You CAN Make a Difference
As a dietitian and exercise instructor, I meet lots of people with different goals and different attitudes about how to achieve their goals. I can typically tell in the first 15-20 minutes where their motivation is and how serious they are about what they want. I don’t react and try to fix their motivation until the second time we meet because I need to see how they do on their own.
I like to get to know the patient on a personal level before I start helping them change their motivation and outlook on their goals. Of the many different ideas and techniques for helping people become more motivated, I have one strategy that I rely on the most.
The Transtheoretical Model or The Stages of Readiness, is a model created in the early 80’s based on research to promote behavior change. I remember learning about this in my nutrition counseling class years ago and thinking, “why would I ever need to know this?” We even pretended to counsel fellow students, and all I can remember is how awkward and unnatural it felt.
Turns out seeing how ready a person is to change is one of the most important things you can know when trying to help someone.
Five years ago, as a new dietitian, I learned that you can’t make someone change if they aren’t ready for it. Although I use this principal for weight loss and disease prevention/control, these stages can be used to asses any changeable action from quitting smoking to saving money. In my own words, here are the 5 stages of readiness:
The person doesn’t recognize there is a problem or that anything needs to be changed. I call this denial.
Example: “I don’t overeat my calories! In fact, I probably under eat, I’m just overweight because of my family genes.”
The person recognizes there is a problem but doesn’t want to do anything about it.
Example: “I know smoking it bad, but I like it too much to quit.”
The person recognizes there is a problem, and is taking some steps towards correcting it.
Example: “I’m doing better with packing my lunch and snacks for work, but if I’m stressed I still go for the candy bowl.”
The person recognizes there is a problem and is on the path to hitting their goal.
Example: “I’ve been to the gym almost everyday this week, and if I have time I take a walk with my kids after dinner.”
The person recognized there was a problem, took the necessary steps to correct it, hit their goal, and is maintaining.
Example: “I hit my goal weight 2 months ago! I did go on vacation and gained a few pounds, but I came home and made sure I had healthy food in the house again and got right back to the gym.”
Once you understand these steps, you realize that you can’t make a person change their behavior without going to the next step. The example I always use is: A person goes to the doctor for their annual checkup. All the blood work comes back normal, but the doctor is still concerned the patient is smoking a pack per day. The doctor says you should really stop smoking, it can lead to lung cancer. The patient replies, my dad still smokes and is 80 years old. The doctor says, well it can still catch up to you! I am going to write you a script for a NicoDerm patch. This guy is clearly at stage 1. So how likely is it he will use the patch and take it seriously.
So, the next question I ask myself is: How do I get a person to the next stage? I didn’t remember if we had learned this in that class, so I looked it up myself. I found that there are typically two things that keep a person from moving to the next stage.
Either a person doesn’t value that goal as much.
Example: “I still want to fit in my old jeans, but ever since the wedding I can’t seem to care as much about my weigh.”
They have failed too many times to believe they can accomplish the goal in the first place.
Example: “I have been to Weight Watchers so many times. I have lost and gained it back. At this point I don’t think I will ever lose and keep it off.”
It is my job to help the person move to the next step. If we come to realize that their goal just isn’t as important as in was in the beginning, then I help them find what their goal is! For instance, if they no longer care about losing weight because the wedding they were in has already passed, then we may discuss a vacation that is coming up or talk about their recent blood work. Or, if a person feels that they have failed so many times and they are helpless, then I may give them an easy to achieve task to build up their confidence.
Every person is different and every struggle is different. But the answer lies somewhere inside, and I love using the stages of readiness to assess where people are in their willingness and help them move forward towards hitting their goals.