PCS ChampionsGTHM: Behavior Change Territory

The Behavior Change We Want

What motivates change?

a) Primarily logic b) Primarily emotionsc) Combination of logic and emotionsd) I feel choices a-c are too limiting

What motivates change?

Q: What do you call a sleeping bull?

Happiness and surprise are the emotional states that lead to behavior change. When children learn language, they love to learn unexpected answers to logical questions!

Q: What do you call a sleeping bull?

A: A bull-dozer

What’s the most important thing about preparing family meals?

a) Provide good nutritionb) Are affordablec) Enjoyed by everyoned) Preparation time

Maybe there’s more to the story?

Q: What has four legs and goes “Oom, Oom”?

Q: What has four legs and goes “Oom, Oom”?

A: A cow walking backwards!

Motivational Interviewing

• People are motivated to change when they see a difference between where they are and where they want to be

• Counselors can help clients examine this discrepancy by comparing their current circumstances and their future goals

We don’t have time to discuss everything!

• We don’t need to discuss everything.– Their big concerns (How do you feel..?)• What’s high on the list?

– Our items to cover (ABCDE)– What is the next step for them?– Snapshots in time

Behavior Change. How?

Lessons from Motivational Interviewing:• True power for change rests within the client.• Counselors reinforce that there is no single

“right way” to change and that there are multiple ways change can occur.

WHAT is important to participants?

• Just ask them! • Why not?– People say what you want to hear.– People say the “right” answer.– Withhold the truth to avoid being judged.

“The mind uses logic, the heart just doesn't understand stuff like that.” T Jay Taylor

Q: Why do fish live in salt water?

Q: Why do fish live in salt water?

A: Because pepper makes them sneeze!

Pregnant Mom: “I love vegetables!”

“What do you know?” “How do you feel?”

• Logical questions narrow responses to logical, factual responses.

• Logical/fact-based questions threaten to expose what participants don’t know.

• Projective questions invite participants to discuss what only they know – they become the expert

“What is your goal?”• “My Goal? Ummmm…”• Lasting change is more likely when

participants discover their own reasons and determination to change.

• Counselor’s role is to “draw out” the person’s own motivations and skills to change

• “What if I don’t know what I want to change?”

• Fezzik: What do I do?• Vizzini: Finish him, finish him - your way.• Fezzik: Oh, good. My way. Thank you Vizzini. Which way's my

way?• Vizzini: Pick up one of those rocks, get behind the boulder. In

a few minutes, the man in black will come running around the bend. The minute his head is in view, HIT IT WITH THE ROCK!

• Fezzik: My way is not very sportsmanlike.

What is my way?

How do you feel about “x”?

• Good/Bad/Not sure. • “Tell me more”• Well, … (unprocessed details + unconscious

factors)

Q: What do you call a cow in a tornado?

Q: What do you call a cow in a tornado?

A: A milkshake!

Nutrition Assessment

• Learning the participant’s story– There’s always more to the story!

• Get to the important part – the heart• For example, “The Three Little Pigs”• Start asking questions!

The Three Little Pigs

Storybook pigs:• Are they baby pigs?• What do they look like?• Do they live on a farm?• Males, females?• Siblings?• Poor appetites?

Growing child:• Does she have a good

appetite?• Drinks water?• Eats vegetables? Fruits?• How much juice? Milk?• Fast food?• Sweets, candy?

The Three Little Pigs• There’s a wolf• If you’re lazy and build a

flimsy house the wolf will destroy it.

• Working hard to build a solid brick house will save you from the wolf

Why are we talking about fairy tales?

• Three pigs – three approaches to making choices

• Wolf – any threat to healthy growth and development

• WIC Counselor? – Listen and share about today’s concerns– Anticipatory guidance– What changes can keep you clear of the wolf?

What helps WIC staff learn to use open-ended questions?

a) Memorizing open-ended questions.b) Feedback after observationsc) Observing experienced counselors.d) Taking an online course like WIC Listens.

“Provide a concise diet report about yourself/your infant, your child, please.”

• Pick a picture…how you feel about…• Pick a color…how you feel about… • Pick a texture…how you feel about…• If you could change something…• What changes in your eating or activity that

will help you reach your hopes and dreams?

How you feel about (child invites)…

• What foods your child eats• Your child’s appetite• The variety of foods • Your child’s acceptance of new foods• Your child’s attention at mealtime• Others?

• Q: What do you call a cow that eats your grass?

• Q: What do you call a cow that eats your grass?

• A: A lawn moo-er.

How you feel about (infant invite)…

• Nursing your baby• Your baby’s appetite• Feeding your baby• Recognizing baby’s hunger cues• Your baby’s signals for hunger and fullness• Others?