Every year millions of Americans struggle to change their unhealthy
behaviors. Less than 30% succeed. Despite the tenacious efforts of healthcare
and family members, people are often ill-equipped with the necessary skills to
change. Most people know what they should do, but few know how to do it.
Unfortunately, the latest gimmicks rarely deliver long-term success. But there
are some time-proven strategies that explain how to change your unhealthy
behaviors, whatever they may be. These are the techniques of behavioral
self-management.
There are only two types of behavior you would want to change. A behavioral
excess is an unhealthy activity you do too much of, like smoking. A behavioral
deficit is a healthy activity you do not do enough of, like exercising. To
change these activities, it is imperative to know why you do them. Basically,
people do things for two reasons: (1) they are reminded to and (2) they get
something out of it! There are events that happen before every behavior (called
triggers) that "set the stage" for that behavior to occur. There are also events
that happen after every behavior (called consequences) that reward or punish the
activity. A rewarding consequence will increase a behavior. A punishing
consequence will decrease a behavior. For example, some people eat fast food
because they are in a hurry (“trigger”) and it saves time ("consequence").
Long-term consequences do little to affect present behavior. For most
smokers, the prospect of dying from cancer is not enough to override their
perceived immediate pleasure of smoking. Thus, they continue to smoke.
Behavioral self-management is a process you can use to reduce behavioral
excesses or increase behavioral deficits to a healthier level. You can start by
following these six steps:
1. Define the target behavior.
The first step is to identify the behavior you want to target. Initially,
pick something that will be easy. If your target behavior is a deficit (like
physical inactivity), it may be useful to identify competing behaviors that
"stand in the way" of change (i.e. watching TV). If your target behavior is an
excess (like smoking), think of alternative behaviors to replace it (i.e.
chewing gum).
2. Set a goal.
The next step is to determine exactly what you want to do and the time frame
you want to do it in. Be specific by making it something you can measure and
realistically achieve (e.g., "I will be biking four times a week by June."). If
your goal is difficult to achieve quickly, break it up into sub-goals and work
your way up.
3. Self-monitor.
Keep a daily record of how often you perform the target behavior. Record
every instance immediately after it happens. Often, simply setting a goal and
self-monitoring your behavior will result in change. Self-monitoring also
enables you to gauge improvement.
4. Analyze your behavior.
Write down what most often triggers the behavior and any consequences that
follow it. For example, seeing other smokers or being in a bar may trigger
smoking. The rewarding consequences might include a "high" or social
camaraderie. The events you write down are what to key on next.
5. Select a treatment.
This is the "nuts and bolts" of the process. Basically, it involves
rearranging the triggers and consequences to facilitate change. It can look
wordy, so read slowly and concentrate on what fits your problem. For a
behavioral excess: find ways to avoid any triggers for the behavior and
eliminate any existing rewards. Introduce triggers for an alternative activity
and reward yourself for doing it in place. Avoid using punishment, though,
because it is difficult to self-administer. For a behavioral deficit: introduce
new triggers and rewards that promote the target behavior. Use a visual prompt
(i.e., a post-it note). And remember those competing behaviors. Avoid the
triggers and eliminate any rewards for them.
6. Reevaluate.
Continue self-monitoring for a while after you have implemented your
treatment plan. If you experience a slip, repeat the steps. If your plan still
is not working, it means you have not chosen the correct strategy or are not
implementing things consistently. Don't be afraid to soften your goals or seek
professional help.
Remember to start small in order to give yourself a taste of success and
build confidence. Change one thing at a time and address both the triggers and
the consequences of your target behavior. Rewarding yourself does not have to be
extravagant, but it must be conditional on the behavior! Reward yourself often.
While you can implement a self-management plan completely by yourself, it works
best when you have someone else deliver the consequences. Draft a behavioral
contract where you write down your goal, the rewards you will get, and who will
give them to you. In addition, make your plan public so others have the
opportunity to praise your accomplishments.
Changing behavior isn't easy, but it can be done. It just takes a little
extra planning. People who are successful have the desire and the skills. Expect
success, but know that failure can be part of the game. Failure is not a
reflection on you - it only means your environment is not yet set up to support
the change. The tools of behavioral self-management will get you thinking in the
right direction and give you the best chance for success. For additional help,
contact MHIF Education Services at 612/863-3979 or out-state toll free at
1-877-800-2729.
