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Change Plan
 
 
 

Make a plan for change
Here is an example of a "Family Change Plan" you can work through together with your child.

Tracker: Right now I play _______ hours a day and about ______ hours a week.

New goal:
I will play no more than _______ hours on any given day and no more than _____ hours a
             week.

      I will stop playing video games.

When? I will start on this date ___________________________________________________

Reasons: My most important reasons to make these changes are:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Alternatives: Instead of playing video games this week I will try these activities:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

People: The friends and adults who can help me are (list names and how they can help you
achieve your goals):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Possible challenges: Some things that might make it difficult for me to cut back on game play and
how I will handle them:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Celebrating my achievements: If I achieve my goal for the week I will:
___________________________________________________________________________
___________________________________________________________________________


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Parent signature(s)                                                        Child signature
 
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  © National Institute on Media and the Family.