The 5 Stages of Successful Behavior Change
Behavior change is hard. It is viewed mostly as a stepwise process, whereby the client will show a capacity to move both forward toward an action, yet may occasionally relapse back toward action, or inactivity, during the coaching relationship. If you are effective enough as a certified wellness coach, you will know what stage of readiness your client is in, and that is important- so that you will be able to employ strategies or techniques to help change in the specific areas identified. Your coaching delivery methods must be effective for the stage of readiness that your client is in. Different applications of strategies or specific techniques during each stage along the way will allow you to coach the client toward reaching their health, fitness or wellness goals on track and successfully. We also want to coach the client toward lifelong change, to maintain changes made during the coaching process.
Behavior changes needs and the stages are easily identifiable and pretty critical. Consider the pre-contemplation stage. During this stage, your client has not yet thought about making any changes in their behavior. On the opposite of the stages of change, we have clients who are in the maintenance phase, where changes in behavior have already been successfully adopted. Within each stage are characteristics that your client presents and are very distinct and luckily, recognizable.
5 Stages of Readiness to Change
- Precontemplation (not ready for change yet)
- Contemplation (thinking about making a change)
- Preparation (preparing for behavior change)
- Action (executing an action plan)
- Maintenance (maintaining a change for good behavior)
It is important for you to know your client’s stage of readiness. Most of your clients, or prospective clients, will have one area of focus, or concern that they would be considered to be in the contemplation stage, (either fitness level, weight control, their nutritional intake, stress levels, mental or even physical health) and your goal is to bring the client to the maintenance phase of sustaining a new behavior change, consistently, within a 12 to 24 week time frame of coaching interventions. As you meet your client on a weekly basis, you will be able to help your client move forward in different areas where they might be pre-contemplative – but only when an opening presents itself during coaching conversations. Remember that when your client shows progress toward one behavior change, their confidence level in self-change and self-efficacy grows, and the client becomes more prepared to move forward in another change effort.
Let’s consider that you have someone who is not even thinking about adopting healthy behaviors, or making a change to their risky behaviors. From the client perspective, they’ll most likely fall into one of two categories… those who won’t or the client who can’t. Those who say they won’t make a behavior change are those who are not interested in making a behavior change because they don’t feel they have a problem, to begin with. If we were to ask your clients friends and family, they would probably feel differently, and might even be expressing concern to the client at regular intervals – yet the client still fails or refuses to acknowledge that there is any behavior problem that needs to be changed or any problem in general. The client most likely to say “I can’t”, would be someone who would like to change but they don’t feel that it is possible for them. They do not believe in it. Although these are completely different reasons for being stuck in the pre-contemplation phase, both types of clients are not contemplating any behavior changes at this time, let alone executing a plan to work on making behavior changes in any particular area in their life.
If your client is in the pre-contemplation stage for some wellness issues, it is important to show sincere empathy toward the client. At this point, your (prospective) client will need to experience sincerity and empathy from the coach in order for them to move forward. During this time, it is ideal to use reflections in conversation with the client, to demonstrate that you have heard, understood, and respect their feelings and what their wellness needs are. This skill of being able to recognize and accept that your client may not intend to change a certain behavior is important in terms of how future interactions and behavior change possibilities occur. The coach does not ask the client to move ahead in the behavior change process at this time but instead chooses to focus on understanding the client at a deep- er level, without any judgment or fear of openly communicating.
One of the most important messages we can provide for a client who is stuck in the “I won’t” mode of thinking is to state that you understand that your client is not ready at this time for a certain behavior change. ”That is fine. Here is my card and I want you to contact me if you decide that you would want to make a change one day about this”. In the end, you have now a client who feels good about their interaction with you, because it has been positive, so the client will think about you in a positive manner. During this time you are careful to not judge your client or make them feel inadequate, and this is very empowering for the client.
Those who are likely to say “I can’t” are your clients who are probably aware that they have some problems and some need to change, but remember, this client believes that behavior change is not possible for them. This could be due to them believing that it’s too difficult or too complicated. The client may have tried and failed when trying to make this behavior change in the past. More so than the “I won’t” client, this client is very aware of their barriers and obstacles and most likely needs help to look at these barriers and obstacles in a more positive and rational manner so that the client can learn from them, how to work around them or how to avoid them. Quite frequently, this type of client feels anxiety or overwhelmed from the negative emotions attached to having failed certain behavior change in the past.
