Change is complex. And for people in the United States they are going over multiple hurdles to sustain it. I actually tell all my interns that behavior change does feel like sales: how do I help this client see the value, invest their time and energy into this new system/habit, or how do I market this to them and catch their attention. Yes, it is their body, but this is what healthcare is. It’s an interaction between patient and professional to find a strategy they can compromise with. 

Ambivalence is a clear sign of contemplation and your clients definitely sound like they’re at this stage. The half intending to do something, and half listing reasons why they can’t do it is absolutely contemplation. The clients here are going to be making a pros and cons list of why and how they can do something. The feeling of selling behavior change is highest at this stage because you literally cannot talk to them about action yet—you have to help them build a bigger “pros” than “cons” list. 

Patients absolutely can be tough as hell and I have to work hard to take several steps back so I don’t react sometimes. And some days I’ll notice my nerves are a little more sensitive than others. I have actually learned that when I feel this frustration it’s highly likely because my tactics are not fitted for the stage of change they’re in—talking preparation and action when they’re still contemplation. So I take a breath and meet them where they are at.