Home All Pursuing Goals: An Interview with Caroline Miller, Part 2

Pursuing Goals: An Interview with Caroline Miller, Part 2

written by Kathryn Britton 6 October 2013

Kathryn Britton, MAPP '06, is a former software engineer and executive coach. She is now a writing coach and editor with a focus on helping people write books, blogs, and articles that contribute to the greater good (Theano Coaching LLC). She has been facilitating writing workshops since 2013. Her own books include Sit Write Share on how to get writing done well, Smarts and Stamina on using positive psychology principles to build strong health habits and Character Strengths Matter: How to Live a Full Life. Full bio. Kathryn's articles are here.

This is the second of two interviews with Caroline Adams Miller, author of Creating Your Best Life: The Ultimate Life List Guide, a book about effectively pursuing life goals, and Positively Caroline: How I beat bulimia for good… and found real happiness, a book about her long-term recovery from bulimia.

The first interview focuses on setting goals, while this one explores actions that make goal achievement more likely.

Caroline runs an online course on setting and pursuing important life goals. The course is open to anyone in the world that can access the lessons by computer. A new cohort of the course starts October 21 with early bird pricing through tomorrow, October 8. Click on Your Happiest Life to explore and register.

Kathryn: Once goals are set, what can people do increase their chances of accomplishing them?

Caroline: There are a number of things people can do to enhance goal accomplishment. It depends on where they are in the change cycle.

In the Contemplation stage, they can search for more and stronger reasons that their goals are important to them, or perhaps make sure their goals have the qualities of powerful goals: approach-oriented, leveraging other goals, aligned with their values, and so on. If they are in the Planning stage, they can start to think about resources they need to acquire, people they need to meet, and research that can be done. There are also a number of other questions that will need to be addressed thoroughly to ensure that the next stage, the Action stage, goes smoothly. In the Action stage, people can use environmental primes, implementation intentions, accountability, and other techniques that make success more likely.

In my online course, Your Happiest Life, we work both on establishing high-quality goals and on establishing the primes and intentions that make goal achievement more likely. I’ve described primes and environmental cues in Creating Your Best Life. The license plate images on this page are primes I’ve collected over the last few years.

Kathryn: How did goal-setting help in the recovery you describe in Positively Caroline?

Caroline: My recovery from bulimia was, in hindsight, a textbook example of goal-setting. I had a major goal, complete recovery, but I had a lot of little steps that needed to be taken to get where I wanted to go.

From Caroline's collection

From Caroline’s collection

I also had accountability to role models called sponsors, I had a written plan for daily success, I spent as much time as possible with people whose behavior was positively contagious, I removed all alcohol from my life because it destroys willpower, and I practiced savoring and gratitude every day. In addition to performance goals with definite outcomes, I had learning goals, such as finding ways to survive in restaurants that made me uncomfortable, where it was okay to just “do my best.” I also found that as I achieved important goals, I reengaged with fresh goals that helped me continue to make progress.

Kathryn: What do you most hope today’s children learn about setting goals? Do you have any recommendations for good practice activities?



Caroline: The most important thing children need to learn is self-regulation. If you can’t delay gratification, there won’t be many goals you can accomplish that require resilience and grit. The next generation has been raised with the immediate feedback of cell phone calls, text messages, and Facebook posts, so no one waits for anything any longer. We’ve also had a generation of parents who raised their children to have self-esteem based on empty praise, which actually reduces confidence and risk-taking.

The research suggests that you select one area of life to improve at a time, and as you get better at resisting temptation, your willpower for other things will get stronger, too. There is also compelling research showing that regular mindfulness practice enhances self-regulation, so those are the two most important components of goal-setting to start with.

Kathryn: What’s your favorite research result about goal-setting?



Caroline: Hands down, it’s Benefits of Frequent Positive Affect by Lyubomirsky, King and Diener. It was the research that completely changed my life by showing that hundreds of studies prove that success comes AFTER you are happy, and not vice versa. I’ll never forget the day I read that research because it turned a lifetime of misconceptions about success upside-down in the best possible way, prompting me to do the capstone project that became Creating Your Best Life.

Kathryn: What comes next for you?



