1. 1 Helping Participants Change Amy Culp, RD, LD amyculprd@sCULPturetexas.com 512-517-7624 amyculprd@sCULPturetexas.com

2. 2 What is Our Overall Goal at WIC? Help grow healthy families. This often means making behavior changes for our participants.

3. 3 Think about change How do you feel? What are you thinking?

4. 4 We change when… We want to or when it matters We know how We believe we can So where do you fit in helping your participants make changes?

5. 5 Determine Readiness Consider the stages of change : 1. Pre-contemplation - Change has not been made yet as participant has not identified a need to change 2. Contemplation - No change has taken place but participant explores the possibility of change 3.Preparation - Small changes may have been made and participant will learn techniques to promote change

6. 6 Determine Readiness Consider the stages of change: 4.Action - Participant has made a change that may be a small or significant change. 5.Maintenance - Change has been established and is continuing Refer to Handout 1 – Stages of Change: Opportunities for Intervention ChartHandout 1 Exercise 1 Exercise 1 – Identify Stage of Change

7. 7 Identifying WIC Participants Readiness to Change Handouts Handout 3: Assessing Importance and ConfidenceHandout 3

8. 8 Determine importance and confidence – counseling tools Assessment Ruler Assessing Importance and Confidence How important would you say it is for you to _______________? On a scale from 0 to 10, where 0 is Not at All Important and 10 is Extremely Important, where would you say you are? 0 1 2 3 4 5 6 7 8 9 10 Not at all Extremely Important And how confident would you say you are that if you decided to ___________, you could do it? On the same scale from 0 to 10, where 0 is Not at All Confident and 10 is Extremely Confident, where would you say you are?

9. 9 How importance and confidence affects change. Four Participant Profiles Low importance, low confidence These people neither see change as important nor believe that they could succeed in making such a change if they tried. Low importance, high confidence These people are confident that they could make the change if they thought it were important to do so but are not persuaded that they want to change. High importance, low confidence Here the problem is not in willingness to change, for these people express desire to do so. The problem is low confidence that they could succeed if they tried. High importance, high confidence These people see it is important to change and also believe that they could succeed. Source: Miller R, Rollnick S. Motivational Interviewing: Preparing People for Change. New York: The Guilford Press, 2002.

10. 10 Determine importance and confidence – counseling tools After the client identifies the level of importance or confidence, explore this further to find out how you can help. Handout 3 Exercise 2

11. 11 Helping Participants Change Goal Importance Assessment Assessing the strength of a persons goal commitment is affected by: the value the person places on the activity perceived attainability of the goals binding pledges made to others. Inquire about: Do you think you can do it? How important is it to you? Is there someone else with whom you can share your plans? Is there someone who will support you in your desire to change? Source: Holli B., Calabrese R., Maillet J. Communication and Education Skills for Dietetics Professionals, 4th ed. Baltimore, Lippincott Williams & Wilkens, 2003.

12. 12 Stages of Change Exercises Exercise 3 Exercise 3 Case Studies