The stages of change model, also known as the transtheoretical model, was developed by James Prochaska and Carlo DiClemente in the 1980s. This model proposes that behavior change occurs in stages, with individuals progressing through several steps before successfully adopting a new behavior. The stages of change include pre-contemplation, contemplation, preparation, action, maintenance, and termination.
Humans all have habits and behaviors that we would like to change. Change can be difficult, whether quitting smoking, exercising more, or reducing stress. One approach to understanding and facilitating behavior change is the stages of change model.
Understanding the stages of change can be helpful for individuals who want to change their behavior and health professionals who work with clients or patients. By identifying which stage of change a person is in, interventions can be tailored to meet their specific needs and increase the likelihood of success. In the following sections, we will explore each stage of change in more detail and discuss strategies for moving through the stages toward lasting behavior change.
Understanding Change
Change is a natural part of life. We all go through big or small changes, positive or negative. Understanding the process of change can help us navigate it more effectively.
There are several models for understanding the stages of change, but one of the most commonly used is the Transtheoretical Model (TTM). According to this model, change occurs in six stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination.
In the pre-contemplation stage, we may not even know that change is necessary. We may be in denial about our behavior or its consequences. In the contemplation stage, we start to consider the possibility of change, but we may still need clarification about whether we want to change.
The preparation stage is when we start to take concrete steps towards change. We may set goals, make plans, and gather resources. In the action stage, we actively make changes and implement our plans.
The maintenance stage is when we work to sustain our changes. This can be challenging, as old habits may be hard to break. Finally, in the termination stage, the changed behavior becomes a permanent part of our lives.
It’s important to remember that change is sometimes linear. We may move back and forth between stages or even relapse into old behaviors. It’s also important to be patient and kind to ourselves as we navigate the change process.
By understanding the stages of change and being mindful of our behavior, we can make positive changes in our lives and achieve our goals.
Precontemplation Stage
When we talk about the stages of change, the first stage is the pre-contemplation stage. This is when a person still considers changing their behavior, even though others may be urging them to do so.
Characteristics of Precontemplation
During this stage, a person may exhibit the following characteristics:
- They may not see their behavior as a problem.
- They may feel defensive when confronted about their behavior.
- They may lack knowledge or awareness about the negative consequences of their behavior.
- They may feel hopeless or resigned to their behavior, believing that change is impossible.
- They may need more confidence in their ability to make a change.
For example, a person who smokes cigarettes may be in the pre-contemplation stage if they do not see smoking as a problem despite its health risks. They may feel defensive when others suggest they quit smoking and may lack knowledge about the negative health consequences of smoking. They may also feel hopeless about quitting, believing that they will never be able to quit successfully.
It is important to note that people in the pre-contemplation stage may need more time to be ready and willing to hear about the benefits of change. It is often necessary to wait until a person is ready to move to the next stage before attempting to persuade them to change their behavior.
In the next stage, contemplation, a person begins to consider the pros and cons of changing their behavior. We will discuss this stage in the next section.
Contemplation Stage
When we reach the contemplation stage, we consider changing our behavior. We may be weighing the pros and cons of changing and considering the advantages and disadvantages of our current behavior. This stage can be challenging to navigate, as we may feel conflicted about whether or not we want to make a change.
Characteristics of Contemplation
During the contemplation stage, we may experience the following characteristics:
- Conflicted emotions
- Weighing pros and cons of behavior change
- Confirming readiness and ability to change
- Identifying barriers to change
It is important to note that people in the contemplation stage may need more time to be ready to act. They may still consider their options and weigh the potential outcomes of changing. It is essential to respect this process and allow individuals to move through the stages of change at their own pace.
To move forward from the contemplation stage, seeking support from friends, family, or a professional may be helpful. Talking through our thoughts and feelings with someone we trust can help us gain clarity and perspective on our situation. Additionally, seeking out resources such as books, articles, or support groups can provide us with the information and motivation we need to move forward.
The contemplation stage can be challenging but necessary in making a change. By acknowledging our conflicted emotions and identifying potential barriers to change, we can take the necessary steps to move forward and progress toward our goals.
Preparation Stage
When deciding to change a behavior, we must prepare for the journey ahead. In the preparation stage, we start to act towards making a change. We gather information, set goals, and create a plan of action. This stage is critical to the success of our behavior change process.