Caroline: I have an idea for a new book and it won’t leave me alone, even though I swore off book-writing for at least one year. I’m a new empty nester with all three of my children out of the house, so I’ve taken up a new martial art and hope to get another black belt within five years. The martial arts are another textbook way to do goal-setting: you pursue a variety of belts on the way to getting a black belt, with stripes denoting continual progress. You are surrounded by positively contagious behavior in a dojo, discipline and respect are paramount, there are multiple role models and other people pursuing similar goals at the same time that give you enthusiasm to keep going in the right direction.


Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131(6), 803-855.

Miller, C. A. & Frisch, M. B. (2009), Creating Your Best Life: The Ultimate Life List Guide. New York: Sterling.

Miller, C. A. (2013). Positively Caroline: How I beat bulimia for good… and found real happiness. Cogent Publishing.

Miller, C. A. (1991). My Name Is Caroline. Gurze Books.

Locke, E. A. & Latham, G. P. (1990). A Theory of Goal Setting & Task Performance. Prentice Hall College Division.

Photo credits
On the peak courtesy of Mikel Ortega
License plates used with permission from Caroline Miller

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Todd Kashdan 7 October 2013 - 8:52 am

Motivational interviewing, which is based on the stages of change model, has a tremendous amount of efficacy. Be a creator… {…edited…}

Here are some of the data you missed over the past 10 years:

Rubak, S., Sandbæk, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. The British journal of general practice, 55(513), 305-312.

Motivational Interviewing is a well-known, scientifically
tested method of counselling clients developed by Miller
and Rollnick and viewed as a useful intervention strategy
in the treatment of lifestyle problems and disease.

To evaluate the effectiveness of motivational
interviewing in different areas of disease and to identify
factors shaping outcomes.

Design of study
A systematic review and meta-analysis of randomised
controlled trials using motivational interviewing as the

After selection criteria a systematic literature search in
16 databases produced 72 randomised controlled trials
the first of which was published in 1991. A quality
assessment was made with a validated scale. A metaanalysis
was performed as a generic inverse variance

Meta-analysis showed a significant effect (95%
confidence interval) for motivational interviewing for
combined effect estimates for body mass index, total
blood cholesterol, systolic blood pressure, blood alcohol
concentration and standard ethanol content, while
combined effect estimates for cigarettes per day and for
HbA1c were not significant. Motivational interviewing
had a significant and clinically relevant effect in
approximately three out of four studies, with an equal
effect on physiological (72%) and psychological (75%)
diseases. Psychologists and physicians obtained an
effect in approximately 80% of the studies, while other
healthcare providers obtained an effect in 46% of the
studies. When using motivational interviewing in brief
encounters of 15 minutes, 64% of the studies showed
an effect. More than one encounter with the patient
ensures the effectiveness of motivational interviewing.

Motivational interviewing in a scientific setting
outperforms traditional advice giving in the treatment of
a broad range of behavioural problems and diseases.
Large-scale studies are now needed to prove that
motivational interviewing can be implemented into daily
clinical work in primary and secondary health care.

Todd Kashdan 7 October 2013 - 10:00 am

so I can’t be accused of cherrypicking. here is a review of 4 meta-analyses:

Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: a practice?friendly review of four meta?analyses. Journal of Clinical Psychology, 65(11), 1232-1245.


This article reviews the research support for Motivational interviewing (MI) so that practitioners can make informed decisions about the value and applicability of MI in their clinical work. We highlight the evidence from the three published meta-analyses of MI and a recent meta-analysis that we completed. MI is significantly (10%–20%) more effective than no treatment and generally equal to other viable treatments for a wide variety of problems ranging from substance use (alcohol, marijuana, tobacco, and other drugs) to reducing risky behaviors and increasing client engagement in treatment. Although most client-related variables are unrelated to outcomes (e.g., age, gender, severity), some decisions about treatment format (e.g., individual vs. group) are important. For example, relying solely on group-delivered MI appears to be less effective than one-on-one MI, whereas delivering MI with problem feedback is likely to generate better outcomes for some problems than MI alone. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1–14, 2009.

from p. 1233 is the link between the stages of change mentioned by Caroline and this brief cost-effective intervention:

Does MI Have a Cohesive Theoretical Base?
Yes. An important characteristic of a psychotherapy system is that it possesses a theoretical base rather than simply being a collection of techniques (Prochaska & Norcross, 2007). A theoretical base provides a roadmap by which practitioners and researchers can direct assessment, conceptualization, intervention, and evaluation. Whereas MI does not advance a wholly new theory about human functioning, it draws on aspects of several other theories in order to understand one essential component of the behavior change process: motivation. To highlight the novelty in the MI conceptualization of human motivation, consider three simple mathematical equations that illustrate how behavioral change might occur.

