Perhaps the most critical moment in the behavior change process is when someone makes a decision to change their behavior. It is that moment where they decide that the consequences—or potential consequences—of their current behavioral patterns are greater than the short-term benefits and that changing may improve their lives. This moment is a pivotal turning point in which they come to believe that they can and will change. Typically, these moments are triggered by a critical event (e.g., a drinking and driving arrest) or the buildup of repeated events (e.g., stepping on the scale every night). Furthermore, these motivational bursts tend to occur while an individual is in their natural environment, such as lying in bed reviewing the day’s events.
Regardless of the path to this cognitive shift, it is during this moment that an individual is highly motivated to meet their behavioral goals. In fact, at this moment the individual becomes their own best advocate. Their self-efficacy is high; they believe they can and will achieve their goals. This is the moment that every motivational interviewing therapist wants to achieve in session. However, this “ah-ha” experience is typically fleeting for most individuals, as rates of initial behavior change have not translated into similar rates of behavioral maintenance – even for those who seek professional assistance.
Of those who do achieve some success early on, most individuals revert back to their old unhealthy behaviors within weeks or months of their initial decision to change. This pattern is remarkably similar across behaviors: exercise, smoking cessation or nearly any other goal-directed behavior that requires persistence and long-term motivation. At its core, motivation is fleeting if not reinforced appropriately.
Several years ago, we published an article suggesting that capturing a person’s cognitions in their own words during a motivational interviewing therapy session when commitment is high and then sending it to the individual when motivation is lower could be an effective means to help maintain motivation over time (Muench, 2006). This article was based on the concept of self-modeling, which posits that an individual can learn by reviewing their own behavior from a previous time or in a different context in the present (Dowrick, 1999). As Bandura (1986) highlights, “model-observer” attribute similarity increases success, and this is heightened when an individual is their own model (Dowrick, 1999). Self modeling interventions have been used to improve sports performance as well as treat a variety of disorders such as selective mutism and social phobia.
Self-modeling was born out of audio and video recording and replay technology. The earliest published reference to a recording tool used for therapeutic means indicated that a tape recorder could function as a self-therapeutic technique to enhance self-awareness (Shor, 1955). Today, self-modeling can be enhanced dramatically through web-based, IVR or mobile capture of text or audio and video recordings at critical behavior change moments which can then be relayed to the individual on their mobile phone when motivation may be lower. The 24 hour accessibility of technology provides an opportunity to capitalize on the fleeting nature of the “ah-ha” experience.