Behavior change is recognized by politicians, scientists, and therapists worldwide as crucial to solving individual and social problems.
The development of effective behavioral solutions to tackle chronic health conditions, mental health problems, financial difficulty, and criminal behavior has impacted fields as diverse as medicine and health, policing, and education (Hagger, Cameron, Hamilton, Hankonen, & Lintunen, 2020).
As a result, many behavioral theories have been developed that offer insight into contextual, environmental, individual, and social factors that influence intervention effects and highlight the potential to resolve problems rooted in how we behave.
This article introduces several theories behind behavioral change, techniques, and worksheets valuable in changing behavior and habits.
Before you continue, we thought you might like to download our three Goal Achievement Exercises for free. These detailed, science-based exercises will help you or your clients create actionable goals and master techniques for lasting behavior change.
How to Change Behavior and Habits
“Many problems observed in today’s society can be linked, directly or indirectly, to human behavior,” including debilitating illnesses and chronic conditions, such as obesity, cancer, sexually transmitted infections, and cardiovascular disease (Hagger et al., 2020, p. 1).
But changing from existing unhealthy behaviors to new and positive ones is never easy.
“If I continue to do what I have always done, then I’m going to get what I’ve always got” (Forsyth & Eifert, 2016, p. 15). Unless we change our behavior, we will likely get more of the same.
And you need commitment. Only you can “decide whether to allow the barriers to continue to stand between you and getting something different out of your life” (Forsyth & Eifert, 2016, p. 16).
But how do you change behavior and habits?
Many psychological theories identify the factors that determine behavior and inform the cognitive development of behavioral change interventions. They include the following (modified from Hagger et al., 2020):
- Theory of planned behavior
- Habit theory
- Trans-theoretical model
- Self-determination theory
- Social cognitive theory
- Control theory
While each theory is unique, they typically consider individual attitudes, beliefs, and environment vital in determining behavioral change.
Habit theory
Habits can be helpful; they “permit fluent action, preserve cognitive resources for other tasks […], and ensure action is not forgotten” (Orbell & Verplanken, 2020, p. 179). As a result of repetition, habits are an essential part of being human but not always healthy or helpful.
The challenge is to find a way to disrupt the habit by removing or ignoring the trigger, inhibiting the habituated response, or replacing it with a new, healthier one (Orbell & Verplanken, 2020).
Trans-theoretical model
The trans-theoretical model was developed in the 1980s to help people reduce unhealthy behavior (e.g., smoking and drinking too much) and increase physical activity (DiClemente & Graydon, 2020).
The trans-theoretical model does not consider people to be lacking in motivation but to need to start, stop, or change how they act, placing them on one of five stages along a journey:
- Stage one – contemplation
- Stage two – contemplation
- Stage three – preparation
- Stage four – action
- Stage five – maintenance
For each stage, the individual must complete tasks to move on to the next. For example, during preparation, the individual must commit to change and create a change plan. The plan must be implemented – problems solved – and revised as required during the action.
This is not necessarily a linear process but rather a cyclical process, with individuals cycling through stages (Prochaska & DiClemente, 1983).
Changing environments
While individual attitudes, beliefs, and plans are crucial, researchers increasingly recognize the importance of the environment (Marteau, Fletcher, Hollands, & Munafò, 2020).
Choice architecture or nudge interventions focus on changing cues in small-scale physical environments. For example, healthy eating can be encouraged through:
- Reducing the size of plates and glassware (discouraging overeating and excessive drinking)
- Placing very graphic warning labels on alcohol and food
- Making healthy food widely available
Testing environmental changes’ positives and potential negatives involve robust laboratory and field studies to estimate effect sizes (Marteau et al., 2020).
There is no one-size-fits-all approach to change. Individuals, environments, and socioeconomic conditions vary across countries and political ideologies, and we should apply theories accordingly.
Setting Achievable Plans and Goals: 5 Examples
Making plans and setting goals are popular and proven mental health interventions for behavioral change (Epton & Armitage, 2020).
Many of us will have used them in education or work-based settings to direct attention, focus, and resources at a particular task.
