Examples of Behaviour Change Techniques

Individuals are often counseled on lifestyle modification when diagnosed with a chronic medical condition. Here are behavioural change techniques to aid adjustment to a health condition.

Education and Information on Behavioural Change

• Educate patients about their chronic disease, including its prognosis and the role of weight loss and exercise, including the benefits and harms relative to other nonpharmacological/pharmacological/ surgical options.
• Help the patient understand the health consequences of changing their behaviour (e.g. benefits of weight loss on their symptoms, function, cardiovascular status, etc) and emphasize the personal relevance of the health behaviour.
• Help the patient believe they are capable of changing their diet or engaging in exercise/physical activity. Ask about and acknowledge patient concerns. Provide reassurance and education as required.
• Counter any misconceptions the patient may have around their condition and the effectiveness of various treatment options.
• Provide information in different formats including verbal, written, and visual.

Goal Setting, Action Planning, and Review of Goals

• Help the patient set goals. These should be goals about the outcome (e.g. to lose 10% of body weight, to reduce the amount of medication, to be able to walk around the shops, to complete a 5km fun run) and goals about the behaviour(s). The goals should be written as SMART goals – Specific, Measurable, Achievable, Relevant, Time-Bound. See the example below:

• Use shared-decision making to come up with feasible and specific plans to achieve the goals and provide detailed instructions so the patient knows exactly what to do, when, and where. For example, how to undertake a ketogenic diet or how to do the chosen exercise program.
• Review both the behavioural and outcome goals regularly and change as needed.

Behavioural Contract

Some patients find it helpful to have a ‘behavioural contract’. This involves a written agreement of the patient’s resolution of a specified behaviour witnessed by another person. For example, agreeing with a friend not to eat chocolate for the next two months.

Self-monitoring

Self-monitoring is useful to help the patient track their progress towards their goals. The patient can self-monitor both the outcome (e.g. body weight) plus the behaviours (e.g. food intake or exercise frequency).

• Recording weight on a weekly basis can be useful. There are a number of resources that can help with this. For example:

Weight loss apps such as Happy Scale
Microsoft Office offer an accessible Microsoft Excel template to help chart weight loss. Find the link for download here

• Record food intake – keeping a detailed food diary for 4-7 days can be used to see exactly what, when and how much the person is eating.
• Record exercise and physical activity levels – this can be as simple as a logbook or using wearable technologies to measure step count or activity levels as well as apps.

Social Support

Encourage the patient to find someone who can offer social support and day-to-day encouragement to help them stick to their weight management plan and achieve their weight loss goals. However, it is important to choose the right person to help. The support person test can help the patient decide whether the person they have in mind is likely to have a positive impact on their weight management efforts.