Sunday, November 7, 2010

Stages of Change

James O. Prochaska, Ph.D. along with J. O. Norcross and J. C. Diclemente are the originators of the Transtheoretical Model of Behavior Change sometimes called the "Stages of Change."

These are the 6 stages that the model identifies...

Precontemplation - Contemplation - Preparation - Action - Maintenance - Termination

I first read about these stages after I had already entered into stage 4 (action). I was fascinated by how well the descriptions of the earlier stages really matched with my thinking in the months before my healthy lifestyle changes began.  It was reassuring to see research that so well explained the process I had been going through and it gave me some structure and confidence in defining my plan and goals.

I was in Precontemplation for years. I believe I was in Contemplation from November of 2008 until April or May of 2009. That is probably when I entered the Preparation stage. Of course Action stage started for me on June 3, 2009. I believe I am currently in a transition from Action to Maintenance. My Maintenance stage may last for the rest of my life as I don't know if I can ever say that I would be totally 'cured' of my food issues. Achieving Termination stage would be a true miracle because it would mean that I could maintain a healthy lifestyle without any real effort or planning... it would be ingrained in me... my very nature!

The description of the changes are taken from the book Changing for Good.

Precontemplation - "People at this stage usually have no intention of changing their behavior, and typically deny having a problem. Although their families, friends, neighbors, doctors, or co-workers can see the problem quite clearly, the typical precontemplator can't."

Precontemplators resist change. They may change if there is enough constant external pressure, but once the pressure is removed, they quickly revert. Precontemplators are often demoralized and don't want to think about their problem because they feel that the situation is hopeless. "There is certain comfort in recognizing that demoralization is a natural feeling that accompanies this stage-and in realizing that if you take yourself systematically through all the stages of change, you can change."

Contemplation - "I want to stop feeling so stuck. Those simple words are typical of contemplators. In the contemplation stage, people acknowledge that they have a problem and begin to think seriously about solving it. Contemplators struggle to understand their problem, see its causes, and begin to wonder about possible solutions."

However, while people in this stage may have vague plans to make changes, they are often not ready to take action yet. Many people remain in the contemplation stage for years.

Preparation - "Most people in the preparation stage are planning to make changes within the next month. An important first step is to make their intention public. "But although those in the preparation stage are committed to action, and may appear ready, they have not necessarily resolved their ambivalence. They may still need to convince themselves that this is the best step.

This last-minute resolution is necessary. People who cut the preparation stage short lower their chances of success. It is important to develop a firm, detailed scheme for action to carry you through.

Action - "The action stage is the one in which people most overtly modify their behavior and surroundings. They stop smoking, remove all desserts from the house, pour the last beer down the drain, or confront their fears. In short, they make the move for which they have been preparing.

Action is the most obviously busy period, and the one that requires the greatest commitment of time and energy. Changes made during the action stage are more visible to others than those made during other stages."

It is important to realize that, while the action stage is the one that usually receives the most amount of recognition, it is not the only stage during which you can make progress toward overcoming your problem.

Maintenance - "In the maintenance stage, you consolidate the gains you made in the action stage and work to prevent relapses.

This stage is a long, ongoing, and critically important process. We all know someone who lost many pounds on a diet, but regained them all in a few months. Successful maintenance requires active alertness.

Termination - "The termination stage is the ultimate goal. Here, your former addiction or problem will no longer present any temptation or threat. You will not need to make any further effort and will exit the cycle of change.

However, some experts believe that certain problems cannot be terminated but only kept at bay.



Prochaska, J.O., Norcross, J.C., Diclemente, C.C. (1994). Changing for Good. New York: Avon Books.


James Prochaska founded pro-change behavior systems, inc. where you can find more information about the Transtheoretical Model.

Other commentaries on this research...
Promoting Health Behavior Change. ERIC Digest.
Stages of Readiness for Change - University of Minnesota

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