Rick Botelho is a family doc who really cares about health promotion and disease prevention. Unlike a lot of doctors who glibly tell patients “lose weight” or “stop drinking”, Dr. Botelho really understands how hard it is to make lifestyle changes. He has written a guidebook, “Motivate Healthy Habits: Stepping Stones To Lasting Change” and a companion workbook, “My Healthy Habits Journal,” to help individuals find the motivation to change.

He advocates moving beyond “health information, advice, and self-management supports,” to “motivational approaches to behavior change.” The book takes you through a step-by-step approach that is designed to move you from an unmotivated state to being ready to make the changes and then actually making the changes.


Checklists and journaling

The book uses checklists and journaling to help you understand your current readiness to change and to explore barriers to change, including emotional barriers. In his chapter on “Understanding Change,” Dr. Botelho describes the “Force for Change” model. The model is based on the idea that both internal and external factors are involved in determining whether we will make changes in our health habits. The internal factors include understanding where you are at on a scale of “readiness to change.” Readiness to change stages are as follows:

  • Not considering change (You don’t know you should change or you do know you should change but have decided against it)
  • Considering change (You have mixed feelings about change, you know you should, but aren’t certain now is the time to do it)
  • Preparing to change (You have decided you will change and you are getting ready to do it. For example, you set a date to quit smoking)
  • Changing (You are doing the work of change—yeah!)
  • Maintenance (You have to keep it up—still hard work)

The book explains that lapses and relapses often occur when someone is trying to break bad habits. You may have to recycle through some of the stages again, but you shouldn’t give up.

External factors can support change or be barriers to change. Family members who support your efforts can help you change. Hanging out with friends who smoke is a barrier to quitting smoking. It’s really hard to kick the habit when everyone around you is indulging.


Pick a habit to change

The book suggests you pick a health habit you want to change, for example, drinking less alcohol. You, then, analyze how you think and feel about changing that behavior in some detail using a “Decision Balance” exercise. In that exercise, you determine both a “Think Score” (what you think you should do) and a “Feeling Score” (how do you really feel about it) for the reasons to change and the reasons to stay the same. Once you tally up the scores, you have a better understanding of where you are in your readiness to change. You are also asked to assess your competing priorities, energy to change, motives for change, and confidence and ability to change. Finally, you are asked to assess your level of emotional work on change—you intellectually want to change, but you really don’t feel like it. The “My Healthy Habits Journal” provides places to log all of this information so that you can track it over time.

The remaining chapters take you through exercises to lower your resistance to change, increase your motivation for change, and make concrete plans for change. These chapters contain written exercises that help you explore all aspects of the change process.

The last two chapters of the book are about becoming a motivational coach for someone else and ideas about how to become a preventive coach for your children. Most of us have had the frustrating experience of trying to get someone to change their health habits. The more we nag, the more they dig in their heels. We bribe, threaten, cajole. They keep on smoking, drinking, or overeating. We’re angry. They’re angry. We just don’t see eye to eye. That’s the point, according to Dr. Botehlo. These chapters contain exercises to help get both sides closer to the same page.


How to get the book

These great little books are recommended reading for anyone who is trying to lead a healthier lifestyle. You can learn more about Dr. Botehlo and Motivating Healthy Habits on his website: http://www.motivatehealthyhabits.com/. You can also order the books there.