Characteristics of Preparation
During the preparation stage, we start to weigh the pros and cons of our behavior change. We identify our readiness and ability to change and begin to identify any barriers that may prevent us from achieving our goals. Here are some characteristics of the preparation stage:
- Goal setting: We set specific, measurable, achievable, relevant, and time-bound (SMART) goals that help us focus on what we want to achieve.
- Information gathering: We gather information about our behavior, the benefits of changing, and available resources.
- Creating a plan: We create a plan of action that outlines the steps we need to take to achieve our goals.
- Identifying barriers: We identify any barriers that may prevent us from achieving our goals and develop strategies to overcome them.
- Building support: We seek support from family, friends, or a professional to help us stay motivated and accountable.
For example, we want to quit smoking. In the preparation stage, we start by setting a quit date, gathering information about the health benefits of quitting, and creating a plan to manage cravings. We might also identify triggers that make us want to smoke and develop strategies to avoid or manage them. Finally, we might seek support from a smoking cessation program or a support group to help us stay on track.
The preparation stage is essential to the behavior change process. We can increase our chances of success by setting goals, gathering information, creating a plan, identifying barriers, and building support. It is important to remember that behavior change is a journey; the preparation stage is just the beginning.
Action Stage
At this stage, we have committed to changing our behaviour and are actively taking steps toward our goal. We have acknowledged that our behavior is problematic, and we are ready to take action to make a change. This stage can be challenging, but it is also where we can see the most progress.
Characteristics of Action
During the Action Stage, we are actively participating in our recovery. Some characteristics of this stage include:
- Making specific plans for change
- Implementing strategies to change our behavior
- Taking steps to avoid triggers or situations that may lead to relapse
- Seeking support from friends, family, or professionals
- Celebrating successes and progress made towards our goal
It is important to remember that change is a process, and setbacks can happen. Staying motivated and focused on our goal is essential, even if we experience setbacks. We can use our support system to help us stay on track and keep us accountable.
The Action Stage is a time of growth and progress toward our behavior change goal. We can successfully make lasting change by taking specific steps towards our goal and seeking support.
Maintenance Stage
In the maintenance stage, we have successfully changed our behavior and are now focusing on maintaining it. This stage is crucial because it helps us prevent relapse and solidify our new habits.
Characteristics of Maintenance
During the maintenance stage, we have already made significant progress and are now focused on keeping up with the changes we have made. Here are some characteristics of this stage:
- Consistency: We consistently engage in our new behavior and make it a routine. This helps us avoid slipping back into old habits.
- Self-Efficacy: We have confidence in our ability to maintain the changes we have made. This helps us stay motivated and committed to our new behavior.
- Support System: We have a support system to help us stay on track. This could be friends, family, or a support group.
- Relapse Prevention: We have identified potential triggers that could cause us to relapse and have developed strategies to avoid them.
- Periodic Review: We periodically review our progress and motivations to refresh our commitment to our new behavior.
The maintenance stage is about staying focused and committed to our new behavior. We can successfully maintain our new habits and prevent relapse with consistency, self-efficacy, and a support system.
Termination Stage
In the Stages of Change model, the Termination Stage represents the point at which the individual has successfully maintained their behavior change for a significant period, and the change has become a permanent part of their life. This stage is only sometimes included in the model, as some argue that there is always a risk of returning to old patterns of thinking and behaving. However, the Termination Stage can be a significant achievement for those who have successfully made the change.
Characteristics of Termination
At this stage, the individual has fully integrated the new behavior into their life and no longer experiences the temptation to return to their old ways. They have developed new habits and routines supporting the change, becoming part of their identity.
The termination stage is characterized by self-efficacy and mastery over the behavior. The individual feels confident in their ability to maintain the change and is proud of their accomplishment. They may also feel a sense of relief and freedom from the burden of the old behavior.
It is important to note that the Termination Stage is not the journey’s end. While the individual has successfully made the change, they must maintain it and be vigilant against the temptation to slip back into old habits. The termination stage is a significant milestone, but the individual must continue to work to maintain the change in the long term.
The Termination Stage represents the point at which the individual has successfully integrated the behavior change into their life and no longer experiences the temptation to return to old habits. It is characterized by a sense of self-efficacy, mastery over the behavior, and pride in the accomplishment. However, it is essential to remember that the journey does not end here, and the individual must continue to work to maintain the change in the long term.