Knowledge = Change

Many professionals interested in helping people make behavioral changes assume
that supplying knowledge is sufficient. Well-intended practitioners advise people who are overweight to eat better and exercise more. Parents who are inconsistent in following through with limit setting are instructed to be clear and consistent with rules. Individuals addicted to drugs are told to avoid situations that will trigger cravings. However, seasoned practitioners realize that even very good advice often fails to generate behavioral change. After all, too many of us and the people we counsel continue to engage in unhealthy behaviors despite clearly knowing what we should do and how to change. What is lacking is the motivation to apply that knowledge.
Consider, therefore, a second equation:

Knowledge x Motivation = Change

Motivation is an essential ingredient to the change process, as any amount of
knowledge multiplied by zero motivation will fail to produce any change. Research has shown that a client’s motivation to change is significantly influenced by the therapist’s relational style (Norcross, 2002), such that the therapist’s behavior may even determine a client’s noncompliance with change suggestions (e.g., Beutler & Harwood, 2002; Miller, Benefield, & Tonigan, 1993; Patterson & Forgatch, 1985). MI posits that a good working relationship in which clients are viewed as the expert on his or her own life serves to minimize resistance to change and thereby enhances motivation as shown in a third equation.

Knowledge x Motivation/Resistance = Change

and there is the scientific backdrop behind Caroline’s comments.


Kathryn Britton 7 October 2013 - 10:26 am

Wow, Todd. Thanks for taking the time to help us all navigate the literature.


tiggy 9 October 2013 - 9:40 am


Two Cochrane Reviews that question the stages of change model

Cahill, K; Lancaster, T; Green, N. Stage-based interventions for smoking cessation. Cochrane Database Syst Rev. 2010

Tuah, N; Amiel, C; Qureshi, S; Car, J; Kaur, B; Majeed, A. Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults. 2011

The critic on wikipedia summarises the major issues with the model see http://en.wikipedia.org/wiki/Transtheoretical_model

Todd Kashdan 11 October 2013 - 2:33 pm

the critics on wikipedia bring up good points. I suspect like myself, Caroline views the stages of change as a continuum and people are not rats that wheel through each subsequent stage in order.

as an analogy, read:
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American psychologist, 55(1), 68-78.

p. 72, Ryan and Deci list different types of motivation from amotivation to intrinsic motivation as a framework to aid our understanding of human behavior. But they will tell you its a continuum and anybody can be at any spot and at skip to any other spot. Stages of change is the same way.

If you want to understand the literature on stages of change, read the original articles, take your time and synthesize existing work instead of relying on wikipedia or 10 minutes on google scholar. And if you do go on wikipedia, don’t skip to the one section of critics to fits your assumption, read it all. You might learn something instead of trying to reify ideas from classes taken 10 years ago.


tiggy 11 October 2013 - 5:57 pm

Todd, a major assessment in final year undergrad psychology involved a critic of the transtheoretical model. So I am reasonably familiar with the literature.The conclusions were essentially the same as in the wikipedia critic.

My initial comment was a little sloppy. It should have read the stages of change model is overly {edited…} simplistic. This is like any staged model, e.g. the stages of grief. They tend to assume that everyone behaves in the same way.

Lynn Johnson 27 October 2013 - 8:17 am

Tiggy / Todd, re: stages of change, I am in the trenches and not an academic. My own understanding of stages of change comes from John Weakland / Steve deShazer. I have synthesized their ideas into Customer Status, seeing the stages as Visitor or Guest, Complainant (a concept that is not clear in other models), Shopper and Customer.

Now de Shazer liked to emphasize these are not states of being within the patient, but are rather relationship qualities between the patient and the therapist. In other words, we aren’t seeing what people are, we are seeing who we are when they are with us. I imagine that Prochaska sees them as stages within a person that must be worked through.

Similarly, deShazer saw “resistance” as the patient offering supervision to the therapist, who would be wise to heed it. That is, resistance doesn’t reside inside of but rather is an experience that emerges between two people.

My Customer Status Matrix has been helpful to therapists, but it is slippery since therapists tend to shift back into a fundamental attributional error, thinking that they are seeing people as they are, rather than seeing people as behaving this way because the therapist is in the room, being who he or she is.


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