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A word to family and friends
Nagging your loved one to change is never the answer, even if you do it out of caring and concern.
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Nagging your loved one to change is never the answer, even if you do it out of caring and concern. Julie Mowrey, a nutritionist at the Eating Disorders Institute of Methodist Hospital in St. Louis Park, Minnesota, uses the stages of change in treating eating disorders. She puts it this way: "Readiness will determine the treatment plan. If a person isn't willing to work on the issue, we'll simply do medical monitoring via their family physician until they are ready." Simply changing the treatment plan in this way and sending the person home without shaming or badgering often gets excellent results - sometimes the client goes home, decides she is ready, and turns right around and comes back.

Barry McMillen, the smoking censation program director at Hazelden in Center City, Minnesota, has been using the spiral model of change for eight years. "You can't ask people to do something they're not going to do." He says that, although the old confrontive/aversive models of changing behavior seem to work well in the short term, people revert very quickly to their old behaviors once nobody is nagging or confronting them anymore. The spiral of change model, which McMillen likes because it is "far more respectful," seems to work much better in the long run.

So, what can you do to help people move from the precontemplative stage to the contemplative phase? Give them information and leave them alone. That's what Mowrey does; it's also what McMillen does through his program entitled Tobacco, the Broken Promise. "It's an attempt to bring people's perceptions up to reality. Smokers have a particularly fine-tuned system of denial. I give information to people in an impartial way; no shame, just facts. I let them know I am concerned for them, but that they have to make the change; then I let it cook. They tend to come back one to two months later, ready to work."

True to his word, McMillen even gives people a cigarette break in the middle of his presentation, though he encourages them to think about what they are doing as they light up. Because of the easy-going, nonjudgmental atmosphere, people leave the workshop feeling happy and free to come to a positive decision for themselves. This would be the best approach in your attempts to support a friend or loved one who is in the process of making a change.

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