Executive Functioning and Decision-Making

One of the continual observations I have made of EF or attention challenged clients is the difficulty they have in making a decision.

The actual first decision often presents its own set of challenges – the decision before the organization and planning of a project or assignment. What should I write this essay about? What should I do for my senior project? What classes should I take? These students, who are often very creative, have the extra challenge of having to hone in on one thing.

A metacognitive skill that I have found helpful to teach students, especially high school and older, is self-observation of their own decision-making. I have based this on something I learned as the “Transtheoretical Change Model”.

This model theorizes how people make major changes, for example, quitting smoking or losing weight. It conceptualizes the “stages of change,” – the process of coming to a decision and then taking action. These stages are:

• Precontemplation – not ready to make any decisions
• Contemplation – contemplating a decision, or slowly getting ready
• Preparation – action is coming
• Action – changes in lifestyle have been made, or behaviors have changed,
• actions are taken
• Maintenance – changes continue, old behaviors don’t continue

This Change Model is largely used in the medical field…

but I have found it useful as a positive mindset tool. For example, if a college student I work with wants to get a part time job but it just isn’t happening, this can be seen as procrastinating, being lazy, not following through, doing the same old thing etc. However, a switch in mindset to, “Looks like you are in the contemplation stage, how can we move this to the preparation stage,” gives a structure and positive re-framing to the process.

The student can acknowledge his or her forward movement and reflect on his or her own thought processes, which can be very helpful to those challenged with executive functioning skills. Framing decision-making this way is also helpful to parents and educational therapists who can allow for time before seeing noticeable action.

It’s also helpful to note that the change stages don’t always move in a linear way. Sometimes a person might be in the preparation stage, then move back to contemplation stage.