What is one sure fire way to predict behavior change (besides evidence of the change actually taking place)?
If we regularly engage with people regarding behavior change, how do we recognize whether others are ready for change?
By listening to what they are telling us.
Yesterday morning my husband was kissing me goodbye as he headed off to work. He knew I was going to visit with a colleague/friend whom I had not seen in a while later in the day. As he kissed me goodbye he said, “Give (him) my best,” but in my half-asleep/half-awake state I heard, “Give (him) a lead vest!” WHAT???? Clearly I wasn’t listening!
What specifically are we listening for with regard to behavior change?
Miller and Rollnick (2013) tell us we should be listening for change talk!
But what is change talk?
Change talk is exactly what it sounds like. It is talk about making a change; however, there are two types of change talk and one is more predictive of actual change than the other.
First there is preparatory change talk followed by mobilizing change talk. Let’s examine the differences:
Preparatory change talk occurs when people are starting to think about change while they are in the earlier phases of the stages of change we discussed earlier. Basically, preparatory change talk occurs during the ambivalence period up until real change actually takes place.
And I promised yesterday to talk about DARN-CATs. Let’s start with DARN!
D is for DESIRE: I want to make a change. I wish I could make a change. Life would be better if I made this change.
A is for ABILITY: I know I can make this change. I can do this. I have made similar changes in the past.
R is for REASON: I would feel better if I made this change. I would be better off.
N is for NEED: I need to do something different or I’m going to be in real trouble.
Anytime someone expressed desire, ability, reason, or need they are expressing preparatory change talk. There is understanding and a willingness to make the necessary change but the actual change has not taken place yet. This type of change talk often occurs in the precontemplative and sometimes the preparatory stages of change.
Mobilizing change talk is recognized by the acronym CATs:
Commitment: I am going to do this! I am going to make this change.
Activation: I am ready and preparing to make this change.
Taking steps: I followed through and did the following things this week toward my change goals.
These three types of change talk occur when people have fully moved onto the preparatory and into the action and maintenance stages of change and are most predictive of actual change occurring.
So back to my running example. These are some statements I might make about running according to each type of change talk:
Desire: I want to run more. I wish I had time to run more. I wish I ran faster. I wish I felt like running more. I wish it wasn’t so hot outside. I want to be able to wear those size six skirts in my closet. I don’t want to have to get rid of those size six skirts!
Ability: I have run many more miles per week in the past. I used to be a faster runner. I have run two marathons, including the Walt Disney World Dopey Challenge in the past. I have scheduled my runs better in the past.
Reason: I feel better when I run regularly. I sleep better at night on days I go for a run. My stress level is lower when I run. I don’t snap at my family members nearly as much when I regularly exercise.
Need: I need to get a handle on my weight because diabetes runs in my family. I need to lose some weight.
Commitment: I am going to start running more regularly.
Activation: I have scheduled my runs in my calendar. I have laid out my running clothes for a run tomorrow morning.
Taking steps: I laced up my shoes and went for a run this morning.
See how these statements fit into each category?
So think back to the change I asked you about earlier, then think forward to the stages of change. What types of statements do you find yourself making about that behavior change? Where do you find yourself? Are you still in ambivalence/preparatory mode or have you moved to mobilization?
Later we’ll talk about listening—for change talk, and listening in general.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. Guilford press.