# 194 It’s Called Behavior Change for a Reason


Many of our clients come to us with what sound like clear health goals. They may want to eat healthier, get off blood pressure medication, or fuel up for the next marathon. When a client has stated the direction she wants to go, our job is to help guide her toward the behaviors that will get her there. Tip #116, The Process of Focusing, explores our role in guiding clients from their overall direction to specific behaviors that will likely achieve success.

To understand the heart and mind of a person,
look not at what he has already achieved
but what he aspires to do.
Kahlil Gibran

You’ve got to think about big things
while you are doing small things,
so that all the small things go in the right direction.
Alvin Toffler

Careful research has shown the connection between the type of behavioral goals a client sets and their success rate. The more SMART (Tip #124) the behavior is, the more likely it is to happen. Here is an example of assessing an exercise goal for SMARTness.

  • Specific: This means that both you and the client know clearly what the behavior is. “Exercise more” is not specific. “Work out at the gym at least twice a week” is specific.
  • Measurable: A goal is measurable if it is possible to know for sure whether it has been achieved. For example, it is clear whether a person went to the gym twice a week; adding “walk on the treadmill at 3.6 miles per hour for 30 minutes” makes it even more measurable.
  • Attainable: How realistic is the goal for this person at this time? The client may want to go to the gym six days a week, but then realizes that what is attainable is two times a week.
  • Relevant: There is sometimes an interesting split between us and the client about what is relevant. As health professionals, we focus on a goal’s relevance to evidence-based outcomes. A SMART goal must also be relevant in the client’s mind (i.e., it is linked to a larger goal). In this example, the client has said he wants to have better stamina and knows that by walking on the treadmill, his stamina will indeed improve. In the professional’s mind, the exercise goal may be linked to its effect on blood sugar. Fortunately, in this case, the goal is relevant for both the counselor and the client.
  • Timely: Goals are more apt to be achieved when they have a time attached. For example, this client might enter “gym” in his calendar at a specific time on Mondays and Thursdays.

We support this process of making success more likely by:

  • Listening for behaviors that will head in the direction that you and the client have agreed upon. You can tune your ear to pick out behaviors.
  • Reflecting the SMARTest of the behaviors you hear. Don’t assume the client knows about SMART characteristics.
  • Affirming the client’s progress with SMARTening her behavioral goals. Affirming assures you will see more of the process you affirm. (Tip #152, #170)
  • Evoking SMARTer behaviors. When you hear a vague behavior, ask, “How might that look?” If the client does not have a date and time, ask, “When will you do this?”
  • Suggesting SMART behaviors. You have lots of good ideas for clients. Be sure to ask permission, and then provide the advice in the most effective manner (Tips #59, #147).
  • Circling back during your summaries, link clients’ targeted behaviors to their overall goals (Tip #72).
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