Brief Action Planning (BAP), developed by Steven Cole and others, is a communication format based on motivational interviewing and designed for health care settings. It supports self-management and behavior change for those with conditions that are at least partially treated by lifestyle. Research has shown that this short format is most useful with those who have some readiness to make changes. For those with little or no readiness or who are openly resistant, the formats suggested in Tips #81, 114 and 125 will fit better.
The best teacher is the one who suggests,
rather than dogmatizes, and inspires
his listener with the wish to teach himself.Edward Bulwer-Lytton
Education is not the filling of a bucket
but the lighting of a fire.W.B. Yeats
This simple format is a useful guide in settings such as WIC clinics and health coaching, whether in person or by telephone. It can fit in onetime contacts as well as ongoing counseling relationships.
Brief Action Planning is organized around three core questions and optional additions as needed:
1. Opening: “Is there anything you would like to do for your health in the next week or two?” or “What do you see as the next step (or change) you might make toward better heath?” If the client tells you a clear step or plan, you ask the client to say it again. This reinforces it in the client’s mind and increases confidence to carry it through. (Tip #69) “To make sure we understand each other, tell me again exactly what you’ve decided to do.”
- Some people need or request ideas for changes to make, so you offer a behavioral menu: “If you would like, I can share some ideas that would help you feel better or that others in your situation have found useful.”
- If the plan does not appear SMART enough (Tip #124), you pursue a line of questioning to clarify and firm up the plan.
2. Scale confidence: “On a 0-10 scale of confidence, where 0 means not at all confident and 10 means completely confident, about how confident are you that you will carry out your plan?” (Tip #42)
- If confidence is less than 7, ask to do some collaborative problem-solving: “Might there be a way we could modify the plan so you would be at confidence of at least 7?”
3. If confidence is 7 or more, affirm the client and ask for follow-up: “You are pleased with this doable idea we came up with. When would you like to meet again to review how you’ve been doing with your plan?” Or if this is a onetime contact, “Who do you see yourself reviewing this plan with in a week or two?”
For more on this BAP process and a handy flow chart, follow this link.