While there are several general approaches, the following two are common.
The SMART Goals Worksheet and the extended SMART+R worksheet use the acronym SMART to guide goal capture and setting. Goals should be:
- Specific
- Measurable
- Attainable
- Realistic
- Time-bound
SCAMP is another valuable approach to goal definition. It focuses on five factors to ensure maximum effectiveness and motivation when working toward goals (Kremer, Moran, & Kearney, 2019):
- Specific
- Challenging and controllable
- Attainable
- Measurable and multiple
- Personal
Goal-setting theory differentiates between behavior (such as eating more healthily, getting more exercise, and adopting policies) and outcome goals (including building a community center, rolling out training practices, or getting a new job).
Examples of goal setting across different fields include (modified from Epton & Armitage, 2020, p. 556):
- Social inequality
By 2030, progressively achieve and sustain income growth of the bottom 40% of the population at a higher rate than the national average. - Fitness
Race under 40 minutes in a 10 km road race by September. - Workplace
Use the end-of-year review process as an opportunity to set attainable yet stretching goals. - Sport
Last year’s Olympics silver medalist says her next heptathlon goal will be to break the 7,000-point barrier. - Environment
To reduce absolute carbon emissions by 35% by 2025/2026.
Approaching Change: 4 Helpful Interventions
Habits are powerful because they turn every small decision – Should I have milk in my coffee? – into a non-decision, freeing up resources. We don’t always create good habits such as eating well; instead, we often form unhealthy ones, such as smoking or drinking too much (Orbell & Verplanken, 2020).
It is possible to “ensure that new desired behaviors will be enacted consistently and not forgotten” (create good habits) and “avoid a habituated action” (undo bad habits; Orbell & Verplanken, 2020, p. 183–184.)
Creating good habits
While goals are crucial to getting things done, sustained change often requires new habits (Clear, 2018).
To turn behavior into a habit, it must be (Clear, 2018):
- Obvious
- Attractive
- Easy
- Satisfying
Try out the Creating Good Habits worksheet to make new positive changes in your life (modified from Clear, 2018).
Undoing Bad Habits
Stopping harmful, negative, or unhelpful habits typically involves preventing their activation in memory or the enactment of the habit response (Orbell & Verplanken, 2020).
The Undoing Bad Habits worksheet aims to break bad habits by making them invisible, unattractive, complicated, and unsatisfying.
- How could I make it less visible?
- How could I make it more difficult?
- How could I make it more unsatisfying?
Motivation to change
Motivation is a critical factor in initiating and perpetuating change and is a factor in overcoming both resistance and apathy (Ryan & Deci, 2018).
The Advantages and Disadvantages of Changing worksheet is a simple yet powerful way to explore the advantages and disadvantages of making a change.
Consider the change. Is it the right thing to do? If it is, your answers should motivate you to plan the changes you wish to make in your life.
Resilience and change
Change is often neither easy nor straightforward. Resilience helps you pick yourself up when things go wrong and start where you left off again.
Carole Pemberton (2015) suggests considering the four Ss when building resilience, which is equally valid for making changes. Ask yourself:
- What skills do I possess?
- What supports do I have (including family, friends, and colleagues)?
- What strategies can I adopt?
- What could sagacity (wisdom and insight) be helpful?
Use the four Ss for resilience and change worksheet to identify the psychological capital you have available to support you along your change journey.
Learn from previous successful transformations and gain confidence in your abilities to change.
3 Techniques & Exercises for Therapy Sessions
Many tools, techniques, and exercises available can help overcome problems and facilitate change.
We have listed four below that are valuable for the therapeutic alliance and change outcomes.
Managing resistance to change
There are many reasons a client may resist change. The following techniques can help therapists ensure the therapeutic process is not damaged (Clay, 2017):
- Remain aware of your emotional and physical state and try to stay calm.
- Validate what the client is saying and display empathy.
- Reframe resistance by encouraging your client to explore and explain their feelings.
- Remember the bigger picture and how you can help them change by taking on the client’s pain.