Using a wellness coach, your client is able to sort out barriers and obstacles into those that are excuses, or those that can be overcome with sufficient motivation, or those barriers that might be exaggerated. Your client will also reveal to you some real obstacles and barriers. Taking real barriers, for which time may have to pass before the client can resolve them, off of the agenda, is important. When you do this, the client’s emotional guard is lowered and the client doesn’t feel like they still need to convince you about the reality of their barriers or obstacles. In turn, this acceptance shows the client that you’re on their side and they are more ready to work with you because you have shown skills as well as signs of being positive and motivating. It is important for the client to realize that the changes they are working on with you will give them something that they really want in the end. In these situations, clients are far more motivated to work on finding realistic solutions to obstacles and barriers that have held them up before, or contributed to their failure.
The contemplation stage is characterized by the term “I may”. During this stage, your client might be thinking about changing an unhealthy or risky behavior or even adopting a healthy behavior. In addition to this, your client is also considering taking action within the next six months on this behavior, be it healthy or unhealthy. With good wellness coaching, your client is aware of benefits tied to changing a certain behavior, while also being less satisfied with their present state of health and wellness.
A client in this state might express a fair amount of reticence about changing a certain behavior, possibly thinking that changing this behavior would be too difficult or even impossible for them to achieve. Some people can remain in this stage of readiness for a long time and become what we call chronic contemplators because they can never imagine seeing themselves behaving in a different way and furthermore they do not know how to change. Some- times this client is still weighing the benefits of changing the behavior against those of what efforts it would take to be successful.
During coaching interventions, when your client opens a statement with” I might”…… express interest in wanting to explore your client’s most positive experience or their best experiences with behavior change in the past, as well as- noting any of the more positive motivations for making a particular behavior change in the future, as part of their vision. When your client is able to focus on their values and their vision, they’re more likely to come to appreciate how behavior change would improve their life or their wellness, overall. At the appropriate time, a wellness coach can share scientific facts that are important for the client to know if they relate to the benefits of a behavior change while helping clients to learn and discover the “pros” that tend to serve as positive motivators for change.
Contemplation Stage Coaching
To move a client forward in the contemplation stage, try connecting them to their natural strengths and abilities – while encouraging them to get motivated about behavior change. As your client discovers their strengths, this alone may be enough to move them into a later stage of change. This may be due to increasing the cli- ent’s awareness of the compelling reasons for a behavior change and then getting the client to connect with other people who have been able to make a behavior change successfully. It may also be due to motivational strategies that you use as a coach during this stage, or a combination of both.
Another strategy to help your client through the contemplation stage is to make connections between the changes they are trying to make and the values that they have presented. Creating the proper setting for behavior change, within this larger context, tends to make change more meaningful, significant and hopefully longer-lasting.
If your client has not been able to properly identify their own personal motivators needed to drive change, the coach may need to intervene and help the client to see a clear vision of what they want. In this case, the coach can suggest new reasons for behavior change or even new supportive relationships for the client to rely upon as motivation.
We will talk about decisional balance as a coaching concept later in this section, but during this exercise, the coach can help the client examine not only the upsides but also the downsides, of changing old behaviors for new, healthy behaviors.
As with any behavior change, encourage clients to identify and accomplish small goals every week, based on realistic thinking and sound goal-setting. This will empower your clients to be more confident in their ability to change a certain behavior. Acknowledging successful outcomes is also vital to this process, as it will also build your client’s self-efficacy. During the contemplation stage, the coach and client are laying a foundation for other more important, or difficult, behaviors to change and this stage may involve small goals such as reflection, listening, discovering or deciding. It does not necessarily have to be characterized by doing a behavior.
The preparation stage can be exciting for the client, as well as the coach. During this stage, language from your client might include statements like “I will” or “I can”. Any trace of reticence or ambivalence from your client has been overcome and they have become strengthened by the motivation to change behavior. At this point, your client is planning to take action right away. With the strong motivation the client has found, they also are aware of their barriers and obstacles, and have come up with some ideas for how to resolve them. If your client has not been able to think through solutions for barriers, then they may still be in the contemplation stage. The main characteristic of the Preparation phase consists of encouraging your client to experiment, or to try different solutions, and to be mindful (can be a reflection used later) of ideas that were not as successful.
