Keeping New Year's Resolutions: What Works for Your Patients?

John Watson

Disclosures

January 04, 2017

With a holiday season of blissful self-indulgence and dietary lapses passing into our rearview mirrors, many of us will now abruptly shift gears and adopt New Year's resolutions that put us on the road toward improved health in the year ahead.

We spoke with three psychologists who have written about New Year's resolutions to better understand what the data show about increasing the odds of their success, the most common contributors to their failure, and the reasons why many of us might procrastinate in making much-needed changes even after the calendar turns to January 1.

Pulling Off a Successful Resolution

John C. Norcross, PhD, is a distinguished professor of psychology at the University of Scranton in Pennsylvania and a clinical professor at The Commonwealth Medical College, also in Scranton. He is the author of Changeology: 5 Steps to Realizing Your Goals and Resolutions.

Medscape: Where did New Year's resolutions first develop, and how did they attain the cultural prominence they enjoy today?

Dr Norcross: The tradition probably began in Ancient Roman times, when Roman citizens would make resolutions of good conduct to Janus, the two-faced deity for whom the month of January is named. Other people trace it back even earlier to Egypt. But whatever their origins, they are psychologically, culturally, and spiritually prominent as a means of self-transformation and are a mark of the ceaseless search for self-improvement among humans.

Medscape: What are the most common types of New Year's resolutions?

Dr Norcross: Resolutions run the gamut of self-improvement, but the majority concern health or money. A Harris interactive poll of more than 3000 adults conducted some years ago found that the top five were weight loss, improved finances, exercise, getting a new job, and healthier eating.

Medscape: Who's generally making these resolutions? Are there particular demographic groups, or is it more universal?

Dr Norcross: About 60% of Americans will declare their intention to make a resolution when queried in early December, but then approximately 40% will actually do so come January 1. Women are slightly more likely to make resolutions than men, but it's a small difference.

Medscape: For people with several unhealthy behavioral traits, is it more likely for them to be successful in the long term if they chip away at them one at a time, or should they aim to address them all at once?

Dr Norcross: Something in between those two extremes. We call this "two's a charm." Old science told us to stick to one thing at a time when it comes to change, because we only have so much effort and brain agility to go around. But new science tells us that we're just as likely to be successful in undertaking two resolutions at once, particularly if they're related. Examples of natural pairings here would be exercise and eating, smoking and stress management, and relationships and communication.

Medscape: How can someone improve their odds of success at the very outset of beginning a resolution?

Dr Norcross: Our research tracking successful resolvers recommend four steps at the very beginning of January. First, develop a specific action plan. What specifically are you going to do differently to counter the problem? What is the healthy alternative to that problem?

Second, resolvers need to establish genuine confidence that they can keep the resolution despite the occasional slip. Such specific confidence is a strong predictor of who's going to succeed in the new year.

Third, publically declare that resolution. We know that public commitments are typically more effective than private decisions.

And fourth and final, make sure that your resolution is a realistic, attainable goal. Grandiose goals beget resignation and, typically, failure. It's far better to say, "I'll lose 15 pounds over the year and actually keep those pounds off," instead of shooting for the moon.

Medscape: Even with those recommendations, it does always seem to get tentative after a few weeks of trying to change a behavior. What's your advice there?

Dr Norcross: Most successful resolvers will slip later in January. Healthcare professionals can remind patients that a slip need not be a fall. We need to normalize slips as part of the process. In fact, in one of our studies, 71% of the successful resolvers at 6 months said their first slip had actually strengthened their efforts. That presumably helped them recommit to their resolution following a slip. One missed appointment need not end the entire program.

We also recommend that healthcare professionals assist their clients in cultivating social support. We know the buddy system works, and those buddies can be support groups, friends, online communities, family members, coworkers, and fellow resolvers. Many resolvers erroneously equate resolutions with going it alone. It need not be so. We can help and rely on each other for social support, particularly at the end of February, when we know the slips begin to pile up.

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