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| Prochaska and DiClemente’s Stages of Change Model
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| Introduction |
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Prochaska, DiClemente and Norcross have created a very useful model of the way in which people change bad habits which they call The Stages of change Model. They discuss this model in detail in their book "Changing For Good".The stages of change theory is useful for people who wish to reduce harm associated with a habit as well as for people who wish to reduce the amounts which they drink or who wish to quit drinking entirely. People can use the stages of change model as an aid to creating realistic self-change plans and they can also use it as a way to understand how and why others change or do not change.
Prochaska, DiClemente and Norcross were specifically studying people who were trying to quit smoking--although the model can be useful for lots of behavioral changes including harm reduction for alcohol.The other people in the study who managed to successfully quit smoking did so in a spiral process which involved Recycling.
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| Stages of Change Model |
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Pre-contemplation:: Not currently considering change: "Ignorance is bliss"
Validate lack of readiness
Clarify: decision is theirs
Encourage re-evaluation of current behavior
Encourage self-exploration, not action
Explain and personalize the risk
Contemplation:: Ambivalent about change: "Sitting on the fence" , Not considering change within the next month
Validate lack of readiness
Clarify: decision is theirs
Encourage evaluation of pros and cons of behavior change
Identify and promote new, positive outcome expectations
Preparation :: Some experience with change and are trying to change: "Testing the waters" ,
Planning to act within 1month
Identify and assist in problem solving re: obstacles
Help patient identify social support
Verify that patient has underlying skills for behavior change
Encourage small initial steps
Action :: Practicing new behavior for
3-6 months
Focus on restructuring cues and social support
Bolster self-efficacy for dealing with obstacles
Combat feelings of loss and reiterate long-term benefits
Maintenance:: Continued commitment to sustaining new behavior
Post-6 months to 5 years
Plan for follow-up support
Reinforce internal rewards
Discuss coping with relapse
Relapse:: Resumption of old behaviors: "Fall from grace"
Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies
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