Preparation Stage Coaching
One of the best strategies to help the client in the preparation stage is to have them solidify what their plans are toward behavior change. Journaling or other forms of written reflections represent formal statements from your client about what they are committing themselves to do, and hopefully will contain specific details for behavior change.
During this process, you may need to help your client to identify some of the small steps that they can take before undergoing a major change. This will require some brainstorming as well as taking a realistic approach to the preparations made. This activity should be done with both the coach and client coming up with ideas, together.
All of your clients will not move through the stages of change at the same timeframe, and furthermore, stages of change tend to show a little bit of overlap. For instance, a client who is still reticent or ambivalent to the process of change might need to be encouraged to explore benefits to changes in behavior; while they may be ready for a specific change, successful changes related to the overall vision may still be stuck in other stages of readiness. During this time it is also important to encourage your client and avoid telling your clients what to do.
In order for your client to properly prepare for behavior change, it is vital to identify situations that could be problematic for the client, once they begin behavior changes. Being able to identify these from the onset will allow you and your client to develop strategies and coping mechanisms before problems arise.
How would you describe a client in the action phase? This would be characterized by your client using the term “I am”, as your client has identified behaviors to change (including new behaviors), or those that they would like to adopt or establish as part of a goal or successful outcome. During this stage, your client is actually doing the behavior while building up to be an acceptable level of proficiency (target level).
As an example, you may have a client who is working on a particular change related to physical activity. After assessing your client’s needs, you develop an exercise program design for the client. Using scientific principles of exercise programming, you determine that your client should do resistance training 3 to 4 times per week, for 60 minutes at a time. Exercise science, combined with wellness coaching, has helped your clients understand that they need to work out at a moderate to a high level of intensity to make it to their goal. This will most likely represent a change in your client’s behavior. As a result, your client will come to feel more empowered, more effective and more confident, in part, due to the work done in earlier stages to set them up for the action phase.
It is during the action stage that your client is at their highest risk for relapse or lapse back to earlier stages (pre-contemplation or preparation). Your ability to coach your client with techniques to manage these challenging situations that put them at risk for relapse or lapse is very important to the process at this time. A lapse is defined as a single slip in certain behavior that could potentially lead to a relapse. Whether a lapse becomes a total relapse depends on your client’s response to the lapse, as well as the client’s perceived loss of self-control.
We know that behavior change is hard and the coach can help clients by exploring their challenging situations and to learn from them. Use coaching skills that encourage your client to share more of challenging situations with you. For instance, what were they doing, what was going on, who are they with, what were their feelings during the time? Have the client troubleshoot by asking them what they could do differently the next time a challenge presents itself.
The main goal of your conversation skills should be geared toward the formation of a plan to help your client prevent a relapse. With this sort of feedback, your client may be able to refer back to strategies the next time they are faced with a situation or scenario that challenges a behavior change they are trying to make.
Another consideration of your client during this time is the relationships with people they are developing as part of any change effort. Coach- es should encourage clients to develop relationships with other people who share common interests, as this could make a significant difference with your client. This type of “modeling” and support is important to your client because they will come to feel that they are not doing this process alone or by themselves, or that they will have to find their way for themselves.
Should your client experience a relapse, they may easily be driven toward a downward spiral. Since lapses can trigger an unwanted response from your client, the relationships and support networks that your client has in place will help to supplement the relationship they have with you, as their coach. In this way, behavior change is most successful when multiple interests are able to support behavior change. The wellness coach should always encourage new relationships as allies.
Action Stage Coaching
Coaching in the action stage is all about making connections – connect your client’s strengths and values and their ideal environments, situations or scenes. Simply put, the more modes of support within your client’s network that they can identify with, the more likely they are to be successful in the behavior change process.
