Stages of Change

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What do you mean by "Stages of Change?"

The "Stages of Change" consist of different stages which help identify where a person is regarding the change of behavior. It may relate to several different things such as smoking, exercise, etc. It consist of several different processes but it is divided into six main stages that are: precontemplation, contemplation, preparation, action, maintenance, and termination. Each one of these phases or "stages" describes an individual's attitude toward behavior change. Each individual may not be in the same stage for each behavior because the transtheoretical model is specific to each behavior.

http://www2.msstate.edu/~bhunt/Stages_of_Change_Theory/transtheoretical.html

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Precontemplation Stage

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This stage represents those individuals who have no desire to change their behaviors in the immediate future. The immediate future usually refers to a six month time period. This is used because this is about as far in the future that most people plan a specific behavior change. It is also because most people are concerned with the present and don't plan far in the future so a six month time frame is used. Individuals in this stage usually have a lack of awareness about the specific behavior. Some individuals in this stage are very aware of the consequences of their behavior but may avoid getting involved in behavior change programs because of rationalizing their behavior to make sense to them. Individuals may also be tired of trying and failing at the desired behavior change.

It may be possible for the individual to move from precontemplation to the contemplation stage by increased awareness. Mass media on certain behaviors can influence awareness. Also, by setting goals that can easily be attained can ensure that the individual is successful and increase self-efficacy or the individual's confidence in themselves to make the desired behavior change.

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Contemplation Stage

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This stage is where the individual has the intent to change his/her behavior within the next six months. Just as in the precontemplation stage, the six month figure is used because this is about as far in the future that most people plan a specific behavior change. This individual is already aware of the benefits and barriers of the desired behavior and plans change their behavior based on their interpretation of the benefits and barriers.

While the benefits of specific behavior change maybe somewhat obvious, the barriers may be different for each individual. One person may not have the finances to perform a certain behavior change, while another may have family problems that prohibit the behavior change, and yet another may not make the desired behavior change because they don't have access to the neccessary things.

The individual in this stage needs extra attention. Everything needs to be at his/her own pace and he/she doesn't need to be rushed into a behavior change that he/she is not ready for. Encouragement and motivational techniques can be used to persuade this individual to the next stage. This may be done by going beyond the awareness by using mass media but by using things that are "tailor-made" for the individual.

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Preparation Stage

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Individuals in this stage intend to make a behavior change within the next month (30 days) and have made at least one previous attempt to make a behavior change.

It is in this stage that the individual is most ready for a change. It is the job of the health promotion professional to help manipulate the environment in order to make it conducive to the desired behavior change, therefore promoting the change. This may involve some policy changes.

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Action Stage

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The action stage is a period of time anywhere between 0 and 6 months that involves a sufficient change of behavior. This stage of change reflects a consistent behavior pattern, is usually the most visible, and receives the greatest external recognition. When measuring the pros and cons of the desired behavior change, the individual's perceived cons of the behavior should outweigh the perceived pros of the behavior if it is an attempt to abstain from certain behaviors such as drug abuse or smoking. The individual's perceived pros should outweigh the perceived cons if the individual is making an attempt at a positive behavior change such as exercise adherence. If the individual making the behavior change continues his/her pattern of behavior, he/she will move into the fifth stage, called maintenance.

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Maintenance Stage

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This stage is one that starts six months after the action stage and can last for several years. The behavior being changed is the key factor in determining how long this stage will last. It is in this stage that the self-efficacy ( one's confidence in oneself to make a behavior change) of the individual is at it's highest, especially when compared to the four preceding stages.

Relapse prevention "is a self-control program designed to teach individuals who are trying to change their behavior how to anticipate and cope with the problem of relapse" and is probably the biggest concern of the health promotion professional in this stage. Since the Transtheoretical model is cyclical, the individual may relapse back several stages instead of just one. The individual needs to be prepared for relapse by knowing exactly what to do about it.

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Termination Stage

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This phase is one in which the individual has permanently adopted a desirable behavior. This involves 100% self-efficacy (one's confidence in oneself to make a behavior change) and absolutely no temptation to relapse. In some behaviors, it may be a more realistic goal to obtain lifelong maintenance since acquiring 100% self-efficacy and no temptation to relapse may be too much to handle for some individuals.