The 6 Stages of Change We Should Know
August 29, 2021
The Trans-theoretical Model is also known as The Stages of Change Model is developed by Prochaska and DiClemente in the late 1970s, It came about through studies generated from the experiences of smokers who quit on their own with those requiring further treatment to understand why some people were able to stop on their own.
It was established that smokers quit as soon as they made intention and determine to do so.
Therefore, the Trans-theoretical Model (TTM) is focus on the decision-making of the individual and is a model of deliberate intentional change.
The stages of change model operates on the assumption that people do not change behaviours quickly and decisively.
Change in behaviour like habitual behaviour, takes place consistently through a recurring process. Stages of Change model has been very well researched and documented in many journals, It’s rarely a swift occurrence, it’s indeed a gradual process.
The Stages of Change is not a theory but a model, different behavioural theories and designs can be put in to various stages of the model where they may be most productive.
The Stages of Change model propound that individuals navigate six stages of change namely :
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination
Although, Termination was not included in the initial model and is usually used in application of stages of change for wellness-related behaviours. For each stage of change, different treatment plans are most effective at moving the person to the next stage of change and eventually to the maintenance level, the ideal stage of behaviour.
Pre-contemplation
The first stage of change is known as pre-contemplation, this is really when the person is in situation where nothing is happening because there’s no commitment that there is an issue or a problem truly exist .
At this phase the best thing to do is developing or ensuring that the relationship between the victim is a healthy.
This is usually referred to as a Therapeutic Alliance in counselling. The usage of force or deliberating making someone to be in the active phase when they’re actually in the pre-contemplation phase will cause a lot of frustration, it may also result to yelling, and little good moment.
In this stage, people are not willing to take action in the near future which is normally within the next 6 months. People who are affected at this stage are not aware that their behaviour is difficult or give rise to adverse outcome.
People in this stage usually play down on the advantages of changing behaviour and place too much importance on the disadvantages of changing behaviour.
Contemplation
This is a stage where an individual admits that there is really a problem, but there is still uncertainty about the entire situation.
Showing empathy and understanding that a substance user has some positive reasons for using, even if all you see are the negative ones, will strengthen the collaborative union that is necessary to move to the next phase.
In this stage, people have good intention to start the healthy behaviour in the near future which is normally within the next 6 months.
People acknowledge that their behaviour may be difficult, and a more reasonable and doable reflection of the pros and cons of changing the behaviour takes place, with equal importance placed on both.
Even with this acknowledgment, people may still feel uncertain with regards to changing their behaviour.
Preparation
This is also called Determination stage and its indeed the most important phase. However, most family members of the victim are in a haste to move past this important stage especially when they noticed the first sign of improvement and progress in contemplation stage.
In the preparation phase the uncertainty is harmonized, values are examined and even though the individual open to change, he or she may not be fully be bold enough of the steps needed to succeed.
Small baby steps towards transition are made such as tapering or sobriety sampling.
There are some situation where people become involve in harm reduction techniques as part of the change process.
Harm reduction can simply be define as showing empathy towards the victim or meeting the person where they are but not where you want them to be and ensuring that we do not withdraw from them or leave them to manage themselves.
Engaging and understanding the process of change enable one to make progress to the next stage.
An awkward truth about harm reduction is that people are more likely to come to terms and maintain abstinence if they are permitted to experience the stages of change, making a short-term stop in harm reduction period.
In this stage, individuals are ready to be committed to change within the next 30 days. They begin to take small baby steps toward the behaviour change, and they have the mindset that changing their behaviour can lead to a healthier and much fulfilled life.
Action
In this phase, an individual is making practical actions and is and is devoted to a new behaviour or doing away with behaviours that are no longer work for them. This is a stage which the individual is already going to places like AA, seeing a counsellor or Partial hospitalisation programme.
In this phase it’s enticing for a family member to ease a big sign of relief breathe and take the eye off the ball of collaborative gas pedal, the ideal thing to do here to continue remain active, giving support and understanding, and assist them into the next stage of change.
This is the shortest of all the stages and its a stage where the individual believe he or she have the ability to change his or her bad behaviour, such people are actively involved in following the steps needed to change their bad behaviour by using different kinds of techniques.
The duration people spend in action stages differs, It usually lasts about 6 months, but it can literally be as short as sixty minutes!
It is a stage when victims most depend on their own willpower, since they are making undisguised efforts to quit or stop the behaviour and are at greatest risk for things to take a different turn for the worse.