Smaller, gradual changes that are targeted are characterized by small achievable steps that your client should attempt first, in order to feel successful about pending behavior changes as part of their vision. Action items for the wellness coach to encourage during the action stage may include all of the following:
- Developing friendships with people sharing similar behaviors, interests, and goals
- Prepare for potential lapses
- Use framing as a learning tool to help your client learn from mistakes
- Work toward helping your client to change their thought process about their goals. The all or none approach tends to only lead to negative thinking
- Talk about situations that could be challenging to your client once behavior change has begun. Discuss strategies around coping with the situations
If the action stage is characterized by the words “I am”, then the maintenance stage would be best summed up by the praise “ I still am”. This stage is defined by any behavior change that has become a habit for your client and is now done as part of their second nature or, automatically. Keep in mind the time frame for behavior change. This can take anywhere from 12 to 24 weeks for your average client. In this stage, clients can show a new level of confidence because they have maintained a new behavior. This new confidence will also help maintain other behavior changes due to the inherent self- efficacy built into reaching the current stage of behavior change. This self-reinforcing quality of maintaining a behavior change is just the beginning. It does not mean that there won’t be more work to do as it relates to eliminating all risky behaviors toward a goal of peak wellness.
Never underestimate the complexity of the maintenance phase. Your client will need to work hard to maintain this behavior change. With maintain- ing a behavior change, there are certain risks involved – including boredom or the realities and dangers of gradually slipping back into old behaviors that might be risky.
Once again we turn our conversation to explore lapses. This is defined as when the client temporarily will abandon or stop any behavior change and can occur during the maintenance phase just as easily or quickly as it does in the action phase. Should your clients find themselves in the midst of a relapse, they may need to reassess and redefine their goals, in addition to some refocusing.
One strategy that the coach can use in a lapse situation is to redirect the client, and to suggest a new strategy or to try a different type of change. In general, this can be easier during the maintenance phase, than if trying it in the action phase, due to the success of their experiences and from the value and benefits they have already noticed or observed as part of the change process. Lapses during the maintenance phase are not seen as either permanent or significant changes in terms of the benefits of changing a certain behavior. This is important because the coach should encourage the client to get back on track because it will be easier and quicker if done responsibly. In fact, making adjustments to your client’s behavior change strategies is an indicator that your client is in the maintenance stage of their behavior change.
In coaching, relapses are more problematic than lapses during the maintenance phase. When your client has a total relapse in their behavior change goals, they have abandoned efforts to maintain their attempt. In order to coach the client through a relapse, it is vital to reconnect the client with their strengths, values, resources, visions, goals, and any compelling motivators. For this type of client, it is preferred to restart them in the preparation stage, while trying to move them back into the action stage with appreciative inquiry, reflection and listening, without judgment. If your client is able to remember and connect their ability to use their strengths for behavior change, it is then possible for them to regain their self-efficacy as well as a sense of control.
Maintenance Stage Coaching
Reconnections are important skills to use during the maintenance stage of behavior change. It might be useful to help your client to reconnect and value a behavior as it relates to realizing their vision. During the maintenance phase, when all seems to be going well with your client, try challenging your client with the behaviors to allow for personal growth, with goals that are creative, interesting, attainable and meaningful. If your client has mentioned compelling motivators, it is important to remember those now, at this stage of behavior change – and if your client can share their healthy behavior change goals with others in their support network, it may act as a motivator to realign them with positive role models in this way.
Avoiding judgment, encourage your client to get back on track when a lapse occurs. Ideally, this should be done as quickly or as early in the process as possible. When you’re able to get your client back on track toward their desired behavior change goal, it is now time to re-strategize to prevent relapses from going forward. The reflection process may be as vital to this as any other form of communication, as you learn exactly why or how the relapse occurred initially.
Now that we have described the stages of change for wellness coaching, we have set the stage to work with clients, while moving our clients through the different stages, toward a successful or healthy outcome. Remember that our clients may not know the science of behavior change, and may not refer to the stages by name, themselves. Therefore it may be difficult to use your “listening for” skills to assess the descriptive statements that your client may use with regard to behavior change.
Your Coaching Career
Becoming a Certified Wellness Coach is the perfect addition for the fitness professional who wants to offer more all-inclusive wellness services to clients. The time is now for you to enjoy this exciting and rewarding career, which offers you personal fulfillment while improving the lives of others.
There is always something exciting about earning a new training or coaching certification and applying that new knowledge of how you train your clients. This also helps you hit the reset button.
NESTA and Spencer Institute coaching programs are open to anyone with a desire to learn and help others. There are no prerequisites.
That’s it for now.