Carlos Diclemente’s Stages of Change model, also known as the Transtheoretical Model, is a widely recognized framework for understanding and facilitating behavior change. Developed in collaboration with James O. Prochaska, this model has had a profound impact on fields such as psychology, counseling, and healthcare. The Stages of Change model outlines a series of psychological stages that individuals typically progress through as they modify or alter a behavioral pattern. These stages offer valuable insights for individuals and professionals seeking to understand and facilitate personal transformation.
Key Definition:
The stages of change, also known as the transtheoretical model, describe a series of stages that individuals may go through when making a significant behavior change. These stages include:
- Precontemplation: At this stage, individuals may not yet acknowledge the need for change.
- Contemplation: Individuals at this stage are considering the possibility of change but have not yet committed to it.
- Preparation: This stage involves specific intentions to take action within the near future.
- Action: During this stage, individuals modify their behavior, experiences, or their environment in order to achieve the desired change.
- Maintenance: Once the desired change has been achieved, this stage involves maintaining the new behavior and avoiding relapse.
- Termination: In this stage, the individual has complete confidence in their ability to maintain the behavior change despite any challenges or temptations.
These stages provide a framework for understanding the process of behavioral change and can be applied to various areas such as health, addiction, and personal development.
The Six Stages of Change
Carlos Diclemente wrote “the road that leads individuals to change an established behavior pattern begins in the Precontemplation stage, where they have no current interest in change. A person moves through the Contemplation, Preparation, and Action stages before arriving at the Maintenance stage. Maintenance becomes the final stage in the transition to the new pattern of behavior and ultimately can lead to the termination of the change process” (DiClemente, 2005).
While the stages of change appears linear, in practice an individual may bounce back and forth between the different phases during their difficult path to lasting change. The stages of change is “a transtheoretical model of motivation, incorporating five stages of readiness to change: precontemplation, contemplation, preparation, action, and maintenance. Each stage characterizes a different level of motivational readiness, with precontemplation representing the lowest level of readiness” (Donovan & Marlatt, 2005).
The underlying concept is that therapists must match techniques to encourage and support change that matches the clients current stage of readiness and motivation. James Prochaska and John Norcross explain “at each stage, different processes of change optimally produce progress. Matching change processes to their respective stage requires that the therapeutic relationship be matched to the client’s stage of change” (Prochaska & Norcross, 2001).
Basically, the stages of change is a theoretical model to assist practitioners assist individuals achieve desired changes. However, the individual outside of therapy may also find helpful information within this model to assist them in their personal endeavors for self-improvement.
Let’s delve deeper into each of the stages:
1. Precontemplation:
At this initial phase, individuals are not seriously considering change and may be unaware of the necessity for it. They may exhibit resistance or denial when confronted with the need to change. Interventions at this stage often focus on increasing awareness and understanding of the potential benefits of change. Basically, during the precontemplation stage a person is not motivated to change. Precontemplation is actually a position of stability, holding onto sameness of behavior.
DiClemente wrote, “precontemplation represents a status quo. An individual in the Precontemplation stage is satisfied with, or at least unwilling to disrupt, a current behavior pattern. Precontemplators are not considering change in the foreseeable future.” He continues “change is seen as irrelevant, unwanted, not needed, or impossible to achieve” (DiClemente, 2005).
Precontemplators may wish to change. However, wishing to change is not synonymous with seriously contemplating change (Prochaska & Norcross, 2001).
It is crucial to approach individuals in this stage with empathy and understanding, acknowledging their current perspectives while gently introducing the possibility of an alternative course. By providing relevant information and fostering a supportive environment, it becomes more feasible to guide these individuals towards recognizing the positive outcomes that could arise from embracing change. This stage can lay the groundwork for the subsequent steps in the change process, ultimately leading to sustainable growth and development.
Individuals in this stage may benefit most from motivational enhancement therapy.
