Readiness for Change Flashcards
What are the five stages of change and readiness
- precontemplative (Not ready for change)
- contemplative (thinking about change)
- preparation (preparing for change)
- action (taking action)
- maintenance (Maintaining a desired behaviour)
Why is it important to identify a clients readiness for change?
Using inappropriate techniques that prematurely encourage new behaviors can discourage change.
What is the goal of coaching in regards to stages of change?
To identify a clients level of readiness and to move them towards maintenance of desired behaviour.
When are people precontemplative?
When they have no intention to change. The are either The are not actively thinkin about change. They are either unaware, uninterested or unwilling to make a changes. This stage can be classified as either I wont or I can’t.
I won’t - They don’t feel that they have a problem. Often it is the people around them that wants them to change. There might also be some sort of “secondary gain” from the behaviour and so they might not want to lose any associated benefit.
I can’t -They are aware they have a problem but don’t believe it is possible to change or think that changing is to complicated or hard, perhaps to having tried in the past and failed (premature cognitive commitment) or perhaps to some insurmountable barrier
People who are precontemplative often play games to avoid responsibillity like “wooden leg”, “yes, but..” and “stupid”
wooden leg
- I would if I could
- What do you expect of someone who …
- you wouldn’t expect someone with …. to …
- If it just wasn’t for this …
What is the best approach to take with precontemplative clients?
The main focus is to build a trusting relationship
This client requires deep empathy and needs to feel that you understand them, without judgment or pressuring them to change.
Unaware of the problem
- educate to raise awareness
I won’t
- Deep empathy
- The client needs a deeper appreciation of the pros
- “I understand you are not ready for change right now, but here is my card should you want to in the future”
I can't - identify barriers - discern between those that are real and those that are imagined - build a greater sense of self efficacy
Scaled questions to ascertain how important it is
Find another related area of focus to work on, in other words work on the things they are ready for
Explain the game of “wooden leg”
Wooden Leg
Another common game people play is “Wooden Leg.”
The premise of this game is that an individual suffers from a certain disadvantage in life, but they use it as a way to justify their lack of drive and motivation to do better.
The form this game often takes is “What do you expect from a person who ______?”
For example:
You: I want to build better relationships, but I can’t. I come from a broken home.
Friend: When’s the last time you dated someone?
You: A year ago, but I cheated on them. What do you expect from a person who comes from a broken home?
Friend: Maybe you just need to find the right person?
You: No, I use everyone and then leave them. What do you expect from a person who comes from a broken home?
The psychological payoff by playing this game is that you get to say “I’m helpless, so it doesn’t matter what I do.”
Another popular form this game takes is, “This is just who I am!”
Of course, if a person has a real disadvantage than they have a good reason to accept their difficulties in a certain domain in life.
But it’s when people use their disadvantage as a reason to completely stop trying to improve – or even self-sabotage – that it becomes more of an excuse rather than a legitimate crutch.
One way to beat this game is by changing the question “What do you expect from a person who ______?” to “What do I expect from myself?”
Do you actually expect more from yourself or do you believe your destined to stay the way you are? You need to be honest.
Explain the ‘yes, but… game, including the payoff and motive.
Yes, But…
“Yes, But…”
This often happens when we bring up a particular problem in our life to a friend. Trying to help, the friend will start giving suggestions on how to fix our problem.
Each piece of advice that is given is followed with a “Yes, but…”
For example:
You: I really need to start exercising more.
Friend: You should join a gym.
You: Yes, but I don’t like working out in front of people.
Friend: Hm, you could always work out at home too.
You: Yes, but I don’t have any equipment.
Friend: I know a good exercise program that doesn’t even require equipment!
You: Yes, but I don’t have time to learn something new.
“Yes, but…” is a common form of excuse-making. It doesn’t matter what the friend suggests, you’ll always find some reason to dismiss their suggestion.
Eventually the friend gives up trying to suggest new things – and therefore you feel you’ve “won” the game.
