Assessing and Improving the
Readiness of At-Risk Youngsters to
Change Aberrant Behavior Patterns
(An introduction to the “Transtheoretical Model of Change”
& assessment instruments and intervention lists aligned with that framework)
Thomas McIntyre, Ph.D.
Note from Dr. Mac: The material that you will read below is excerpted from the Behavior Transformation Guide (BTG). The BTG contains two assessment instruments and an extensive listing of suggested interventions for advancing the youngster to higher levels of readiness to undertake positive change. Click here to view the Table of Contents
Click here to go to a Quick Overview Page (instead of this extended explanation)
Introduction
One’s character, values code, social skills, and behavioral patterns are major determinants of personal and professional success in life. Students identified as having emotional/psychological/mental health and/or behavioral disorders, are at great risk for poor life outcomes due to their deviation from the norm in the above-mentioned personal traits. Despite their awareness that their actions are deemed errant and wrongful by mainstream society, they are oftentimes resistant to efforts to help them change their ways for the better.
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“Faced with the choice between changing one’s mind and proving that there is no need to do so,
almost everyone gets busy on the proof.” John Kenneth Galbraith
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Long term, persistent mental health disturbances and contra-social behavior patterns are difficult to change when that person’s daily surroundings and influences remain relatively unchanged. While many of our wayward youth can identify how they SHOULD behave in particular situations (“I need to be appropriate and make better choices.”, “I should use my words instead of my fists.”), humans are creatures of habit who need practice and the receipt of benefits in order to consider change and maintain new behaviors in a habitual manner.
The present ingrained ways of acting and reacting brought, and continue to bring reinforcement. Neither “Do it now!” approaches or extended programmatic interventions will be effective in producing a better junior citizen if the at-risk youngster lacks inner motivation to change, is provided inadequate instruction and/or support, and/or continues to obtain reinforcement and rewards for displaying the present actions that outweigh the benefits accrued for displaying a new response. Newton’s laws of physics apply to behavior change too. His first law of inertia: “A body in motion remains in motion unless acted upon by oppositional forces.” explains persistent misbehavior… Devoid of forces to the contrary, a behavior pattern tends to move in a straight-line path indefinitely. We, as concerned professionals, must redirect the errant actions.
Many theoretical models and their interventions have been developed with the intent of explaining, assessing, and changing errant behavior. However, no matter which approach is implemented in an attempt to modify aberrant action patterns, one variable exerts a massive impact on the effectiveness of interventionist’s efforts: A youngster’s willingness to cooperate in the behavior change venture.
Individuals develop behavior tendencies and patterns as they respond to events in their lives (or watch the actions of others) and assess the outcomes of those actions. Behaviorally errant youth are a result of, a product of, and often a victim of the life circumstances in which they find themselves. Professionals who serve misbehaving children and youth (educators, counselors, camp staff, social workers, etc.) must recognize that it is non-productive to blame the recipients of misdirected guidance and ill-applied character molding approaches. Adults will be more effective in their promotion and support of positive behavior change if they are: (1) Able to determine the present status of the errant youngster’s motivation to change, and (2) Cognizant of effective methods for increasing that willingness to engage in a more socially appropriate approach to life.
Helping students to develop more appropriate behavioral responses to happenings in their lives is an important role for those professionals who work with misguided and disconnected junior citizens. Sadly, many professionals, frustrated with the lack of success in helping their charges change their inappropriate ways, focus their explanations for the failure on the youngsters “noncompliance” and “lack of motivation”. If they better understood the levels of “readiness for change”, had assessment instruments for determining the readiness level, and knew of effective strategies for increasing the readiness for positive behavior change, they would be more accomplished in their intervention efforts. As a result of these improved approaches, behaviorally errant youngsters would be more fully and authentically motivated to undertake the difficult task of modifying their errant ways.
