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NAME:DATE:Behavior Change Contract DIRECTIONS: Choose a health behavior that you would like to change and fill out this behavior change contract (a sample on the next page). Sign the contract at the

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How to fill out behavior change contract

01

To fill out a behavior change contract, follow these steps:

02

Clearly define the behavior you want to change. Be specific and measurable.

03

Set a clear goal for the behavior change. Make sure it is realistic and achievable.

04

Identify the rewards or consequences associated with the behavior. Determine the positive consequences you will experience if you achieve the behavior change, as well as the negative consequences if you do not.

05

Develop an action plan. Break down the behavior change into smaller, manageable steps. Outline what actions you will take and when you will take them.

06

Seek support. Enlist the help of someone who can hold you accountable and provide encouragement throughout the process. This could be a friend, family member, or even a professional.

07

Set a timeline. Determine a start date and an end date for the behavior change contract. Hold yourself accountable to the agreed-upon timeline.

08

Monitor your progress. Regularly track your behavior and measure your success. Adjust your action plan if necessary.

09

Celebrate milestones. Acknowledge and reward yourself for achieving small successes along the way.

10

Review and revise. Periodically reassess your behavior change contract. Make adjustments as needed to ensure continued progress.

11

Evaluate the contract. Once you have completed the behavior change contract, evaluate its effectiveness. Celebrate your accomplishments and reflect on the lessons learned.

Who needs behavior change contract?

01

Behavior change contracts can be beneficial for anyone looking to make a positive change in their life. This can include individuals looking to quit smoking, lose weight, manage their time more effectively, improve their communication skills, or develop healthier habits. Behavior change contracts provide structure and accountability, making it easier to stay motivated and achieve long-term success.

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What is behavior change contract?

The behavior change contract is a written agreement between an individual and a therapist or counselor outlining specific behavioral goals and the steps to achieve them.

Who is required to file behavior change contract?

Individuals who are working with a therapist or counselor to modify their behavior are required to file a behavior change contract.

How to fill out behavior change contract?

To fill out a behavior change contract, individuals should work with their therapist or counselor to clearly define their goals, outline specific steps to achieve them, and establish a timeline for progress.

What is the purpose of behavior change contract?

The purpose of a behavior change contract is to provide a structured plan for individuals to modify their behavior and track their progress towards their goals.

What information must be reported on behavior change contract?

A behavior change contract must include specific behavioral goals, the steps to achieve them, a timeline for progress, and any consequences for not meeting the goals.

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