Topic 4 SMART goals, Appropriate Rewarding, Self-Monitoring and Positive Feedback

  • Specific: Well-defined, clear, and unambiguous
  • Measurable: With specific criteria that measure your progress toward the accomplishment of the goal
  • Achievable: Attainable and not impossible to achieve
  • Realistic: Within reach, realistic, and relevant to your life purpose
  • Timely: With a clearly defined timeline, including a starting date and a target date. The purpose is to create urgency.

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Choose among different goals or set your own goal

A 4-step method to set goals in CBT

  • The reward is given consistently and is predictable.
  • Always include praise.
  • Make sure the child wants and likes the reward.
  • Use different rewards because sometimes they lose their effectiveness.
  • The reward must be earned – it comes after a positive behavior.
  • Label the behavior — be descriptive (e.g., Thank you for doing your chores right after you came home from school.)
  • Reward frequently
  • Withhold the reward for incorrect behavior.
  • Make sure you can control the child’s access to the reward
  • Reward behaviors that come close to the behavior goal – it is necessary to reward effort.
  • Use age-appropriate rewards

Rewarding to promote healthy eating. What parents should do and what to avoid:

  • verbal and not material rewards;
  • small instead of big rewards;
  • reward for the quality and the quantity (e.g., rewarding when the child just tried to eat legumes even if he did not eat all the amount he had on his plate);
  • non-food rewards (e.g., “Once you eat your food we will go to the park to play“ instead of “Once you eat your food you will eat chocolate);
  • no punishment (e.g., “If you do not eat your vegetables you will not seeTV“ or “if you do not eat all your food, you will not play“);
  • no mixed messages (e.g., we do not used unhealthy foods like sweets or unhealthy behaviors like screen time to reward children since they automatically consider that behaviors as good).

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Reward charts for kids

Self-monitoring can be used to record dietary habits, behaviors and / or thoughts. With self-monitoring the child perceives his behavior, determines the parameters he wants to change, identifies problem areas of dietary behavior, high risk situations, negative messages, consciously regulates food intake and monitors his progress.

Food diaries can be used as self-monitoring tools. They allow to record, in addition to dietary intake, other information, such as time and place of consumption, possible accomplices, what the person did before the meal or snack, feelings and thoughts before and after eating.

The health professional should not forget to review the diary at each appointment and should recognize the effort and time required for self-monitoring. The health professional can let the child guide him in the diary and be ready to accept many questions.

Self-monitoring is also a good strategy to achieve maintenance of dietary/lifestyle modifications.

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Feedback (how the child ultimately did) on subjective or objective information, observations or measurements (dietary habits and other behaviors) is important. It enhances child mobilization and contributes to the achievement of goals. To be more efficient, the feedback focuses on the positive changes, no matter how big or important they are.