Mentally, they review their dedication to themselves and map out plans to deal with both personal and external pressures that may lead to failure.
They sometimes use short-term rewards to support their motivation, and examine their behavioural change efforts in a way that increases their self-confidence. They are open to receiving help and are also likely to seek support from others.
In this stage, people have recently changed their behaviour which is usually within the last 6 months and plan to keep moving forward with the change in behaviour. Victims reflect this by modifying their problematic behaviour or acquiring new healthy behaviours.
Maintenance
In this stage, the victims main worry is sustaining the breakthrough made in the active stage.
During this stage, there will be situations where victim will want to drift, it’s important for the victims to initiate new coping strategies as well as introduce fresh activities or a restart of preferred old ones to fill up for the substance use.
However, it shouldn’t come as strange if relapse or lapse (if its very short) as life journey doesn’t always follow a straight line. it’s not also uncommon for individuals to move backwards temporarily, say from preparation to contemplation.
Following up with the individual with effective communication skills can help propel them forward again.
Maintenance involves being able to successfully avoid any desire to return to the bad habit. The goal of the maintenance stage is to continue the new current situation.
Victims at this stage tend to serve as reminders to themselves of how much progress they have made in order to avoid relapse or lapse.
They are self conscious and tend to endure through the process because they are aware of what they are striving for is personally valuable and important to them.
They are at peace with themselves and acknowledge that it often take some time to totally do away with old behavioural patterns and practice new ones,until they are second nature to them.
Even though they may have thoughts of falling back to their old bad habits, they resist the urge and remain focus.
In this stage, victims have sustained their behavioural change for a while which is usually more than 6 months and plan to sustain the behaviour moving forward.
They put in the work at this stage in order to prevent relapse to earlier stages.
Termination
In this stage, people have no desire to return to their bad behaviours and are sure they will not fall back to their old ways or get worse.
Although, this is rare stage due to the fact that victims seldom attain this, and people tend to stay in the maintenance stage, this stage
is often not part of wellness promotion programs.
Processes of Change
Processes of Change are the open and overt activities that people use to progress through the stages.
Processes of change provide important guides for intervention programs, since the processes are the independent variables that people need to apply, or be engaged in, to move from stage to stage.
In order to advance through the stages of change, people uses cognitive, affective, and evaluative processes.
There are Ten processes of change that have been recognised with some processes being more important to a specific stage of change than other processes. These processes result in ways that help victims make and sustain change.
The Ten processes have received the most empirical support in the research till date. The first five are classified as Experiential Processes and are used primarily for the early stage transitions. The last five are labeled Behavioral Processes and are used primarily for later stage transitions.
Below are breakdown of the list of the processes with a sample item for each process from smoking cessation as well as different labels.
Processes of Change: Experiential
- Consciousness Raising : Increasing awareness I recall information people had given me on how to stop smoking
- Dramatic Relief : Emotional arousal
I react emotionally to warnings about smoking cigarettes
- Environmental Reevaluation : Social reappraisal
I consider the view that smoking can be harmful to the environment
- Social Liberation : Environmental opportunities
I find society changing in ways that make it easier for the nonsmoker - Self Reevaluation : Self reappraisal
My dependency on cigarettes makes me feel disappointed in myself II. Processes of Change: Behavioural - Stimulus Control : Re-engineering
I remove things from my home that remind me of smoking - Helping Relationship : Supporting
I have someone who listens when I need to talk about my smoking - Counter Conditioning : Substituting
I find that doing other things with my hands is a good substitute for smoking - Reinforcement Management :Rewarding,I reward myself when I don’t smoke
- Self Liberation : Committing
I make commitments not to smoke
Disadvantages of the Trans-theoretical Model
There are a number of limitations of TTM, which should be considered when using this theory in public health. They include the following:
- The theory disregard the social context in which change occurs, such as Social Economic Class and income.
- The lines between the stages can be arbitrary with no set criteria of how to determine a person’s stage of change. The questionnaires that have been developed to assign a person to a stage of change are not always standardised or validated.
- There is no definite time of how much time is needed for each stage, or how long a person can remain in a stage.
- The model assumes that individuals make coherent and logical plans in their decision-making process when this is not always true at all time.
In conclusion, It’s not easy to initiate a change and make it stand the test of time. Some people may be more successful in keeping their resolutions by using the above steps.
Many health programs for behaviour change use them too, issues like smoking cessation to addiction recovery.
Please feel free to let us know which of the stages is most difficult to follow through or any other ideas you think one can quit bad behaviours in the comment section below.
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