Goals, values and motivation

Today I thought I’d start by walking through one way I’ve used to help people set goals.  These goals are ‘medium term’ goals, that is, goals the person may want to work through in a twelve week period.

I often start by using the ‘menu’ approach as described in Rollnick, Mason & Butler’s book ‘Health Behaviour Change: A guide for practitioners’.

People come in to pain management with lots of concerns on their mind – yes, they’d love to have their pain removed or reduced, but at the same time, they’d also like to talk about medications, to sleep better, to cope with work, relationships, and to exercise. In many settings it’s almost assumed that the plans the clinician have are both more important and more accurate than those the client is thinking about.

So I start with either a menu, or perhaps what we’ve started to call a ‘Wish list’.

From this, I ask people to indicate the areas they’re particularly interested in, and you will see I’ve left some of the areas blank – so they can fill in what they want if I’ve missed anything out.

Then I ask them to put these areas into priority, so we can focus in on just two or three.

Then comes the real work: how to actually turn these ‘wishes’ into goals and action plans. That’s tomorrow’s post!
Today, though, an introduction I include in the folder each person receives as part of their pain management programme:

Some quick thoughts about change

You’re going to have some sessions on change and what it means over the next few weeks. To give you something to think about now, here are some notes that will help put this programme into perspective.

  • Change is a process rather than an event
  • Motivation is something that can change over time, it’s not a fixed characteristic, and it’s not something that can be ‘done to’ someone
  • A variety of factors are identified as influencing the change-making process, two influential ones are importance and confidence
  • Importance is influenced by beliefs (values), weighing up costs/benefits, past learning experiences, and contingencies
  • Confidence (self efficacy) is influenced by personal experience, modelling, verbal persuasion, vicarious learning (watching others), and perceived barriers
  • Change isn’t always linear, it’s common to move back and forth through various stages
  • Relapse, or moving backwards, can occur anywhere – even during maintenance
  • People don’t make wholesale change – they remain in two minds very often, and may be more or less ready for different aspects of pain management
  • Readiness for change seems to consist of at least two components – importance and confidence
  • People may spend more or less time in each ‘stage’ of change – sometimes change can be very rapid once it starts, sometimes it slows in one stage then proceeds again

Some More Quick thoughts
1. Begin by making small changes or break up large-scale changes into more manageable pieces. This can make you feel better about handling the changes you are about to make while making you more comfortable with change in general.

2. Mentally link changes to daily routines you already do. This can make changes like taking on a new habit happen much more smoothly. For example, if you want to begin meditating at home, try weaving it into your morning routine.

3. Going with the flow can help you accept change instead of resisting it. If you stay flexible, you will be able to ride out change without too much turbulence.

4. When a change feels most stressful, relief can often be found in finding the good that it brings. An illness, a financial loss, or a broken relationship can seem like the end of the world, yet they also can be blessings in disguise.

5. Remember that all change involves a degree of learning. If you find change particularly stressful, try to keep in mind that after this period of transformation has passed, you will be a wiser person for it.

6. Remember that upheaval and confusion are often natural parts of change. While we can anticipate certain elements that a change might bring, it is impossible to know everything that will happen in advance. Be prepared for unexpected surprises, and the winds of change won’t easily knock you over.

7. Don’t feel like you have to cope with changing circumstances or the stress of making a change on your own. Talk about what’s going on for you with a friend or write about it in a journal. Sharing your feelings can give you a sense of relief while helping you find the strength to carry on.

8. Give yourself time to accept any changes that you face. And as change happens, recognize that you may need time to adjust to your new situation. Allow yourself a period of time to reconcile your feelings. This can make big changes feel less extreme.

9. No matter how large or difficult a change is, you will eventually adapt to these new circumstances. Remember that regardless of how great the change, all the new that it brings will eventually weave itself into the right places in your life.

10. If you’re trying to change a pattern of behavior or navigate your way through a life change, don’t assume that it has to be easy. Wanting to cry or being moody during a period of change is natural. Then again, don’t assume that making a change needs to be hard. Sometimes, changes are meant to be that easy.
“There is
nothing so
useless as
doing efficiently
that which
should not be
done at all.”
(Peter Drucker, 1909-2005, Austrian born US
management guru, writer and seminal business

for your
and sure
(Richard Bach, b.1936, American writer and pilot,
from his 1977 book, Illusions.)

“We don’t
see things
as they are,
we see
things as
we are.”
(Attributed to Anais Nin, French-born American writer,

Have a great day – and come back tomorrow for ‘developing the action plan’

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