The psychological payoff after winning the game is that you get to say to yourself, “You see? I’ve considered everything, and it’s just not possible.”
The ulterior motive is that you were never actually looking for an answer to your problem, you just wanted the friend to agree with you that it’s “impossible” for you to solve it.
Explain the I’m Stupid game
I’m Stupid
Have you ever seen someone play “Stupid?”
You know someone isn’t really that dumb, but they seem to purposely make mistakes or errors so that other people can see just how “stupid” and “blameless” they are.
Often the game is played until someone finally caves in and calls the player “stupid,” confirming what they wanted to hear all along.
For example:
You: Oops, I forgot that my presentation is today.
Coworker: That’s okay, we probably won’t get to you today. Have it ready for next week.
You: The presentation is supposed to be about improving our sales right?
Coworker: No, your presentation is about customer service.
You: Okay, it’s supposed to be about 10 minutes long right?
Coworker: No, I told you guys at least a half hour each.
You: Does that include a 10 minute intermission?
Coworker: Holy crap, you’re stupid. I’ll do it myself.
The psychological payoff from playing this game is that you often get to avoid responsibilities – because the assumption is you’re too “stupid” to get them done properly.
It’s also common to see this game played by girls at a bar or party. By playing “stupid,” girls come off as easy and ditzy, which can attract certain guys to want to sleep with them.
The ulterior motive behind playing “stupid” is you can make bad decisions and then justify them by telling others, “Silly me! I never know what I’m doing!”
When is someone contemplative?
When they are thinking about change. They are aware of the benefits of the new behaviour and is somewhat disatisfied with their current situation.
This stage, also known as the “I may” stage, is catagorized by ambivalance. Wanting to change, but seeing change as too complex or hard, they are weighing the benefits of change against the effort it will require.
Change talk and sustain talk are often simultanously expressed int the same sentence…
“I really want to start exercising but then I will have to drive further everyday and I don’t want to do that”
clients also often say…
- I go back and forth between …
- a part of me wants x and another part wants y…
- I can’t make up my mind
- I am confused
- I don’t know if I should
People can get stuck in this stage for a long time and become chronic contemplators due to not knowing how to change or not being able to imagine themselves behaving differently.
What approaches should you take with someone in the contemplative stage?
The main focus is to show the client that change is possible
Motivational interviewing to explore ambivalance and to encourage commitment to change
When is a client in the preperation stage?
When their ambivalance have largely been resolved and they are commited to change. They have also identified barriers and come up with possible solutions for dealing with barriers
also known as the I will stage
How can you help a client in the preparation stage?
The main focus is on problem solving and building confidence
formulating concrete plans
identifying contingencies
When is the client in the Action stage?
When clients are working on building new relationships, practicing new behaviors, and establishing new habits. They may have to concentrate very hard while practicing the new behaviors and refining their lifestyles.
also known as the I am stage
How can we help clients in the action stage
The main focus is on skill development
Checking in, supporting, training and helping clients in the event they slip back into old patterns
- Encourage clients to develop new relationships with people who share their interests and behavioral goals.
- Anticipate and be prepared for lapses.
- Help these clients reframe a lapse as a temporary setback.
- Assist clients to frame mistakes as learning opportunities rather than as failures. Learn from all mistakes to minimize the chance of them happening again.
- Help these clients move away from an all-ornothing mentality about their goals, which only leads to guilt, self-blame, and an excuse to quit.
- Unless clients are ready to take a bold step forward, which sometimes happens, it is usually best to avoid high-risk situations that unduly test a client’s new skills and behaviors.
- Conduct a planned lapse, such as a day without exercise or a meal where they eat whatever they want, to develop new mental skills, perspective, and resilience under a controlled situation.
- Discuss situations that could be problematic when they actually start the behavior. Have clients develop strategies to cope with these situations before they actually come up.
When is a client in the mantenance stage?
When they have been practicing their new behaviors for at least 6 month and it is becoming a habit.