Miracle question
“The miracle question invites people to imagine a future where a solution to their problem has been found and it no longer dominates their lives” (Rogers, Whitaker, Edmondson, & Peach, 2020, p. 247).
Ask the client to imagine falling asleep one night and awakening the next day, and the problems they have discussed disappear.
What would it look like? How would they first see a difference? How would they feel?
The above ‘ask’ can be modified slightly to imagine what it would be like if the change they wished for happened.
If–then plans
Implementation or if–then plans specify what to do should a particular situation (expected or unexpected) arise (Rhodes, Grant, & de Bruijn, 2020).
Work with the client to identify as many critical situations or cues that might occur and the appropriate behavior to perform.
It may be helpful to write these out during or after the session and work through and practice them.
Eliciting Behavior Change: 12 Questions to Ask
Motivational interviewing “is designed to find a constructive way through the challenges that often arise when a helper ventures into someone else’s motivation for change” (Miller & Rollnick, 2002, p. 4).
Ultimately, motivational interviewing is about clients talking themselves into change based on their values and interests.
DARN is a helpful acronym for generating questions to encourage change talk and can help invite change to happen.
The following worksheets and sample questions will help (modified from Miller & Rollnick, 2002):
- Desire questions explore the client’s desire for change and often include words like want, wish, and like. For example:
What changes do you hope these sessions will bring?
How do you want your life to be different in a year?
How would you like things to change?
- Ability questions ask about what the client can or could do without expecting them to commit. They prompt the client to consider what change is possible. For example:
If you decided to get fit, how could you do it?
What aspects of your life do you think you might be able to change?
How likely are you to be able to make that change?
- Reasons questions prompt if-then thinking. These questions help generate good reasons to change, even if the client is not yet ready to do so. For example:
Why would you want to change your diet?
What would make it worthwhile to make that change?
What are the three best reasons for starting a new job?
- Need questions express “an urgency for change without necessarily giving particular reasons” (Miller & Rollnick, 2002, p. 173). For example:
4 Questionnaires to Measure Behavioral Changes
Behavioral change can be attempted at many levels within communities, groups, and individuals.
Measures and assessments provide a means to track the success of change intervention programs and increase the likelihood that the person will perform the behavior (Godin et al., 2010):
- Behavioral Risk Surveillance System (BRFSS)
BRFSS is part of the Centers for Disease Control and Prevention and provides mental health questionnaires in multiple languages for tracking health-related behaviors. - Advance Care Planning Survey
This survey assesses process measures that affect behavioral change, such as knowledge, contemplation, self-efficacy, and readiness (Sudore et al., 2013). - Science of Behavior Change
This website offers several measures for assessing behavior and behavioral change, including:- Behavior Rating Inventory of Executive Function – assesses self-reported behaviors associated with the executive function.
- BIS/BAS Scale – measures the motivation to approach goal-oriented outcomes.
2 Activities for Group Settings
While the following cognitive development activities can be performed individually, they are compelling in group sessions.
Powerful group change questions
Change is not easy. Before we are motivated to make the change, we must first dare to dream about how that change may look.
These Powerful Change Questions encourage reflection on the bigger picture to help clients consider what they want. The questions also are helpful inputs to the GROW coaching model (modified from Whitmore, 2017).
Take time to reflect on the questions and your answers. What do they tell you about what you want to do next in your life?
Nudge interventions in groups
A nudge “is any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives” (Thaler & Sunstein, 2021, p. 8).
A group environment lends itself to exploring, identifying, and discussing nudge interventions and their effect on individuals and the community, such as:
- Provision of information
Health warnings on cigarettes and calorie counts on menus encourage a healthy lifestyle. - Changes to the environment
More stairs and fewer elevators to boost exercise. - Use of norms
Supplying information on what others are doing socially to facilitate positive behavior.
Each intervention has the potential to impact behavior positively without eliminating or restricting choice or introducing financial disincentives (Thaler & Sunstein, 2021)
Use the Group Nudge Intervention worksheet in a group setting to explore how to nudge techniques can be more successful than attempting to enforce behavioral change.
