People change when they are ready, willing, and able. We know this because of exciting scientific data backing up this worn cliché. In the 1970s, Rhode Island University researchers James Prochaska and Carlo DiClemente developed the Stages of Change or Transtheoretical Model. They were studying ways to help people quit smoking and discovered a technique that went beyond smoking cessation.
Change is rarely easy and often requires a gradual progression of small steps toward a goal. People are often unwilling to change during the early stages. The Stages of Change model is an effective aid in understanding how people change problematic behaviors.
According to Author Educator Kendra Cherry, in order to succeed, you need to understand three important elements of behavior change:
1) Readiness to change: Do you have the resources and knowledge to make a lasting change successfully?
2) Barriers to change: Is there anything preventing you from changing?
3) Likelihood of relapse: What might trigger a return to a former behavior?
Prochaska and DiClemente investigated these nuances, listing the steps as Precontemplation, Contemplation, Preparation, Action, Maintenance and Relapse, defined as the following:
1. Precontemplation: Because the individual is unaware or under aware of their problem, there is no intention of making a behavioral change in the near future. They may not see the behavior as a problem, and do not believe it is as problematic as external observers see it. These individuals are often labeled as “resistant” or in “denial.”
2. Contemplation: The person is aware a problem exists but has not made a commitment to an action. They are ambivalent yet considering the pros and cons of making a behavioral change. They are in the process of evaluating whether to do anything about it. Important questions that need to be asked are, why do you want to change, and do you have the confidence to make this change? Unfortunately, many people in the contemplation phase, view change as a process of giving something up rather than a means of gaining emotional, mental, or physical benefits. They need to ask themselves, “Will my life be better without these people, places or things?”
3. Preparation: This is an exciting transitory stage. The individual is planning to take action in the next 30-days. They have unsuccessfully taken action in the past year, but, with renewed self-efficacy, are ready, willing, and able to attempt this change.
4. Action: The person is actively working to change behavior for up to a six-month period. The person is aware a problem exists and actively modifies their behavior, experiences and environment. It is, in a sense, actualizing the cliché, “people, places, and things.” This stage requires the greatest commitment of time and energy and is the place where we begin to “walk the talk.”
5. Maintenance: The person consolidates what they have learned from maintaining action for over a six-month period and works to prevent relapse. Maintenance is often viewed as an afterthought where very little activity occurs, however, maintenance is not a static stage, according to Experience Life writer Jessie Sholl:
For our behavior change to prove sustainable, it must enter a Maintenance phase (generally, six months or more of consistent action) until it finally becomes ingrained as a stable habit. This final, ongoing phase is known as Termination, which implies that the change is now permanent part of our lifestyle.
Termination was not included in the original Stages of Change, but concludes that, in this stage, people have no desire to resume their unhealthy behaviors and will not relapse. Since this is rarely reached, the Termination stage is often not considered in health promotion programs, because being “in recovery” is preferred over “having achieved recovery.”
6. Relapse: The individual experiences minor slips or major relapses. Sometimes called “falling forward,” relapse can be viewed as a normal part of the process, providing a therapeutic window into what could have been done differently. If you do relapse, it is important that you restart the process at contemplation, preparation, action or even the maintenance stages. According to SmartRecovery:
Most successful self-changers go through the stages three or four times before they make it through the cycle of change without at least one slip. Most will return to the contemplation stage of change. Slips give us the opportunity to learn.
The Four Rs of Resistance
The most challenging aspect of change is in the precontemplation stage, referred to “the Four Rs” of Resistance — reluctance, rebellion, resignation and rationalization. Individuals in the Precontemplation Stage are not thinking about changing a behavior. DiClemente has described why these groups do not consider change and methods for intervening.
Reluctance: The individual lacks knowledge about the problem’s impact or may not have the energy to engage in change. Intervention: Time may change things. Sensitive and empathic feedback may help influence change.
Rebellion: The uncooperative individual is heavily invested in the problem behavior and in making one’s own decisions. Insecurity, fear and prolonged adolescence may feed a rebellious stance. Intervention: Encourage individual to shift energy invested in the problem behavior into contemplating change. Encourage individual to choose between change rather than resistance and rebellion.
Resignation: The individual is being overwhelmed by the problem and feels hopelessness. They are listless and lack energy. Intervention: Instill hope and provide support. Explore barriers to change.
Rationalization: These individuals love to engage in intellectual debate, having as many answers as those above lack. Resistance lies more in thinking than in emotions. Intervention: Utilize empathy and reflective listening. Avoid discussion and debate.
Positive Behavioral Change
The Stages of Change Model has been applied to a broad range of behaviors including weight loss, injury prevention, overcoming alcohol, and drug problems among others. Behavior change does not happen in one step, but rather, people tend to progress through different stages of being ready, willing, and able to successfully change. Because each of us progresses through the stages at our own rate, the decision to change must come from an internal locus of control. Those who fall short of the goal should view this as motivation to start over. Each day is a renewed opportunity to begin again, to make a fresh start, and attempt a positive behavioral change.
Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis. For contact: https://www.linkedin.com/in/maxim-w-furek-3ab0007/
