Kenneth W. Phelps, MS, MFTAMedical Family TherapyEast Carolina University

Social

Psycho-logical

Biological

Spiritual

FOCUSFOCUS

Who?What?When?Where?Why?How?

Who can be my partner or support person?

• Emotional support- empathy, love, trust, caring Example: providing comfort and encouragement

• Instrumental support- tangible aid or service Example: transportation, chores, healthy cooking

• Informational support- advise or information Example: facts on nutrition, weight, or coping

• Appraisal support- information used for self-evaluation

Example: progress reports, reflection, constructive criticism

Adapted from House's (1981) types of social support

What am I thinking, feeling, or doing?

We make the change…

THOUGHT EMOTIONBEHAVIO

R

Identify the thought “What is running through my mind right now?”

Weigh the evidence for the thought “What information supports this thought?”

Weigh the evidence against the thought

“What information disproves this thought?” Create an alternative explanation

“Taking a balanced strategy, I can see both sides and create a reasonable, thoughtful perspective.”

Adapted from Beck's Cognitive Therapy: Basics and Beyond

Automatic thought: “I feel so low today. Today is just another day of the same old, same old.”

Emotion: SadnessBehavior: Sleeping more, snacking, crying

Evidence for: My body hurts. I’m still in the same job I hate. My husband and I yelled this morning

Evidence against: I usually feel better after I get moving.

I may be able to apply for other jobs. My husband did call to apologize.

Revised automatic thought: “Yes, I feel low. However, if I get moving, I might feel better. Maybe I should look at

my job as a stepping stone to something better for myself.”

Emotion: HopefulBehavior: Active, taking care of self, goal-directed

Place Home Work Environment

Time Early Morning Daytime Night

People Family Friends Coworkers

Events Parties Stores Holidays

When do your thoughts become a problem?

Using the STOP sign • Post a picture of a stop sign in challenging

thought areas• Picture a stop sign in your mind and say

“stop”

• After saying “stop” to the thought, try to find a balanced perspective…go slow

• Use your supports and resources (spirituality, distraction, etc.) to move forward

Where you see yourself in the future?• In shape• Successful• Happy• Content• In a relationship• Running a 5K• Etc.

Scaling • From 1-10 where are you at being at your goal• How can you move from a “3” to a “4”?

Visualization• Imagine yourself and what you would be doing

Pictures• Post photographs of where you see yourself

Motivating Statements• “Yes, I can do this!”• “Look how much progress I have made so far!”• “Don’t get discouraged. Keep taking small

steps!”

Adapted from de Shazer's Keys to Solutions in Brief Therapy

Why are you making these changes?• Health• Children• Family• Being a role model• Energy• Strength• Accomplishment

NOT because a doctor, therapist, educator, or dietician told you to do so. This has to be YOUR

reason for making this change.

Make a list of reasons to change• Example: The reason I would like to make a

change is to 1) decrease my high blood pressure, 2) be a good role model for my children, 3) get more restful sleep, 4) show myself I can do things if I put my mind to it.

• Read this list often to generate motivation.

How can we set ourselves up for success?

Set goals that are SMART:• Specific• Measurable• Attainable• Realistic• Time Bound

Lose weight Exercise Better control my diabetes Take more me-time

Rewriting these goals…

Lose 1-3 lbs. per week (total of at least 20 lbs. by July) by cooking healthy at home for 75% of meals. • Reward: Go to favorite restaurant once per month

Walk 3 times per week from 7:30 am – 8:30 am at a rapid pace. If it is raining, do my exercise DVD.• Reward: Manicure, pedicure, or hair appointment once per

month

Attain an A1C of 8.0 or below by August by taking medication at prescribed times and following other goals• Reward: Schedule appointment to talk with physician about

decreasing medication

Spend 10-20 minutes every night alone to revisit goals, pray, meditate, or read daily devotion. • Reward: Buy a new magazine or book to read