A Take-Home Message
Effective behavioral solutions are crucial in managing chronic physical and mental health problems and the ongoing challenges in society from financial difficulty and criminal behavior.
Making changes at a personal or a community level is not easy. As a result, many behavioral theories have arisen in recent decades to understand the influences on the effectiveness of interventions and how to encourage their uptake.
New positive habits can be implemented and unhealthy ones disrupted to encourage behavior aligned with overall goals. Environmental change can also be compelling, making positive behavior easier and promoting wellbeing.
Planning and goal setting are valuable tools for increasing motivation and positive feelings regarding the potential to reach wished-for outcomes while tracking progress.
As a therapist, it is essential to work with clients to understand what they wish to achieve, whether significant outcomes or more minor habitual, but equally important, behavioral changes, as they encourage a happier, more fulfilling life.
- Clay, R. A. (2017). Coping with challenging clients. Monitor on Psychology, 48(7), 55. Retrieved November 28, 2021, from https://www.apa.org/monitor/2017/07-08/challenging-clients
- Clear, J. (2018). Atomic habits. Random House.
- DiClemente, C. C., & Graydon, M. M. (2020). Changing behavior using the transtheoretical model. In M. S. Hagger, L. D. Cameron, K. Hamilton, N. Hankonen, & T. Lintunen (Eds.), The handbook of behavior change (pp. 136–149). Cambridge University Press.
- Epton, T., & Armitage, C. J. (2020). Goal setting interventions. In M. S. Hagger, L. D. Cameron, K. Hamilton, N. Hankonen, & T. Lintunen (Eds.), The handbook of behavior change (pp. 554–571). Cambridge University Press.
- Forsyth, J. P., & Eifert, G. H. (2016). The mindfulness & acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias & worry using acceptance & commitment therapy. New Harbinger.
- Godin, G., Sheeran, P., Conner, M., Delage, G., Germain, M., Bélanger-Gravel, A., & Naccache, H. (2010). Which survey questions change behavior? Randomized controlled trial of mere measurement interventions. Health Psychology, 29(6), 636–644
- Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N., & Lintunen, T. (2020). The handbook of behavior change. Cambridge University Press.
- Kremer, J., Moran, A. P., & Kearney, C. J. (2019). Pure sport: Practical sport psychology. Routledge.
- Marteau, T. M., Fletcher, P. C., Hollands, G. J., & Munafò, M. R. (2020). Changing behavior by changing environments. In M. S. Hagger, L. D. Cameron, K. Hamilton, N. Hankonen, & T. Lintunen (Eds.), The handbook of behavior change (pp. 193–207). Cambridge University Press.
- Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change. Guilford Press.
- Orbell, S., & Verplanken, B. (2020). Changing behavior using habit theory. In M. S. Hagger, L. D. Cameron, K. Hamilton, N. Hankonen, & T. Lintunen (Eds.), The handbook of behavior change (pp. 178–192). Cambridge University Press.
- Pemberton, C. (2015). Resilience: A practical guide for coaches. Open University Press.
- Prochaska, J. O. & DiClemente, C.C. (1983). Stages and processes of self-change of smoking, toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.
- Rhodes, R. E., Grant, S., & de Bruijn, G. (2020). Planning and implementation intention interventions. In M. S. Hagger, L. D. Cameron, K. Hamilton, N. Hankonen, & T. Lintunen (Eds.), The handbook of behavior change (pp. 572–585). Cambridge University Press.
- Rogers, M., Whitaker, D., Edmondson, D., & Peach, D. (2020). Developing skills & knowledge for social work practice. SAGE.
- Ryan, R. M., & Deci, E. L. (2018). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Press.
- Sudore, R. L., Stewart, A. L., Knight, S. J., McMahan, R. D., Feuz, M., Miao, Y., & Barnes, D. E. (2013). Development and validation of a questionnaire to detect behavior change in multiple advance care planning behaviors. PLoS ONE, 8(9).
- Thaler, R. H., & Sunstein, C. R. (2021). Nudge: The final edition. Penguin Books.
- Whitmore, J. (2017). Coaching for performance: The principles and practice of coaching and leadership. Nicholas Brealey.
