If… then…

Today, I attended a workshop on changing behaviours through brief interventions. As a psychologist with a special interest in health, I am open to learning new ways of motivating people to make healthy changes, whether that is a change in their diet, physical activity, or even an addiction. Changing behaviours can be really hard! So, it’s good to try new things and get different perspectives.

In my practice and research, I focus a lot on being mindful. Mindfulness is about paying attention to the present moment, non-judgmentally. By focusing on the ‘here-and-now’ experience, mindfulness can reduce the impact of difficult thoughts and feelings, while increasing emotional stability and self-acceptance. Research shows that mindfulness interventions can lead to improvements in depression and anxiety, and increase healthy eating and physical activity. Mindfulness is an important and evidence-based intervention. But, this blog isn’t really about mindfulness.

At the workshop, attendees were encouraged to think about actions that might be done impulsively (that is, without thinking or being ‘mindless’). This includes, being aware of what prompts a person to act, even when the action is in conflict with their motivation. For example, a person may eat doughnuts when they’re trying to lose weight. Even though they have a clear goal for their weight loss, they still struggle when it comes to sweet foods, like doughnuts. They may even find themselves tempted by sweets because they often pass a great bakery on the way to work, and because the feeling they get from doughnuts is usually “comforting”.  They know that eating doughnuts only provides a temporary relief, and in the long-term they feel worse, but they still struggle to change this behaviour.

Sound familiar?

A possible intervention for this may be, “If… then… planning”. This is where a person not only sets goals for what they want to achieve, but also plans for risky or tempting situations that inevitably arise. A study1 among women who were taking part in a Weight Watchers program, investigated whether “If… then… planning” would make a difference when it came to how much weight they lost. The women were split into two groups – the first group completed the Weight Watchers program as usual, and the second group completed the program but they were also given an extra ‘planning’ session where they were encouraged to plan for risky or tempting situations. The plans looked something like this:

“Many situations may tempt you to eat something that you had not meant to. Make a plan about how you would react to these risky situations and fill in the form.”

The form provided three prompts:

“I have my own plan that will help me to maintain my healthy diet. If I am hungry, then instead of eating an unhealthy snack I plan to … (write down what you plan to do). If someone offers me my favourite unhealthy food then in order not to eat it I plan … (write down what you plan to do). If I meet with my friends or family over dinner, then in order to eat healthy food I plan … (write down what you plan to do).”

At the end of the study, it was found that the women in the “If… then…” group, lost significantly more weight, as compared to the other group. What this study suggests is that this simple and brief intervention works among people who are already motivated to make changes.

There are a few things that can help with “If… then… planning”. These include:

  • Recognise the things that prompt the behaviour and avoid them. Using the previous example, the person recognises that walking past the bakery every day is risky! So, they might consider an alternative route where they won’t be tempted.
  • Develop easy, rewarding alternatives. Think of behaviours that can substitute the old behaviour and practice them so they become more automatic.
  • Seek support. Sharing goals and intentions with others can be a helpful strategy for sticking to a plan.
  • Unlearn emotional associations. When a person anticipates that a behaviour will make them feel ‘good’ or ‘comforted’ it will strengthen the impulsive impact. Replace these messages with automatic negative evaluations. For example, “eating sweets may make me feel good for a very short time, but in the long-run I feel worse and it’s not worth it.”
  • Practice the above, again and again. Like I said earlier, changing behaviours is hard work, especially when you’re so used to doing something. Don’t expect huge changes overnight because this will set you up for failure. Be patient, and practice, practice, practice!

TO SUM UP

  • Changing health behaviours is challenging, and it can be difficult to know where to start!
  • “If… then… planning” is a simple yet effective intervention for those who are motivated to make a change
  • “If… then… planning” requires awareness of cues that prompt the behaviour and strategies to overcome temptations
  • Changing health behaviours takes time and practice, but it is possible

 

Reference
1. Luszczynska et al. 2007. Health Psychology. doi: 10.1037/0278-6133.26.4.507.

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