behavior change assignment 0

2. I will begin on March 21, 2014 and plan to reach my goal of losing 25bs by April 21, 2014.

3. In order to reach my final goal, I have devised the following schedule of mini goals. For each step in my program, I will give myself the reward listed.

Mini Goal

Target Date


1.    Lose 5 pounds

March 28, 2014

A new pair of jeans

2.    Lose  5 more pounds

April 4, 2014 

A new cap

3.    Lose  5 more pounds

April 11, 2014 

New pair of Jordan’s  

4.    Lose  5 more pounds

April 18, 2014  


5.    Lose  5 more pounds

April 28, 2014  

 One football ticket 

My overall reward for reaching my final goal will be __________

4. I have gathered and analyzed data on my target behavior and have identified the following strategies for changing my behavior:

5. I will use the following tools to monitor my progress toward reaching my final goal: (list any charts, graphs, or journals you plan to use)

I sign (type your name) this contract as an indication of my personal commitment to reach my goal.

I have recruited a helper who will witness my contract and (list any way in which your helper will participate in your program).
Witness Name _________________   Date ______

Describe in detail any special strategies you will use to help change your behavior (refer to Activity 7).

Create a plan below for any charts, graphs, or journals you will use to monitor your progress. The log format you developed in Activity 3 may be appropriate, or you may need to develop a more detailed or specific record keeping system. You might also want to develop a graph to show your progress; posting such a graph in a prominent location can help keep your motivation strong and your program on track. Depending on your target behavior, you could graph the number of push ups you can do, the number of servings of vegetables you eat each day, or your average daily stress level.



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