Helping People Change
By Holly Socolow, CEAP, hsocolow@lifemanagement.cc

Many corporate wellness programs begin enthusiastically then lose steam after the initial flourish of walking or smoking cessation programs.  I often hear from frustrated wellness committees that the only people who participate are those who are already motivated - a small fraction of the employee population.  To engage more people in the wellness process,  it may be helpful to understand the process we all go through to change our behavior and then incorporate programs that will support this process.  Your EAP is a perfect complement to your health risk reduction efforts as the mind and body are inextricably linked.

Over 25 years ago, I quit smoking cigarettes.  When I look back on how I started and how I eventually quit for good, I realize the process took place in stages.  These stages are beautifully explained through a model developed by James O. Prochaska and colleagues of the University of Rhode Island called Transtheoretical Model of Change.  The stages of change are:

1. Pre-contemplation
   The person is actively engaged in the behavior and considers it enjoyable or normal.  It may be an unexamined habit or a social norm.  In my case with smoking, it was glorified in magazine ads, looked "cool" in movies, and many of my friends and family smoked.  I had little interest or awareness of a problem.

2. Contemplation
   The person becomes aware a problem exists.  In the case of smoking, the awareness may be comments by family about concerns for health referencing news reports linking smoking to health risks.  At this point, the person has made no commitment to change and perhaps is even resistant to it.

3. Preparation
   Something causes the person to make a decision to change.  It's a personal wakeup call.  A friend of mine, healthy by outward appearances, recently had a heart attack.  Luckily, he received help early and is alive to tell the story.  In his case, he had a lifelong habit of unnecessary overwork.  He elected to work extra time or multiple jobs and odd hours for weeks, even though he did not have to.  One day he experienced the classic signs - pain in the chest, perspiring, clammy hands, nausea that didn't go away.  He is convinced the attack was due to stress to which he was oblivious.  The experience was undeniable and shocked him into making a commitment to change his lifestyle to let go of unnecessary stressors and enjoy life more - have more balance, as he put it.

4. Action
   The action stage is when you actually do something to change your old behavior to the new behaviors you want to cultivate.  It is one thing to make a decision and another to actually make the behavioral changes.  When I asked my friend for examples of how he might "balance his life" he looked at me blankly.  This where we can benefit from the help of a professional to put the intention into action.

5. Maintenance - sustained change.  New behavior replaces old.
   If you've ever gone on a diet to lose 10 pounds, only to have the 10 pounds or more return, you understand the importance of maintenance.  To achieve maintenance takes time and sustained effort, because you really are changing your attitude in a sustained way.  It does get easier over time until the change becomes the new deeply ingrained habit.

6. Relapse
   As Mark Twain said, "Giving up smoking is the easiest thing in the world.  I know because I've done it a thousand times."  In my case, I tried quitting smoking on my own but started again countless times.  Eventually I sought professional help which helped me understand the ingrained nature of the habit and more importantly, gave me hope through specific strategies to break it.  Even with the best laid plans, unforeseen events can create conditions for relapse.  Relapse is not the end of the story, or a permanent condition, and we should not think of it as a weakness.  Rather, it is simply another stage in learning, a chance to step back, see what happened, learn new strategies, and begin again.

7. Sustained Change
   Learning to change is an upward cycle, as each time we begin again, we learn something new and also develop the confidence that we can change when we know how.  It becomes self-reinforcing.

Now that you have a framework for the change process, try these suggestions for your wellness program.

For employees in Stage 1, Pre-Contemplation, you could offer educational programs on a variety of topics such as stress management and expressly target family members.  Make sure family members know the resources available to them.

In Stage 2, Contemplation, you might offer a program on this very topic, "How People Change" to plant the seed of hope of how to change.

In Stage 4, Action, provide concrete information on how to make change on a variety of health related topics.  Check with your health care provider about what they have to offer.  LMA-EAP offers many wellness programs.

In Stage 6, Relapse, remind employees and family members of EAP for private individual counseling support.

Reference:
Changing for Good:  A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Forward Positively by James O. Prochaska, John Norcross and Carlo DiClemente (Sep 1, 1995)

Holly Gardner Socolow, MHS, is Manager of Employee Assistance Services at Life Management Associates.  You can contact Holly at 717.394.6688 / 800.327.7770 or via email hsocolow@lifemanagement.cc

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