Relapse Stage
When making changes in our lives, we often face setbacks and challenges. The Relapse Stage is a normal part of the change process, especially regarding addiction recovery. In this stage, we may return to old habits and behaviors, returning to substance use or other destructive behaviors.
Characteristics of Relapse
Relapse can be a frustrating and discouraging experience, but it is essential to remember that it is not a failure. Here are some common characteristics of the Relapse Stage:
- Loss of motivation or commitment to change
- Return to old patterns of behavior
- Difficulty managing triggers and cravings
- Feelings of guilt, shame, or hopelessness
- Increased stress or anxiety
Recognizing these warning signs and seeking help if you struggle in the Relapse Stage is essential. Remember that setbacks are a normal part of the change process, and with the proper support and resources, you can get back on track toward your goals.
One way to prevent relapse is to identify and address the underlying factors contributing to your substance use or other destructive behaviors. This may involve working with a therapist or counselor to address trauma, anxiety, or depression.
Another critical aspect of preventing relapse is developing a strong support system. This may include attending support groups, contacting friends and family for help, or working with a sponsor or mentor. A network of people who understand and support your goals can make a big difference in your recovery journey.
In summary, the Relapse Stage is a normal part of the change process, especially regarding addiction recovery. By recognizing the warning signs and seeking help, you can overcome setbacks and continue progressing toward your goals.
Applying the Stages of Change Model
Knowing where to start when making changes in our lives can be challenging. The Stages of Change model can be a helpful tool for understanding the behavior change process and identifying where we are in that process. By recognizing these stages, we can better prepare ourselves for the challenges ahead and increase our chances of success.
The Stages of Change model, also known as the Transtheoretical Model (TTM), outlines six stages people typically go through when making a change. These stages are:
- Precontemplation: In this stage, we are not yet considering a change in our behavior. We must know the need for change or resistance to the idea.
- Contemplation: In this stage, we are considering a change but have not taken action. We may weigh the pros and cons of making a change and decide if it’s worth it.
- Preparation: In this stage, we have decided to change and are taking steps to prepare ourselves. We may be researching options, setting goals, and seeking support.
- Action: In this stage, we are actively changing our behavior. We may use new strategies, seek feedback, and track our progress.
- Maintenance: In this stage, we have successfully made the change and are working to maintain it. We may adjust our strategies, seek ongoing support, and celebrate our successes.
- Termination: In this stage, the change has become a natural part of our lives. We no longer need to actively work on maintaining it and can enjoy the benefits of our new behavior.
It’s important to note that not everyone will linearly go through each stage. We may move back and forth between stages or even skip stages altogether. This is normal and expected.
When applying the Stages of Change model, it can be helpful to identify where we are in the process and what strategies will be most effective for us at that stage. For example, if we are in the Contemplation stage, we may benefit from exploring the potential benefits of making a change and identifying the barriers holding us back. If we are in the Action stage, we can seek feedback and support from others who have successfully made a similar change.
Frequently Asked Questions
What are the stages of change in recovery?
In recovery, there are five stages of change: pre-contemplation, contemplation, preparation, action, and maintenance. These stages represent the process of change, from not even considering changing a behavior to maintaining the change over time.
What is the cycle of change in CBT?
In cognitive-behavioral therapy (CBT), the cycle of change is a model that describes how people move through the stages of change. The cycle includes pre-contemplation, contemplation, preparation, action, and maintenance, followed by possible relapse and a return to pre-contemplation or contemplation.
How do you move through stages of change?
Moving through the stages of change involves recognizing where you are and taking steps to progress to the next stage. For example, in the pre-contemplation stage, a person may not even be aware of the need for change, while in the contemplation stage, they may be considering the pros and cons of change. To move from one stage to the next, it can be helpful to seek support, set goals, and develop a plan of action.
Are there 5 or 6 stages of change?
There are five stages of change in the original model, but some adaptations include a sixth stage, termination. This stage represents a complete absence of the behavior and a sense of self-efficacy in maintaining the change.
What is the difference between contemplation and action stages of change?
In the contemplation stage, a person is considering the possibility of change and weighing the pros and cons. In the action stage, they are actively making changes to their behavior and implementing their plan of action.
How can the stages of change model be applied in therapy?
The stages of change model can be applied in therapy by helping clients identify where they are in the process of change and developing strategies to progress to the next stage. Therapists can also help clients set realistic goals, develop a plan of action, and provide support and accountability throughout the process.