2.5 Stages of Change

Stages of Change

Diagram shows the 6 stages of changes as a pie with arrows point from stage 2 to 6. Stage 1 is outside the pie pointing to stage 2. Permanent Exit is outside also with an arrow from Stage 5.
Figure 2.2 Prochaska & Diclemente’s Six Stages of Change
Table 2.1 Six Stages of Change
Stage Description Indicators
Stage 1: Pre-contemplation This is the entry point of a person into the change process. The individual has not even considered the prospect of change and is unlikely to perceive a need for change. It is usually someone else who perceives a problem. At this stage, a person is not likely to respond positively to anyone (family or professional) being confrontive or demanding change.
  • Total resistance to doing anything
  • No willingness to meet, talk to a professional, or get assessed
  • Angry at any indication from another that there is a problem
  • Blaming others
  • “Everything is okay” statements
  • Willingness to work on other things, but not the specific problem
  • Refuse to let a professional in and work with him/her
  • Lack of awareness
Stage 2: Contemplation Once the person has some awareness of the problem, then the person enters the stage called Contemplation. It is an ambivalent state where the individual both considers change and rejects it. If allowed to just talk about it, the person goes back and forth about the need to change without justification for change.
  • Saying one thing, doing another
  • Rationalizing, minimizing
  • Anxiety rises while trying some things that do not work
  • Both talking about change and arguing against it
Stage 3: Preparation The person is ready to change. This is a window of opportunity when the person resolved the ambivalence enough to look at making change.
  • Admitting the need for change
  • Accepting negative ramifications of their behavior
  • Asking for help
  • Starting to look at alternatives
Stage 4: Action The person engages in particular actions that intend to bring about change.
  • Starting to work out a plan
  • Making changes in behavior
  • Asking for professional help, or using professional help to make their plan more successful
Stage 5: Maintenance The person identifies and implements strategies to maintain progress, and to reduce the likelihood of slips or full relapse into old behaviors.
  • Making the long-term life changes needed to “actualize” the changes made in the action stage
  • Focusing less on refraining from old behavior and more on a “recovery” lifestyle
Stage 6: Relapse The person has a slip, or returns to behavior at a level higher than acceptable to either the person or family. At times, the person might slip and not regard it as serious enough to be concerned, yet someone may be at risk. A professional needs to help the person holistically look at the situation.
  • Repeating behavior that they are trying to change
  • Engaging in different, but equally problematic behavior.
  • Feeling shame about behavior
Table 2.2 The Stages of Change: Worker Tasks and Skills
Pre-Contemplation Contemplation Preparation Action Maintenance Relapse
  • Build a relationship
  • Diffuse the crisis
  • Assess safety concerns
  • Show empathy and caring
  • Provide needed services in areas other than the specific risk
  • Assess and affirm the individual’s strengths and capacity to change if he or she wishes to do so
  • Provide information and feedback on the possible risks of behavior to raise the awareness of the possibility of change
  • Listen for windows of opportunity where the person talks about problems, concerns and need to change
  • Provide specificinformation
  • Help tip the balance to favor change
  • Evoke reasons to change and risks of not changing
  • Continue to strengthen the client’s self- efficacy
  • Strategically use open-ended questions, affirmations, and summarizing
  • Have the person voice the problem, concern, and intention to change
  • Have the person self-assess values, strengths, and needs
  • Facilitate the development of a vision for their future
  • Provide information on all available options
  • Explore all available options, and the benefits and consequences of each
  • Help the person set specific goal(s)
  • Help the person develop the plan
  • Help the person choose strategies to use, resources needed, and potential barriers to the plan
  • Introduce and practice coping strategies to avoid, change, replace, or change a client’s reactions to triggers and conditions leading to problem behavior
  • Suggest methods, provide support in trying them out, and help evaluate the effectiveness of those methods
  • Keep steps small and incremental
  • Teach skills
  • Access resources for the specific target behavior
  • Reward small steps of progress
  • Assess success
  • Make necessary changes in planning as the person continues to progress
  • Assist in sustaining changes accomplished by the previous actions
  • Help the person to develop the skills and self- efficacy to build a new life
  • Build relapse roadmaps
  • Prepare crisis plans for when a relapse might happen
  • Review warning signs of a possible slip or relapse
  • Help the person connect to other support systems for a healthier lifestyle
  • Assist in processing the emotions resulting from the slip
  • Help the person understand what happened to lead to another slip
  • Help the person process the experience and use the slip as a learning experience
  • Review the plan and commitment to continue
  • Adjust the plan as needed
  • Implement the plan (as adjusted)

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Guiding While Instilling Hope Copyright © by Jo Ann Jankoski is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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