The package contains instruments that allow professionals to pinpoint the youngster’s level of readiness for change. They are: (1) The Ready Report (an instrument completed by the youngster), and (2) The Behavioral Assessment of Readiness for Change(an instrument completed by adults who are familiar with the youngster). This package also includes lists of suggested interventions that are tailored to each of the levels of readiness. These extensive listings are designed to motivate the youngster to enthusiastically and proficiently engage in (or maintain) determined efforts at modifying his/her behavioral repertoire. The basis for this formative assessment and prescribed intervention process is found in the Transtheoretical Model of Change (Prochaska, DiClemente & Norcross, 1992; Prochaska, Velicer, st al. 1994; Zimmerman, Olsen & Bosworth, 2000), also known as the “Stages of Change Model”.
Validity of the Readiness for Change Model
The developers of the Transtheoretical Model of Change, medical professionals, have verified its validity in studies regarding improvement in lifestyle choices in areas such as frequency of exercise, change of diet, smoking cessation, and contraception use. Given the widespread utility of the model with respect to positive change in highly resistant and addictive behaviors, its application to youngsters who habitually display negative behavior patterns is apparent..
Change is the end result of all true learning. Change involves three things: First, dissatisfaction with self -- a felt void or need; second, a decision to change to fill the void or need; and third, a conscious dedication to the process of growth and change -- the willful act of making the change, doing something.
Leo Buscaglia
The Positive Behavior Change Process
Being creatures of habit who exhibit behaviors that have been reinforced and rewarded, humans commonly resist change. When attempts changing one’s persistent actions are engaged, the replacement actions typically develop in a hesitant, slow and inconsistent manner. Rarely do we witness a single moment of inspiration followed by a permanently successful morphing to a new behavioral repertoire. Once present, newly acquired actions are fragile; fully exposed to circumstances that could result in their collapse. For most individuals, change is a prolonged and gradual process with the following stages being evident:
These typical stages of change are described in more detail below. No matter in which stage the youngster resides, professionals have duties to perform. Depending on the stage of readiness, intervention strategies are geared toward moving the youngster to the next stage of readiness, supporting the youngster in his her efforts, or motivating him/her to try again.
It is important to note that one factor plays a crucial role in the success or failure of a behavior change attempt: The relationship between the mentoring adult and the youngster. The strength of the interpersonal trust bonds and supports exert great influence with regard to the youngster’s readiness for and success in changing for the better, behaviorally speaking.
“You have to like the messenger if you’re going to listen to the message.”
Dr. Mac
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The Pre-Contemplation Stage
Youngsters in this stage possess no thoughts of changing their character, views, values, or social actions. They do not see their behavior as a problem, or are resigned to their present fate due to previous failures.
To the caring adult, they may appear to be in denial of any problems. However, it is important to remember that their habitual ways have brought benefits, either desirable outcomes (positive reinforcement) or the avoidance/escape from undesirable outcomes (negative reinforcement). The persistent actions continue because “They work!” Until other actions are shown to bring more benefits, any consideration of change will be absent.
Those adults who work with at-risk youngsters are charged with implementing effective behavior change programs that will lead their charges to social success. A positive change in value systems and behavior patterns is more likely to occur when the youngster is cognizant of the problematic nature of the behavior and motivated to adopt another social outlook and behavioral repertoire. Simple promises of a better life fall on deafened ears if life circumstances and the voices of influential others reinforce the present lifestyle.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngster to understand the problematic nature of their situation, and bring forth thoughts of changing.
The Contemplation Stage
Because a knowledgeable and skilled adult or team of individuals kindled the youngster’s desire to change for the better, that young person can now move into the contemplation stage. However, even when greater benefits are shown to be the case, the youngster will likely consider whether s/he has the ability to be successful in the attempt, and whether leaving behind the “payoff” for present behaviors is a wise choice. For a youngster who has been demoralized by repeated failure in behavior change attempts, even a remaining desire to be different may be muted by doubt about one’s possibility of success. S/he must also reflect upon whether s/he can hazard leaving behind his/her present group membership, the security found in the mastery of certain life skills (distorted as they might be), and the other rewards that have maintained the present behavioral patterns for so long. As per the old adage: “The devil you know is better than the one you don’t know.”
