Randell Allen is a nutritionist and personal trainer based in Los Angeles, California and the creator of NutritionX. NutritionX Los Angeles develops personal programs for fat loss and muscle gain based on your body type.
It should be obvious when you are ready to change your diet and exercise habits, but it’s not. Being a nutritionist and personal trainer for over 20 years, I have found that it’s almost impossible to know right away what stage a person is in when committing to a nutrition and exercise plan. Some people can change their habits and implement new information quickly, while others may have to progress more slowly, and some may not be ready to change their lifestyle and adopt health dietary and exercise habits at all.
When you are aware of what stage of change you in, and set backs are to be expected, it seems to help take the pressure off of trying to get everything “perfect” right away. It also helps the health professional, not take it so hard when an existing client fails to stick with the guidelines set forth.
As health professionals, we all want are clients to perform well, and feel a sense of accomplishment when we have a positive impact on the people we work with.
When I first read about the Transtheoretical model of behavioral change (TTM), I thought that the information was obvious and of little value. I have since changed my mind. The TTM can be a valuable guide in helping both the professional and client to realistically assess motivational levels. Thus, goals may be made based on the stage of change of each individual, which may improve the long-term effectiveness of adopting healthy habits.
The TTM is broken down into four components: What stage of change are you in?
- Stages of change
- Process of change
- Decisional balance
The first stage of change is called precontemplation.
In this stage you are oblivious to exercise, you may even make fun of people who do. Statements like calling someone a “health nut,” may come from someone not considering exercise and diet as worth value. In the precontemplation stage, you are not exercising or eating well.
The next stage is the contemplation stage.
In this stage you are considering changing your bad habits, but not ready to commit to change. Often, someone you know may be telling you, you should be worried about your health, and should “do something.”
These are the “tire kickers.” The expression comes from someone who visits a car lot looking for a new car, but not really ready to buy. They come on the car lot; kick a few tires pretending like they are interested, but then head home. I often get calls from people in the contemplation stage. Most health professionals don’t mind inquiries. The frustration begins when we take time and schedule an appointment and you don’t show up.
Stage three is the preparation stage.
In stage three you may be beginning to walk, or join a gym, although you may be inconsistent. The preparation stage is nice stage to be in because you are ready to adopt healthy habits. This is an ideal time to begin to work with a professional. You may not be perfect all the time, but you are making the effort to change. I find that education is a motivating factor for people in the preparation stage. The more scientific information learned at this phase, the faster the progression.
Stage four is the action stage.
According to TTM, at this stage you are exercising, perhaps eating healthy, but for less than 6 months. The danger in the action stage is the temptation to fall back into bad habits.
The final stage is the maintenance.
Healthy exercise and eating habits for longer than 6 months marks the maintenance phase.
The maintenance stage may entail some setbacks, but perseverance and continuing to cultivate your healthy habits is key. In other words, if you all off your food and exercise plan during vacation, get back on as soon as possible.
Approximately, 65% of people beginning an exercise program quit after 4 to 6 weeks. So, to get the maintenance phase is a big accomplishment.
Core Principals Of The Transtheoretical Model
Core principals of TTM include decision making, which means the ability to see that the pros outweigh the cons of your new healthy diet and exercise habits. Compartmentalizing is important in the decision making phase; so many people come to the gym until they get stressed out, busy, or sick then never return. Setting time aside and making a decision to come to the gym no matter what, even if it is only a couple times a week due to a changes in schedule is important.
Don’t let other things get in the way of exercising and eating well. If you are depressed, go to the gym, instead of letting depression keep you from making your commitment to your health. That is compartmentalization. The ability to organize your time and not let one upset take you away from your fitness goals.
Self-efficacy is the confidence to continue your new regime. Joining gym for some is intimidating. I often here comments from people new to the gym like,” everyone is in such great shape, which is completely inaccurate. Most people who come to the gym, especially in the beginning, are not in great shape. I know that my clients are somewhat successful, when I see them exercising in the gym without me. It means they now have the confidence to workout by themselves without felling self-conscious.
Self efficacy is important for an advanced exerciser also. Let’s say your trying to push from 16% body fat to 10%. This means you are going to have to make additional changes to both your food and exercise regime. Having the faith to make the necessary changes to your lifestyle is what self-efficacy is all about.
The 10 TTM Processes Of Change
1.Consciousness Raising— The people who know the most about a subject are liable to be successful. Educating yourself on the proper dietary and exercise techniques is paramount to long term success.
2. Dramatic Relief— entails alleviating fear and anxiety about not being able to accomplish your goals. I once had someone call me and admit that they were not sure they could be successful in starting exercise. I told her to just show up. After training with me for several months, she now trains on her own. She worked past her fear and anxiety.
3. Self Reevaluation— Valuing your health and visualizing the person your want to be is important. The self revaluation process is akin to accepting that your new goals are an important part of the person you strive to be.
4. Environmental Reevaluation—is realizing how negative behavior has an impact on other people. Let’s say you have kids, and you want them to incorporate a healthier lifestyle. You begin to understand that your positive choices will most likely have an impact positive impact on your family. Conversely, your negative choices will impact those around your as well.
5. Social Liberation— is the understanding that society values positive behaviors. People are attracted to success. Success in our society is usually rewarded by financial and social influence. Society often rewards excellence.
6. Self-Liberation— enables you to have faith in your commitment to change and the ability to stick to your goals despite challenges. I often tell my clients that developing healthy habits is a skill. Developing success in one area o your life, often carries over to other areas.
7. Helpful Relationships— are people who support your change in lifestyle. Nothing is worse than someone attempting to sabotage your healthy goals. I remember when I decided to quit drinking; many of my friends did not want me too. Every time I was with certain friends, one would attempt to buy me a free drink.
This is where working with a professional or group can help give you support on the changing your lifestyle.
8. Counter-Conditioning—one major issue we may have is with negative thinking. Often we have to learn to substitute healthy habits, and healthy conversations with our self to offer are own self-support. Be your own best friend. Don’t beat yourself up for not getting everything “right” all the time. If you find it difficult to nurture yourself, simply letting negative thoughts go as they enter your mind is a useful technique to help stay positive.
9. Reinforcement Management—Rewarding yourself when accomplishing a goal is a means of reinforcing your efforts. Perhaps your goal is to keep a food journal. After 3 consecutive days, perhaps you reward yourself by doing something nice for yourself like getting a massage.
10. Stimulus Control— The ability to develop the skill of self-control is a must, and learning to say no is a skill to develop. Sometimes I work with people who say they have to wine and dine their clients, or their clients have to wine and dine them. Sure, enjoying yourself is important, but not being able to say no, when you are jeopardizing your goals is no good. Sometimes you have to practice saying no.
“The map is not the territory.” It is not enough to simply read about success, you must be willing to continue to cultivate success.Developing a healthy lifestyle may take many months or years of practice. The Transtheoretical model of change simply describes the process of change, the existing conflicts, and the positive traits we must ultimately adopt to successfully change our lifestyle.
1.The Transtheoretical Model for change James O. Prochaska et al. Am J Health Promote 1997: 12(1): 38-48
2. Pro Change Behavior Systems. About us. Transtheoretical model. 2008 Mar. Accessed 2009 Mar 21.
3. Ace person Training Manual (2010) Fourth Edition
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