1. “Unless we change directions, we are liable to end up where we are headed…” Chapter 13

2. “The only person who likes change is a wet baby.” - Roger Von Oech

3. “I didn’t come to be told I’m burning the candle at both ends,” said a patient to his doctor. “I came for more wax.”

4. How People Change Doctors – 3% Self help groups – less than 3% Friends – 14% Family – 21% Spouse/significant other – 29% People on their own – 30% Gallup Poll 1990

5. Your Attitude on Change I won’t I can’t I will try I can I will I commit Can’t is a will that refuses to succeed

6. Locus of Control Locus of control: Perception of one’s control over events that affect one’s life (Use Lab Assessment 7.5 p.164 to identify your locus of control) Use Lab Assessment 13.4 as a guide to reducing stressful behaviors

7. Behavior Change Hear a good idea20% Develop a plan40% Decide when to implement plan55% Discuss with another (commits)80% Set a future date for accountability95%

8. Health and Lifestyle Behaviors Health Behavior: Activities taken by people who believe themselves to be healthy and that are designed to maintain health; a subclass of lifestyle behaviors Examples: limiting sugar and salt in your diet, avoiding smoking cigarettes, exercising Before you can change health-related behaviors, you must identify behaviors that need to be changed (Lab Assessment 13.1) Lifestyle Behavior: All of the activities in which people engage Examples: daily chores, going to school or work, meeting new people, listening intently to a lecture (Lab Assessment 13.2)

9. Types of Conditioning Classical Conditioning (Pavlov) Stimulus produces physiological reflex Operant Conditioning (B.F. Skinner) Reward / punishment Modeling Concept of imitation

10. Barriers to Changing Behavior--- reasons given as preventing one from engaging in certain activities Cost Embarrassment Family responsibilities Inconvenience Lack of family support Lack of proper facilities/equipment Lab Assessment 13.3 Fatigue Not available Other people Pain/discomfort Time Transportation Weather Work responsibilities

11. Methods for Decreasing Stressful Behaviors Self-monitoring: Observing and recording behavior Tailoring: Making changes specific to the life of the individual Material reinforcement: Rewarding a behavior with a tangible object Social reinforcement: Rewarding a behavior with social approval Social support: Emotional or informational support from a friend

12. Methods for Decreasing Stressful Behaviors (cont.) Self-contracting: Making a contract with oneself to change behavior Contracting with a significant other, a person who is important to you Shaping: Changing behavior a little at a time Reminders: Receiving messages to promote behavior change Self-help groups Professional help

13. Application of Behavior-Change Techniques Example: Exercise – Identify desired behavior – Identify barriers – Self-monitor behavior – Write a self-contract or contract with a significant other – Tailor the program – Include material or social reinforcement – Shaping: start with an easy program – Use reminders – Consider using self-help groups or professional help © 2011 McGraw-Hill Higher Education. All rights reserved.

14. Behavior Change Theories and Stress Stages of Change Theory Precontemplation- unaware of the problem or need to change Contemplation- thinking about change, but no action taken yet. Decision/determination- start planning change/action. Action- implementing management program. Maintenance- continuing the changed behavior over time.

15. Behavior Change Theories and Stress (cont.) Self-Efficacy Theory Confidence in ability to carry out the change is predictor of success Four ways to increase confidence: Performance attainment- nothing succeeds like success. Vicarious experience- influenced by observing others. Verbal persuasion- “you can do it” Physiological state- receive information from our level of stress.

16. Behavior Change Theories and Stress (cont.) Theory of Reasoned Action Behaviors are a result of attitudes, norms, and intentions. Intent has been shown as the best predictor of the behavior actually being performed. Theory of Planned Behavior Adds the variable of amount of perceived control

17. Goal-Setting Theory Moderately difficult goal is best Establish proximal and distal goals People with higher self-efficacy set higher goals Self-efficacy and importance assigned to goal are predictors of success Core properties include specificity and difficulty of goal, anticipated benefits, and feedback

18. Effective Goal Setting Be specific about the goal and how difficult it is to achieve. What are the anticipated effects of achieving the goal? Feedback regarding the goal.