Youngsters who are pondering changing their behavioral actions, reactions and patterns, are weighing the hurdles (doubt, loss of a pleasure, exclusion from present support group, effort to be expended and benefits for doing so) against the promised benefits. They are determining whether the scales are tipped one way or the other.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngsters look at the scales with an optimistic eye.
The Preparation Stage
If and when a youngster decides to undertake the change process, s/he enters the preparation stage. Providing support to him/her at this stage is essential. Devoid of competent guidance, initial training and feedback, and encouragement, the change attempt is most likely doomed to failure. Training by trusted adults who makes use of task analysis, modeling, shaping, progressive schedules of reinforcement, and other helpful training strategies give the youngster practiced skills for the next stage.
During this stage, the youngster will be “testing the waters”, so to speak, and determining whether s/he will indeed go forward into a full-fledged, active endeavor to change. During this stage, the young person is in need of guided experience, being allowed to sample new behavioral responses in psychologically safe settings. This is a time of anxious decision making for the youngster. While the preparation stage involves walking into icy behavioral waters up to one’s knees, it is in the action stage in which full immersion occurs. While some cherish the challenge, others fear the depth.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngster to succeed at his/her initial attempts, and summon the strength to venture into the action stage.
The Action Stage
Staying with the deepening water analogy, the pre-contemplation stage is akin to a young child who looks at a lake and is frightened of going into it (or at one time fell face-down into it and is scared to wade in again). S/he became satisfied with playing on the shore despite urgings from others to venture into the water. The contemplation stage found him/her peering at the lake and wishing s/he were enjoying it as others do, but still harboring uncomfortable fears. With the hand-holding of a trusted adult who allows the child to venture out at his/her own pace, comfort and enjoyment in the wet environment sprouts. A desire to go deeper is present, but accompanied by fear of doing so.
In the action stage we use the psycho-social equivalent of a training swim vest, a life-vest filled with multiple sheets of foam. The puffy vest provides full floatation for the initial attempts. As the youngster becomes more comfortable and competent, floatation layers are removed from the vest, requiring the young person to do more on his/her own. We move further away as the youngster becomes more accomplished, while still remaining close enough to encourage him/her and if needed, come to the rescue.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngster to understand the problematic nature of his/her situation, and bring forth thoughts of changing his/her actions.
The Maintenance Stage
For a youngster to continue to put forth effort into positive behavioral change, success must be experienced (at different levels for different individuals), and failures must be viewed as part of the change process. Handling failures well requires the support, feedback, training, and encouragement found in stellar mentors who turn lack of success into a learning experience that re-motivates the young person. Our task in the maintenance stage is to shore up fragile emotional and behavioral states, while strengthening them so that in the future the scaffolding can be removed from the now-strong structures.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngster to understand the problematic nature of his/her situation, and bringing forth thoughts of undertaking change.
Relapses
Discouragement resulting from lack of success (at the level needed by a particular youngster) can bring a promising positive progression to a grinding halt. When the anticipated benefits of showing the new behaviors do not arrive, demoralization, distrust of the guiding adult, and a return to old ways is common.
It is at this point that the supportive adult must avoid being disillusioned with the apparent failure. Mentor adults must re-bolster themselves, assess what happened, determine a course of action, and re-engage the disheartened youngster.
Reflective listening is indicated, providing the youngster the opportunity to “vent out” his/her experience and feelings regarding them. After a full debriefing, the adult asks: “So what did you learn for your experiences? What went wrong, and what else could have been done?” The youngster’s responses are then followed by the question: “So what do we do now to change failure to success?” Over the course of days or weeks we re-motivate and retrain the young person, preparing him/her to re-engage in the behavior change process.
