6.3: Models of Change

Models of Change

Figure \(\PageIndex{1}\): The purpose of counseling is to facilitate change. (Photo by Alexas Fotos from Pexels.)

There are many models of change to choose from when working toward a goal. Achieving change is the purpose of seeking counseling. Change theory is different from the theories of counseling in that clients may not improve as a result of any particular theoretical orientation as much as due to a specific process of change. In this section we will explore a few of the models of change to inform the underlying change process that might impact how your client responds to your interventions.

Models of change arise from the question “How do people change?” This of course, is very complicated, depending on the past experiences and future expectations of the individual. They are also influenced by their environment and the people in them (Granello, 2013). Understanding a few models of change will assist you in helping your client navigate this complex and often frustrating process.

The Behavioral Learning Model

The Behavioral Learning Model (BLM) can help people learn new positive behaviors or unlearn maladaptive behaviors. BLM utilizes a behavioral chain and/or a behavioral contract. A behavioral chain is a sequence of events that either enhance or detract from the performance of a behavior. It consists of identifying the maladaptive antecedent or stimulus that leads to a certain unwanted behavior and consequence. A second modified behavior chain is then created identifying a modified antecedent or stimulus, behavior and consequence. The behavior chain should answer the questions who was involved in what happened, when did it take place and did that play a part in why it didn’t work out, what was happening that might have interfered with you having success, and where were you when it failed, and finally why do you think your efforts failed. You may have to explore your thoughts, emotions, and behaviors to answer the why question. Consider all of these questions when constructing the behavior chain.

Figure \(\PageIndex{2}\): The Behavioral Learning Model (BLM) utilizes a sequence of events that affect the performance of a behavior, defined as a behavioral chain. (Photo by Joey Kyber from Pexels.)

Behavioral Contracts can also be useful in setting and maintaining goals. They consist of an If….then…format. They should be written so they can be reviewed and tweaked if necessary. An example would be “If I take a 30-minute walk at least four days a week…” “…then I will feel wonderful and proud of myself and reward myself with a new pair of shoes.” (Granello, 2013).

The Health Belief Model

The Health Belief Model (HBM) arose in the 1950’s by the United States government over concerns regarding why people would not get screened for tuberculosis even after treatments had been developed. Here are the resulting five principles found essential to understanding why people would or would not make behavioral changes (Granello, 2013).

1. Perceived severity: Individuals are not aware or have knowledge about the condition and why it matters that they address it.
2. Perceived threat: Individuals believe they will not personally be affected by the health problem
3. Perceived benefit: Individuals do not believe that changing their behavior will reduce the threat. They don’t believe the intervention will benefit them.
4. Perceived barriers: Individuals must believe there are no insurmountable barriers preventing them from accessing the intervention.
5. Self-efficacy: If an individual believes they can control their own behavior, they are more likely to make a change.

Transtheoretical Model

The Transtheoretical Model (TM) is probably familiar to you and is also known as the Stages of Change model. It is primarily related to the “readiness” of a person to make a change.

Figure \(\PageIndex{3}\): In the Transtheoretical Model (TM), action is only on step in the process of change. Taking a dive involves contemplation, preparation, and intention. (Photo by Markus Spiske from Pexels.)

• Precontemplation: The stage where the person is not aware of the need for change or has no intention of making a behavioral change.
• Contemplation: The person is seriously considering options to change but has not yet committed to action.
• Preparation: The person may make small attempts at changing behavior.
• Action: The person engages in specific behavior to produce a desired outcome.
• Maintenance: The person makes efforts to avoid relapses (Granello, 2013).

Social Cognitive Theory

Figure \(\PageIndex{4}\): Social Cognitive Theory emphasizes the environment’s role in shaping beliefs and behaviors. (Chu Chup Hinh from Pexels.)

Social Cognitive Theory explains the relationship between the individual and the environment, specifically how actions and conditions reinforce or discourage behavior. It is explained through constructs of the change process including:

• Reinforcement: Either positive or negative consequences of behavior.
• Behavior capability: Knowing what is required in order to perform the change and how to do it.
• Expectancies: The value the person places on the expected result.
• Self-efficacy: The belief in one’s ability to change one’s own behavior.
• Reciprocal determinism: The dynamic actions the person may take to change their environment, and the influence of the environment on the actions of the person.

As a counselor, we can work with clients on their self-efficacy, or their belief and confidence in their ability to consistently and effectively provide self-care for themselves. Often a person will have the information they need to reach their goals, but do not really believe they are capable of carrying out the necessary steps to succeed. An effective way to help someone with this is to help them complete a series of small, manageable steps that build confidence slowly over time. Offering positive reinforcement for completion of small goals also builds confidence and belief. The client will evaluate their successes and begin to grow more and more confident in their ability to achieve any goal they set for themselves (Granello, 2013).

The Counseling Model for Positive Behavioral Change

Figure \(\PageIndex{5}\): Behavioral change begins with a clear target. (Photo by ClickerHappy from Pexels.)

The Counseling Model for Positive Behavioral Change (CM-PBC) involves:

• Determining client readiness, which involves assessing the client’s level of desire and motivation to change, their knowledge and skills they will need to make the change, and to examine the potential barriers and resources they will need to be successful.
• Developing goals which will involve exploring a variety of approaches and potential solutions for change, keeping the goals simple, achievable, positive, measurable, and future oriented.
• Monitoring initial performance by having the client self-monitor targeted goals by available resources, barriers, what affects successes and failures, behaviors, and consequences.
• Refining goals and commitment through goal modification to reflect the information gathered during the monitoring phase and commitment to the goal.
• Performance includes creating circumstances that are likely to create a positive outcome for goals, practicing new behaviors, and soliciting and utilizing help from others.
• Persistence which includes ongoing self-monitoring, acknowledging success, continuing to collect data and comparing progress to baseline, adjusting goals as necessary, and developing a maintenance plan (Granello, 2013).

Reflection Moment \(\PageIndex{1}\)

1. What model of change do you align most closely with? Why?
2. What model of change have you used when working with clients? Was it effective? Why or why not?

These reflection questions are also available as a PDF download: Models of Change