A prospective client said to me, “I know I need to change my diet. I just keep wondering if this is the week I’m going to do it.”
We’ve all been there. We know we ought to make a change, but we’re not quite committed and we don’t have a plan. This feeling describes the contemplation stage, according to one useful way of looking at behavior change.
The “transtheoretical model” (TTM) developed initially by psychologist James Prochaska, labels five stages of readiness for behavior change: pre-contemplation, contemplation, preparation, action, and maintenance.
Where are you in your readiness to change? What does that mean for your goals, health, and well-being? Consider the case of eating more healthfully.
Pre-contemplation
Your doctor might tell you that you should change your diet. If you’re lucky, you might get the good general advice to cut your sugar and processed food; and eat more vegetables, nuts and seeds, healthy fats, and fermented foods.
In this stage, however, you are unconvinced. Maybe you’ve tried before to change your diet and time and again you returned to your old eating habits. Perhaps you are satisfied with your weight and believe that therefore your diet isn’t that important to your health. Or, contrary to your clinician’s hopes of spurring you to action, his or her dire warnings make you think your doctor is overreacting to some lab results. The possibility that you are at risk of developing potentially devastating metabolic syndrome, or other diet-related diseases, seems remote.
At this stage, you may need more information. What are the risks of continuing to eat the foods you are currently consuming? What are the rewards of eating differently? If you were my health coaching client, I’d help you answer these questions.
Contemplation
Like my prospective client, in this stage you acknowledge that you ought to change your diet, but are unsure how and if you will begin. In his case, he knows that because of his medical condition, his diet is making him feel unwell and might lead to complications down the road. But where to start? He made the first move on his road to better health by making an appointment with me for a free initial consultation.
At this stage, I help clients weigh the pros and cons of changing their diets (for instance) and help them see that there is hope as well as a accessible path to change.
Preparation
You move from thinking about your diet, to planning to purchase new healthier foods and get rid of foods that you realize you should be avoiding. You might start looking for recipes and more specific information about what to eat and what to stay away from.
In this stage you are laying the groundwork for future success. I often help clients at this point by celebrating their decision to make a change and supporting them in following through with their plans. We come up with strategies for success and troubleshoot challenges they have encountered in the past or they likely to meet in the future. I can even help with a “pantry cleanout” to provide a foundation for new eating habits. Recipes and lists of foods, books, websites with more detailed information that I provide are now helpful. Together we create a roadmap, often in the form of a flexible meal plan, that clients are eager to try.
Action(!)
You take your first steps on your new eating program. You may not be consistent yet, and you may fall for those donuts your colleague brought into work, but you’ve made a start.
This is a critical place for me, as a health coach, to support my clients and celebrate their small successes. We are not looking for perfection but progress. As long as we keep moving towards the goal of healthier eating habits, we are on track. I’m there to work through struggles, find new healthier habits, and hold my clients accountable to their own goals.
Maintenance
At this stage you’ve successfully made the changes in your diet and have reached a sense of stability. You’ve also noticed new positives of eating better: the increased energy and clearer thinking. The key is to keep up the good work!
Some people are finished with a health coaching program at this point and are ready to use the tools I’ve taught them to continue on their own. Others enjoy support and accountability through at least some part of this phase until they feel confident they can stick with their new healthier lifestyle and enjoy the benefits long term.
Where are you on the stages of behavior change?
Challenge: Identify one health or well-being behavior you feel you ought to change or know you desire to change. Use my example above to determine how ready you are to make the change: what stage you are in. Consider what you might need to progress to the next stage of readiness and move towards reaching your goal. I challenge you to take a step!