2. Contemplation:
The individuals in this stage of the process are in a critical phase where they are more receptive to the concept of change and are carefully evaluating the advantages and disadvantages. Contemplation is moving from the stability of the norm to a state of discomfort. DiClemente explains that the contemplation stage entails the “consideration of the value and need for change.” He continues. “with this, the individual enters into a period of instability” (DiClemente, 2005). Consideration of change by nature suggests an internal struggle, facing the possibility of leaving one behavior pattern in exchange for a different pattern of behavior.
Prochaska and Norcross describe it this way, “contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action” (Prochaska & Norcross, 2001). During contemplation, an individual may experience overwhelm contemplating the change. The necessary steps toward the final goal may appear as impassable mountains.
The Discomfort of Contemplation
These contemplation stir fear and uncertainty. Because of the cognitive dissonance between thoughts that life is not right now and thoughts that change is unobtainable, this stage can be emotionally draining. The strain of contemplation is a breeding ground for defense mechanisms (denial, projection, etc…).
Contemplating change creates discomfort, but reality may continuously remind that change is necessary. A person may leap back and forth between precontemplation and contemplation many times before proceeding to an actual planning stage of change. Once a person acknowledges the dramatic reality of their situation, denying it requires more cognitive juggling then before reality of deprivation was noticed.
It’s common for them to feel ambivalent about moving forward and taking action. This phase presents an opportunity for individuals to delve into the potential obstacles to change and to gain a more profound understanding of their motivations. By doing so, they can clarify their internal drives and gain insights that are essential for making informed decisions and initiating meaningful changes in their lives. Understanding the factors that may be holding them back and becoming more attuned to their underlying motivations can be pivotal in guiding them towards a path of positive transformation and growth.
See Contemplating Change for more on this topic
3. Preparation:
During this phase, individuals actively prepare for change and may take some initial steps or set a clear intention to modify their behavior. During this phase, individuals should establish strategies and align support to help facilitate the change process. This preparatory phase is crucial as it sets the foundation for the journey towards meaningful transformation. It’s a time of reflection, self-evaluation, and decision-making.
DiClemente states that the preparation stage “entails developing a plan of action and creating the commitment needed to implement that plan” (DiClemente, 2005). During the preparation stage, an individual must identify some of the probable setbacks and dangers that they may encounter during the initial efforts for change, strategizing responses for when these critical moments occur.
Coping and Change
During the change process motivation will wane, impulses to quit trying will get stronger, and the likelihood of relapse swirls in tighter and tighter circles around the person engaged in the change process. Coping with these impulsive desires without quitting one’s final objective is a key skill.
Dennis M. Donovan and Alan G. Marlatt wrote “based on the cognitive-behavioral model of relapse, the most critical predictor of relapse is the individual’s ability to utilize effective coping strategies in dealing with high-risk situations. Coping includes both cognitive and behavioral strategies designed to reduce danger or achieve gratification in a given situation” (Donovan & Marlatt, 2005). Preparation stage establishes a few notable coping strategies for the intense moments when temptations to give in are strongest.
Seeking support from professionals, mentors, or peers can significantly enhance the chances of successful implementation and maintenance of new behaviors. This proactive approach demonstrates a strong commitment to personal growth and development. The preparation stage creates a solid framework for the all upcoming stages in the process.
See Planning Stage of Recovery for more on this topic
4. Action:
At this point, individuals have already taken proactive measures to make substantial adjustments to their behavior and have wholeheartedly committed to the process of change. They are currently in the phase of executing various strategies that effectively deal with the inevitable challenges of change. Prochaska and Norcross wrote “action is the stage in which individuals modify behavior, experiences, and environment in order to overcome their problems. Action involves the most overt behavioral changes and requires considerable commitment of time and energy” (Prochaska & Norcross, 2001).
Real change begins here. T. Franklin Murphy wrote, “thinking entertains, distracting burdensome thoughts away from our wretched life, but thoughts alone do not create the escape from poverty, unless, of course, we act on the thoughts” (Murphy, 2018). The first few steps of action are difficult. Habits of change are not yet formed.
DiClemente explains, “action is the initial behavioral step on the path to creating a new pattern of behavior.” He continues, “however, the new behavior must be sustained over time in order to create the new habit. A behavior cannot simply be done several times and automatically become established.” He then pointedly warns, “the old pattern retains its attraction and returning to it is often easier than sustaining a new pattern. It takes a long time to establish a new pattern of behavior” (DiClemente, 2005).
