How  many times have you counselled someone or given advice only for the person to say “ya butt”, have excuses or they come back time and time again with the same issue and have done nothing of what you discussed.  

What causes people to change their behaviour has been a topic for social scientists for decades and Prochaska & DiClimente’s model of stages of change continues to be used as best practices when looking at behaviour change theory and addiction. 

Change is hard.  

So as helpers and caregivers we are often walking alongside people who are facing change.

One of the best-known approaches to change is the Stages of Change Model, introduced by researchers James Prochaska and Carlo DiClemente.

The Stages of Change model is helpful in understanding how people go through a behaviour change that change occurs gradually and that relapses are not to be punished but are considered to be part of the process. 

This model demonstrates that change is rarely easy and It often requires a gradual progression of small steps toward a specific goal.

The first stage of change is known as pre-contemplation.

 

1.  Pre-contemplation

During the this stage, people are not considering a change. They actually don’t even see their behavior or lifestyle as a problem.

In some cases, people in this stage do not understand that their behavior is harmful, and may believe that they have no control over the behavior.

If you are supporting someone at this stage it would be too far of a jump to ask for change because for them, there is no incentive or benefits to change.  

Whether they say it out loud  or not they are likely thinking “why change”, or “I can’t change”, or “I don’t want to change”.  

If the person you’re supporting is in the pre-contemplation stage you are simply asking curious questions and introducing the idea of change.  

In this stage you may be more focused on building awareness of the harmful consequences of their actions.

Ask questions like:
How does that behaviour/habit impact your life, relationships, health, finances etc?
Has that behavior ever caused your hardship or problems?
Have you ever tried to change this behavior in the past?
How would you know if it became a problem?

This type of questioning is not intended to create change, but just self reflection so that the desire for change grows. 

2.  Contemplation

In this stage, people are more aware of the benefits of making a change; however, the costs or pain of change often outweighs the benefits. 

As a result there is ambivalence or uncertainty.  People talk of change, but there is little action or progress. The anthem of this stage is “yea but”  If you hear “ya but., then it is likely the person is in the contemplation stage

This stage can last a very long time, months or possibly even  years. And this is often where people get stuck. 

As a helpers our role is to build the awareness of the benefits of change and support people to overcome the barriers.  This can be slow and tedious work.  

And as a result it can be tempting to push people harder than it is helpful.  But this isn’t a time to manipulate, shame or coerce people into change.

Ask questions like: 
Why do you want to change?
What is it that is preventing you from changing?
What are some things that could help you make this change?

This type of questions are helpful as they point to problem solving the benefits of change

3.  Preparation

During the this stage, those you support might begin making small changes to prepare for a larger life change. For example, if losing weight is the goal, they might switch to lower-fat foods or if the goal is to quit smoking, they may smoke less each day.

These are the beginning steps to change.  The scale has shifted.  The pain of remaining in the habit is now greater than the pain of change. 

However, disappointment, lack of quick wins and setbacks can be considered failure and deter people from change. 

It can be helpful to prepare a list of motivating statements. Write down goals. Find resources such as support groups, counselors, or friends who can offer advice and encouragement.

Try to build positive momentum early and start small to achieve some quick, but small wins. 

4.  Action 

Action is the fourth stage,  and people begin taking direct action in order to accomplish their goals.

If someone is taking action towards achieving a goal, congratulate and reward them for any positive steps taken. Reinforcement and support are extremely important in helping maintain positive steps toward change.

But this isn’t the time to sit back.   Take time to periodically review motivations, resources, and progress in order to refresh the commitment and the belief in their abilities.

5.  Maintenance 

Maintenance phase involves successfully avoiding former behaviors and keeping up new behaviors.

It’s helpful when trying to maintain a new behavior to look for ways to avoid temptation. So brainstorming ways to replace old habits with more positive actions is helpful.

If people falter, don’t be too hard on them or critical.  Instead, remind them that it was just a temporary set-back it’s not a permanent situation .

During this stage, people become more assured that they will be able to continue their change.

6.  Relapse

The 6th and final stand is Relapse.  In any behavior change, relapses are a common occurrence.

When people go through a relapse, they might experience feelings of failure, disappointment, and frustration.

The key to success is to not let these setbacks undermine self-confidence. 

If there is a lapse back to an old behavior, take a hard look at why it happened. What triggered the relapse? What can be done to avoid these triggers in the future?

While relapses can be difficult, the best solution is to start again at the beginning with the preparation stage

It might be helpful to reassess people’s resources and techniques. Reaffirm motivation, plan of action, and commitment to the goals. Also, make plans for how to deal with any future temptations.


I hope the 6 stages give you a framework to see how people change. 

If you are finding that you’re working harder for change then the person you’re supporting they may be in the pre-contemplative stage.  And your time may be better spent on awareness building. 

Or if you are getting frustrated at hearing people complain or say they need to change but never following through.  They are likely in the contemplative stage.   And your support should shift from action focused on minimizing barriers and confidence building. 

Change is difficult, but we can do hard things.  As supporters we are often walking alongside people building into their lives so they can overcome.  Use the Stages of change model to learn how to best support people through difficult changes.