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Tuesday 18 December 2012

Using personal experience of behaviour change to inform how we motivate and inspire others

Encouraging positive behaviour change is not something that should exclusively be aimed at people with substance misuse problems or indeed any problem that we might regard as being hugely significant.  Notions of positive change can be applied to all aspects of our lives and not necessarily in response to traumatic or devastating circumstances; such as being admitted to hospital because your alcohol use led to a diagnosis of pancreatitis or because your injecting drug use caused septicaemia.

These 2 examples may be obvious examples of moments when people may reconsider their behaviour and decide to make some changes, but at some point in our lives we will all have a behaviour or set of behaviours that for a given period of time (it might be a day or it might be 10 years) we were happy with and which later on we decided to change for one reason or another.

Think for a moment about a behaviour you have that you would like to change... 

...we all have them; for some us this will be dramatic and highly significant, something that the majority would agree is necessary to change, whilst for some of us the behaviour may be something that would seem to be relatively inconsequential to others.  It's significance to other people matters little; the only thing that does really matter is its importance to you.

For how long have you had this particular behaviour...

...is it something you've done for years or is it something that you only started doing recently?  Time can be a significant factor in us deciding to change or conversely a major part of our rationale for carrying on ("why should I change now, I've done it for years and its not really causing me a problem?") .

Now think about WHY you would like to change this particular behaviour...

...is it because it is damaging / having no positive benefits to your physical or emotional health, is it because its costing you money that would be better spent elsewhere, is it harming your relationship with friends and family, is it negatively affecting the way you feel about yourself?

Its highly likely that your reasons for wanting to change this behaviour will be associated with at least one of the above scenarios to a greater or lesser degree.  Its effects may be subtle or dramatic, life-threatening or relatively innocuous.  Again the significance to others is not relevant, defining your reasons for change is the most important thing.

After considering the above, you may realise that you feel really strongly about making changes; you may regard it as being one of the most important things you've done in your life - it might just be that important.  On the other hand, you may continue to feel ambivalence towards changing things.

Assuming its important to you now think about the challenges you will face when you start to make changes...

There may be few or many, they may be easy to overcome or seem like impossibly high hurdles.  This will depend upon the nature of the changes you want to make, to some extent how long you've done the behaviour for, whether you have support to make changes and crucially whether you believe that you can make them.

Belief is key; the easier path is probably to carry on with the behaviour, unchanged.  The alternative path represents a test, a greater challenge.  It is the one where we start to make changes and these may initially cause a feeling of discomfort.  Having the faith to continue at this point is vital and this faith will come from the personal reasons we gave ourselves for wanting to change in the first place. 

The point of this is that for all of us, the decision to change a particular behaviour is a deeply personal one; it can obviously be positively (or negatively) influenced to some extent by the opinion or actions of others (your family, a health professional and so on), but we will only sincerely regard it as a necessary change when we decide to that it is important enough; when the benefits of changing outweigh those we can think of for continuing.

We may have done the behaviour for many years and never regarded it as a problem (others may have told us it was but we didn't hear or believe them), we may have tried to change it on many occasions but struggled to overcome the challenges or struggled to maintain it.

Whether such decisions are about reducing your alcohol use, not injecting drugs, stopping smoking, eating a healthier diet, doing more exercise, being a better listener....the list is endless.  Whatever the change is, realising that it is personal, that it is going to take time, energy and perseverance are all extremely important factors.

If we use this knowledge of the challenges we have faced when changing our own behaviours to inform the way we encourage and motivate others to make positive behaviour changes, our interventions / advice are more likely to be effective.  

The decision to change may be a deeply personal one but we should never under-estimate the influence, both positive and negative, that we can have on this.

Cycle of Change - Prochaska and DiClemente