Pic 0: The screen changes to a close-up of Dr. Schwartz in front of a blue background. A figure appears next to Dr. Schwartz with two word bubbles above its head which reads “Fast food is cheap” and “I don’t have time to exercise.”
Dr. Schwartz: Have you ever had a family shut down a discussion with a comment like “Fast food is cheap” or “I don’t have time to exercise”? Why do people say things like that, when they know change is in their best interest? To answer that question, let’s learn more about the process of behavior change.
Pic 1: Dr. Schwartz disappears and the figure moves to the center of the screen. A plus sign appears on one side of the figure, and a minus sign appears on the other.
Eva: Imagine you have a big decision to make, maybe you were offered a promotion, but you’d have to move to a new city.
Pic 2: The word “Ambivalent” appears above the image, and the plus sign flashes for a moment before the minus sign does the same.
You might feel ambivalent, simultaneously thinking about the upsides and downsides.
Pic 3: The figure and text disappear and is replaced with an image of three figures, two large and one small. To the left of the family, a word bubble pops up that reads “We want to change” and to the right of the family one pops up which reads “Things are fine.” Above the left word bubble, the words “Change Talk” appear. Above the right, the words “Sustain Talk” appear.
Families are often in a similar situation when they consider behavior change. They might voice both sides of their thought process in the form of “change talk” and “sustain talk.” Just as change talk is any speech in favor of healthier choices, sustain talk is speech defending the status quo.
Pic 4: The images disappear, and the words “Behavior Change” appears between “Change Talk” and “Sustain Talk.” A series of arrows move from “Change Talk” over “Behavior Change” to “Sustain Talk” while another goes from “Sustain Talk” under to “Change Talk.”
Both are part of behavior change. It’s a process and not a single event.
Let’s look at some examples of sustaintalk.
Pic 5: The screen changes to one titled “Identify Sustain Talk.” The slide reminds the reader that sustain talk is “any speech in favor of the status quo.”
Here’s an example of sustain talk:
“I don’t have 30 minutes to take a walk every day.”
Here are some examples of related statements that are change talk, not sustain talk:
“I’ve been thinking maybe I need to get more exercise.”
“I could probably fit a 30-minute walk into my routine.”
Pic 6: The screen transitions to the slide with the next set of example statements.
Here’s an example of sustain talk:
“I can’t picture our lives without fast food.”
Here are some examples of related statements that are change talk, not sustain talk:
“If we eat fast food for dinner, I feel tired the next day.”
“I know we shouldn’t be eating so much fast food.”
Pic 7: The screen transitions to the next slide with a set of example statements.
Here’s an example of sustain talk:
“At least we aren’t drinking soda.”
Here are some examples of related statements that are change talk:
“What options would be healthier than juice?”
“Juice is good but I know it can have a lot of sugar.
Pic 8: The screen transitions to the next set of example statements.
Here’s an example of sustain talk:
“Her grandparents give her more treats than I do, and I can’t change that.”
Here are some examples of related statements that are change talk:
“I could try getting her grandparents to buy healthier snacks.”
“I don’t like how many treats she gets at her grandparents’ house.”
Pic 9: The screen returns to Dr. Schwartz. An image of three figures appears next to Dr. Schwartz with a word bubble underneath them that reads “We want to change” and the words “Change Talk” above them. After a moment, “Change Talk” is replaced with “Sustain Talk” and the word bubble changes to read “Things are fine.”
Dr. Schwartz: Research shows that just as change talk can predict commitment to change, dwelling on sustain talk can make people less likely to change.
Therefore, a primary goal is to emphasize and explore change talk while acknowledging but de-emphasizing sustain talk.
If you’re hearing a lot of sustain talk, the key is not to react negatively.
Pic 10: The screen changes to one divided in two colors. On one side, an image of a health coach appears with a word bubble that reads “Change Talk.” On the other is an image of three figures with a word bubble that reads “Sustain Talk.” After a moment, the figures become larger as the health coach becomes smaller and more gray.
If you argue for change, the family is more likely to take the other side and argue against change.
Pic 11: The words “Double-Sided Reflections,” “Affirmations,” and “Reframing” appear in a list beneath the health coach.
Instead, I recommend three techniques: double-sided reflections, affirmations, and reframing. Let’s learn more about each one.
Pic 12: The screen changes to one titled “Double-Sided Reflections.” An image of a scale appears, and each side dips a bit for a moment before returning to balance.
Eva: Double-sided reflections show the client you heard their reasons both for and against change. This points out their ambivalence and subtly encourages them to resolve it.
Here are some examples.
Pic 13: The screen changes to one titled “Examples of Double-Sided Reflections.” It includes an example conversation between a client and health coach told through word bubbles.
Client: I want to eat healthier, but I don’t know if I can completely stop eating fast food.
Health Coach: Fast food is convenient, and you also want to eat healthier.
Client: Right. I guess it would be okay to cook at home a little more often.