The following example is designed to help you think through the steps involved in behaviour change.
People often assume that change happens because someone is told what to do or realises something is important. In reality, behaviour change is usually a gradual process that involves reflection, planning, and trying things out. The steps below show how this can work in practice.
Step 1: Becoming aware that something needs to change
Someone who works from home notices that they are moving very little during the day. They feel more tired, sluggish, and find it harder to sleep at night. Over time, these experiences lead them to recognise that their current routine is affecting how they feel.
Behaviour change often begins with awareness, rather than action.
Step 2: Identifying a realistic change
Instead of aiming for a large or unrealistic goal, such as dramatically increasing fitness levels, the person looks for a small, manageable option. They decide that a structured programme, such as the Couch to 5K, feels achievable and appropriate for where they are starting from.
Choosing a realistic change makes it more likely that action will follow.
Step 3: Drawing on past experience
The choice is influenced by what the person already knows about themselves. They remember that digital tools, reminders, and structured plans have helped them in the past, and that breaking tasks into smaller steps makes change feel more manageable. Behaviour change is shaped by past experiences — both positive and negative — rather than starting from scratch.
Step 4: Planning before acting
Before any physical activity takes place, several decisions have already been made. The person has chosen what they will do, how they will do it, and what support or tools they will use. This planning stage is often invisible, but it is a critical part of behaviour change.
Step 5: Managing barriers and motivation
As the person begins the programme, they encounter common challenges such as lack of time, low motivation, or competing priorities. Motivation is supported by focusing on short-term benefits, such as improved mood, feeling less tired, or a sense of achievement after completing an activity.
Barriers are a normal part of the process and need to be anticipated, not avoided.
Step 6: Accepting setbacks
Missed sessions or lapses occur, particularly when routines are disrupted. This does not mean the change has failed. Behaviour change is rarely linear, and new routines take time to become established.
Over time, with reflection and adjustment, the behaviour begins to feel more familiar and requires less effort.
Key messages from this example
- Behaviour change involves multiple steps, not just motivation or willpower
- People already hold valuable knowledge about what does and does not work for them
- Planning and small, realistic steps support action
- Setbacks are expected and do not mean failure
Why this matters for the RETURN intervention
Patients attending urgent dental care are often at an early stage of behaviour change. They are usually in pain and are keen to avoid returning in the same situation.
This creates an important opportunity to talk about what happens next, including attending for stabilisation and follow-on care, rather than waiting until problems become urgent again.
The RETURN intervention does not aim to force action or solve problems for patients. Instead, it creates space for patients to:
- Reflect on past experiences of dental care
- Identify barriers that have made attending for routine or stabilisation appointments difficult
- Begin planning a first, realistic step towards stabilisation or ongoing dental care
Your role is to support this process in a collaborative way, helping patients move from urgent care towards planned, stabilising treatment, rather than directing or persuading them.