It is not unusual for youngsters who enter the action and maintenance stages to experience problems that result in “slips”, “backsliding”, and “quitting”. It is the consummate caring adult who mentors, supports, educates, and motivates the youth for another attempt at a bright future.
In the Intervention & Support Strategies section of this package, you will find strategies for helping the youngster to experience success, handle failure in a productive manner, and remain enthused about positive change.
Promoting and Modeling Persistence and Resilience
Whether stuck-in-the-muck in the pre-contemplation stage, or falling deeply into the relapse stage after some modicum of success, it is not uncommon for both the youngster and professional to experience feelings of demoralization. At these points, it is important for the adult to avoid labeling the youngster as being “non-cooperative” or “defiant” or “unmotivated”. Rather, one must recognize (and help the youngster to recognize) the complexity of the behavior change process.
Professionals must view those in their charge as being involved in an intricate, complicated process of change. Given the interplay of the situational, intrapersonal, and interpersonal facets of behavior, no one approach is the default choice. “One size fits all.” is a lie in fashion, and a lie in behavior change. However, modeling a “can do” attitude and continued training and support are always part of the plan.
“Be the change you wish to see in this world.”
Mahatmas Ghandi
“Be and teach the change you wish to see in this world.”
Dr. Mac
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Assessment and Interventions
Which goals, supports, training procedures and specific interventions are applied is dependent upon the youngster’s present state of emotional, social, and behavioral being. Different stages require different approaches designed to engage the young person and move him/her to the next higher stage of the behavioral change process (or support him/her when she reaches the maintenance stage).
This Behavior Transformation Guide package of materials contains assessment instruments for determining the youngster’s present state of readiness to undertake positive behavioral change, and extensive listings of suggested interventions (many of them hyper-linked to web pages describing their use) that are tailored for each stage.
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TIME FOR A CHANGE!
Steer your intervention-resistant youngsters to better life choices.
Who could make use of these materials?
Click on the Behavior Transformation Guide in order to learn more about it.
The binder image visually represents what you will receive electronically & how you might wish to store any printouts.
Upon purchase, the BTG is delivered immediately to your e-mail inbox in PDF form.
The electronic format allows you to make modifications for the particular circumstances of your setting before printing.
It also allows you to access hyperlinks to how-to-do-it web pages for the indicated intervention strategies.
AND... Never buy more assessment instruments. Just print another! It's another HUGE savings.
The BTG is a 67 page packet contains:
1. An overview of the Readiness for Change Model ...... READ IT NOW! (free)
2. Procedures for administering the assessment instruments
3. The Behavioral Assessment of Readiness for Change (BARC) (Completed by Adults)
4. The Ready Report (Completed by the youngster)
5. Tailored Lists of Behavior Change Interventions for Each Stage (For moving the youngster to higher levels of readiness for change)
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References
Prochaska, J,O,, DiClemente, C.C., & Norcross, J.C. 1992. In search of how people change. American Psychological;47:1102–1104.
Prochaska, J.O., Velicer, W.F., Rossi, J.S., Goldstein, M.G., Marcus, B.H., Rakowski, W., et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology13:39-46.
Zimmerman, G.L., Olsen, C.F., & Bosworth, M.F. (2000). A ‘stages of change’ approach to helping patients change behavior. American Family Physician, March 1. Source: http://www.aafp.org/afp/2000/0301/p1409.html
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When changing behaviour for the better, we want to work with, not against our kids.
Form that alliance with Dr. Mac's Readiness-to-Change materials!
The Behavior Transformation Guide
Pup, I think they're ready to change ... pages.
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Author: Tom McIntyre, Ph.D. Thomas.McIntyre@Hunter.cuny.edu
Dr. McIntyre conducts training workshops on promoting readiness to change in children and youth with disruptive behavior disorders (O.D.D., Conduct Disorders)