per week from 7:30 am – 8:30 am at a rapid pace. If it is raining, do my exercise DVD. Reward: Manicure, pedicure, or hair appointment once per month  Attain an A1C of 8.0 or below by August by taking medication at prescribed times and following other goals Reward: Schedule appointment to talk with physician about decreasing medication  Spend 10-20 minutes every night alone to revisit goals, pray, meditate, or read daily devotion. Reward: Buy a new magazine or book to read