Examine your target behavior—make a list of the

Examine your target behavior—make a list of the ways it affects you now and how it may affect you in the future:

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Change Agenda Worksheet

CNUR 201: Assignment 1

Student name:


Date Submitted:


Seminar Facilitator:


The trans-theoretical model, originally developed by Carlo DiClemente and James Prochaska, includes five well-defined stages that people move through as they work to change a target behavior (Bastable, 2014, p.239; Dart, 2011, p. 2; Halter, 2014, p. 387; & Kozier et al, p. 148). It is important to determine what stage you are in now as you embark on your journey of change.


As part of the required first step of Assignment 1, you are required to complete pages 1-2 AND complete the section corresponding to your stage of change. This is a mandatory, non-graded component of the course. The remainder of the worksheet includes optional activities you may choose to do throughout the term as you focus on your change agenda and critically reflect on your journey.   


Target behavior:





Goal of behavior change:




Some examples of target behaviors that students have chosen in the past have included: procrastination, obesity, smoking, poor nutrition, stress, or anxiety.


Some examples of goals of the behavior change have included effective time management, to reach a healthy weight, to quit smoking, to follow the Canada food guide, to create more home/school balance, or to reduce anxiety.


NOTE: You are encouraged to choose a target behavior and goal that is meaningful and relevant for your own life. You will only be required to share your behavior change agenda with your seminar facilitator through completion of the assignment. It is your choice whether or not you share your change agenda within seminar to your peers.







Part I. Assess Your Stage 


For a review of the trans-theoretical model, begin by reading Dart (2011) p. 2-4 and watch the following video: https://www.youtube.com/watch?v=oO80XyBDrl0. Then, to determine your stage, check true or false for each of the following statements:







  1. I changed my target behavior more than 6 months ago.
  1. I changed my target behavior within the past 6 months.
  1. I intend to take action in the next month and have already made a few small changes in my behavior.
  1. I intend to take action on my target behavior in the next 6 months.



Find the stage that corresponds to your responses:


False for all four statements = Precontemplation

True for statement 4, false for statements 1–3 = Contemplation

True for statements 3 and 4, false for statements 1 and 2 = Preparation

True for statement 2, false for statement 1 = Action

True for statement 1 = Maintenance


To provide context to your change agenda, please briefly describe what this change means to you. Consider the questions: What would it mean to me to be able to make this change?  What’s at stake if I don’t make this change?

Part II. Strategies for Change

(Note: Complete the section corresponding to your stage of change)

To help you move forward in your journey, you can try the techniques and strategies listed below for your stage of change. You may find it helpful to work through the strategies for all the stages. If you are comfortable, you can share your experiences within your seminar group. As you complete your critical reflections over the term, you are also encouraged to integrate theoretical concepts that connect to your experience from this document, course readings and additional resources. If applicable, you may choose to attach parts of this completed document as an appendix for your critical reflections throughout the term.


        Examine your target behavior—make a list of the ways it affects you now and how it may affect you in the future:


















        Become aware of the defenses you use to resist change; examples of defenses include denying the consequences of your target behavior and rationalizing your reasons for not changing. List some of the key defense mechanisms that you use to resist change (see Halter et al, 2014, p. 204-205 for common defense mechanisms):


















        Enlist friends and family members to help you learn more about your target behavior and the defenses that block your progress. List the people you have spoken with, and briefly describe what they told you about the defense mechanisms you use:







Contemplation (Choose at least 2 activities listed)


        Complete a cost-benefit analysis of your target behavior:

Pros of current behavior:                            Cons of current behavior:

























Pros of changing:                                         Cons of changing:
























        Imagine your life in 5 years without changing (or 10… 20… etc). 


        Examine the current impact of your behavior on your life. For example, if you are focusing on improving your study habits related to a pattern of procrastination, try logging how many hours you spend on social media each day. Or, if you are considering reducing the amount of alcohol you consume, take the following on-line screening test to increase the awareness of the impact of alcohol on your life: http://camh.alcoholhelpcenter.net/cyd/CYDScreenerP1_0.aspx


List the strategies you tried:













        Keep a journal of your target behavior to establish a baseline. Examine the behaviors that lead up to and follow your target behavior.




        Create a new perspective: envision yourself and your life after you change your target behavior:









        Enlist the help of friends and family members to support your efforts and help you identify the causes and consequences of your target behavior. List the people you’ve spoken with, and briefly describe what they told you about your target behavior:







        Identify and list external resources that can help you change your target behavior—for example, a gym membership, counsellor, a stop-smoking course, a stress-management student workshop, internet sites, an app, etc:





















Preparation (Choose at least 2 activities listed)



        Make change a priority in your life by create a specific plan for change (set a date and complete a plan to commit the necessary time and effort to change)


            My change date: ___________________



        As you prepare to make the change, list steps will you take towards action:











        Tell the people in your life about the change you will be making.


List the individuals you have spoken with and how they will support you in your change:









        List other external supports that will help you through your journey:









        List quotes that will help you through your journey:






Action (Choose at least 2 activities listed)


        Use a journal to track your behavior change.

        Substitute healthier responses for your problem behavior. Complete a plan to manage lapses. Identify ways to break the chain of events that leads to your behavior.

        Manage your stress level. As part of the course, you will be developing a psychological first aid kit in seminar. Begin to brainstorm strategies you’ll use to help manage stress during your behavior change program:









        Practice positive, realistic self-talk (see resources provided in Unit 7: Cognitive Behavioural Interventions).










        Make changes in your environment that will minimize your target behavior and encourage healthier choices. Identify triggers of your target behavior and develop strategies to manage more effectively.


        Give yourself healthy, positive reinforcement as well as plenty of self-praise.


        Involve supportive people around you. Find a friend to work with you on change and/or find a role model who has already made the change you are working toward and who can provide both inspiration and practical advice.



Role model:



        Keep a realistic attitude about yourself and the change you are attempting. Don’t get discouraged in the process as the action stage typically lasts for at least several months and lapses are common.




Continue with all the positive strategies you used in the action stage!



        Continue to monitor your behavior with a journal

        Continue to manage your environment

        Continue to practice realistic self-talk

        Plan for challenges and triggers, but don’t let a lapse set you back. Be prepared for challenges!

        Consider helping someone else make the change that you have just made.




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