The process of change: Part 3

In this series, we are looking at how we support clients making changes. In this article, we will look at action: how do clients take concrete steps and measurable behavioural changes?

If you are new to this article series, you may want to start with part one which outlines the Transtheoretical Model and explores contemplation. Part two covers preparation, which is the step before action.

Shifting into action

The first parts of the change process revolve around thinking. In contemplation, we ask ourselves "Should I change?" In planning, we ask "How could I do it?" Action changes this: here we are moving onto doing.

A client's motivation to change is often high at this point. Although it is not as linear a process as the textbooks suggest, clients at this stage have decided to change and set forth a vision of how they could do it.

But in some ways, this motivation is high because they have not done it yet. Once we get into the doing, we often realise how hard it is, how much effort it might take, and how many setbacks there might be, reducing our motivation over time. In short, our internal motivation is tested against real-world challenges.

Skills and resources for change

Change is often hard so a key skill here is tolerating discomfort. Part of this is having that strong motivation we established earlier. But there are also practical skills we can develop to increase our ability to tolerate difficult feelings.

Second, we want effective goal-setting. Understanding exactly how we are going to do something and the steps involved makes it easier to execute. A significant part of this is the ability to break goals down into small and concrete steps.

We might run these as experiments: we take a small change we could make, try it out, and reflect on the results. Was it as bad as we thought? Did it move us further towards our goal? What can we learn?

We are likely to encounter barriers and setbacks during the action stage. Expecting these can soften their impact, and using effective problem-solving helps us overcome them.

We also want to continue to build motivation by reinforcing continued change talk and acknowledging and celebrating wins.

Practical tools

There is a range of techniques to help us tolerate discomfort. Cognitive approaches help us challenge thinking around the need to remove distress. More commonly, third-wave approaches such as Acceptance and Commitment or Dialectical Behaviour, encourage us to practice mindfully sitting with discomfort.

Goal-setting frameworks such as SMART and INSPIRED help us set effective goals. We can also use experiment worksheets from cognitive-behavioural approaches to try out new behaviours and break tasks down into small pieces.

Problem-solving frameworks such as ADAPT and PIE help us troubleshoot problems and overcome barriers. Positive psychology techniques, such as leveraging strengths to overcome challenges and celebrating and savouring wins, can also be useful.

Applying change

What does action look like for each of our vignettes?

Charlie, the overachiever with a strong self-critic now needs to put his self-talk into action and give himself time for relaxation. He is likely to feel guilty when "doing nothing" (relaxing) and it may be hard for him to sit with that. He may also run into barriers with people making demands on his time and the need to carefully set boundaries with himself and others.

Nina, looking to make a career change, will have to submit her resignation, begin job hunting and reduce her spending. Challenges might include feeling sad that she is losing her luxuries, a challenging job market, and maybe judgement from others about giving up a well-paid job.

Jesse, wanting to stop binge drinking, might find themselves lonely when they miss out on social events and implement other practical strategies for meeting their relational needs. They may need support in what exactly they will tell their friends and generating ideas for how else they will achieve their self-care needs.

Conclusion

Action is an exciting time because we see our clients move from the talking stage to the doing stage. But it is also a time fraught with difficulty: the novelty can quickly wear off when barriers appear, discomfort arises and the true reality of change hits home.

We can support our clients by helping them develop specific, clear and actionable plans for change. But also through continuing to reinforce their motivation and by providing hope when they are under the most amount of pressure.