This particular stage typically demands persistent dedication and ongoing support. Essential to the stage of action is maintaining the momentum by employing the prepared coping mechanisms as necessary, and drawing upon prepared resources as needed.
Maintenance:
After successfully making changes and implementing new behaviors, individuals enter the maintenance stage. It is a crucial phase characterized by a focus on consolidating progress, preventing relapse, and integrating the new behavior into daily lives. During this phase, support and reinforcement play a vital role in sustaining the positive changes. This phase is about turning the newly adopted behavior into a lasting habit. During this phase of change, stability begins to return.
New Habits
Marlatt and Norcross define “maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action” (Prochaska & Norcross, 2001). DiClemente adds that “to become habitual the new behavior must become integrated into the lifestyle of the individual. This is the task of the Maintenance stage of change. During this stage the new behavior pattern becomes automatic, requiring little thought or effort to sustain it. It truly becomes an established, habitual pattern.: DiClemente continues by reminding that “during maintenance there is still an ever-present danger of reverting to the old pattern.” he concludes by saying that “the new behavior becomes fully maintained only when there is little or no energy or effort needed to continue it and the individual can terminate the cycle of change” (DiClemente, 2005).
Because new patterns of behavior have been established, individuals often feel empowered to let their guard down. They feel they can return to old environments without falling prey to old habits. This is a fools game. Behavior reactions are often still strongly in place, tied to old stimuli. Reintroduce the previous environments and the old habits will likely follow.
During this phase, the individual puts effort into establishing habits that yield long-term benefits. It’s a time for individuals to cultivate self-awareness. The heightened awareness of self provides protections, flagging potential triggers, and developing effective strategies to overcome such challenges. The commitment to maintaining change during this phase can lead to a sense of accomplishment and empowerment, further solidifying the newly acquired behaviors.
Termination:
In some formulations, the model also include a final stage known as “termination.” At this stage, individuals have full confidence in their ability to maintain the change. Consequently, the old behavior is no longer appealing. Not all individuals reach this stage, and it’s more common in certain types of behavior change, such as addiction recovery.
During this termination stage, individuals exhibit a remarkable level of self-assurance in their capacity to uphold the positive changes they have made. They deeply internalize the transformation and no longer find their previous behavior enticing or compelling. It’s truly a remarkable phase, one that signifies the profound shift. In this stage, change is expressed in the individual’s mindset and habits. In many cases, this stage is particularly noticeable in the context of addiction recovery, where individuals undergo a comprehensive process of self-reflection and development. They reach the pinnacle of confidence and resolve. This stage is not only a testament to their dedication but also a symbol of their tremendous personal growth.
Change is Complex
The Stages of Change model acknowledges that behavioral change is not a linear process, and individuals may move back and forth between stages. It emphasizes the importance of tailoring interventions to an individual’s specific phase to maximize the likelihood of successful change. This model has been applied to a wide range of behaviors, including smoking cessation, weight loss, exercise adoption, and more.
Understanding this model can equip individuals and professionals with valuable insights into the process of change, enabling them to provide more effective support and interventions. By acknowledging the nuanced nature of behavior change and the different stages individuals may experience, the Stages of Change model offers a comprehensive and empathetic approach to personal transformation.
See Courage to Change and Commitment to Change for more on this topic
Last edited: April 9, 2024
References:
DiClemente, Carlos C. (2005) Addiction and Change, Second Edition: How Addictions Develop and Addicted People Recover. The Guilford Press; Second edition.
Donovan, Dennis M.; Marlatt, G. Alan (2005) Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. The Guilford Press.
Murphy, T. Franklin (2018). Change Through Action. Psychology Fanatic. Published 11-1-2018. Accessed 1-30-2024
Prochaska, James O., Norcross, John C. (2001). STAGES OF CHANGE. Psychotherapy, 38(4), 443-448. DOI: 10.1037/0033-3204.38.4.443
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