Prochaska and DiClemente’s Stages of Change Model
Introduction
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.

Stages of Change Model
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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