While the Stages of Change name is not entirely representative of The Transtheoretical Model created by Prochaska, Di Clemente, and their colleagues in the late 1970s, it is the more commonly used name for the model. The model came about as there was an attempt to distill multiple theories of change in psychotherapy into a single model.
As a result of its heritage, it’s more frequently used in individual behavior change and addiction recovery than in organizational change, yet it follows a strikingly similar path.
Precontemplation and Contemplation
During these stages of change, the person becomes progressively more aware and willing to consider change. These phases correspond to Lewin’s Unfreezing stage. In precontemplation, the individual is completely unwilling to consider a change. Stages of change was frequently used with smoking cessation. Smokers in the precontemplation state would not listen to the research stating that their behavior was unsafe, unhealthy, or even problematic. Individuals in the precontemplation phase normalize their behavior. It’s what they’ve always done. It’s what their family has always done. It’s what the entire community does. To not do this might jeopardize their perception of themselves, and therefore it’s too scary to consider.
Contemplation is a step closer towards change, but still not ready to accept that a new behavior is better. Individuals in the contemplation stage can listen to some evidence and opinions that their behavior is bad. Here, they’re contemplating whether the change would be beneficial to them. They’re deciding whether they desire to change or not.
Preparation and Action
Once the decision is made to make the change, it’s time to do it – but not so fast. Benjamin Franklin said, “If you fail to plan, you’re planning to fail.” The preparation and action stages of change correspond to Lewin’s Change and Transition stage in his model but recognizes Franklin’s important point about the necessity of planning for success.
Planning is often about how do you setup the right systems around you to be successful. In ADKAR, this means developing the right knowledge and ability to accomplish the change. Planning takes many forms, but ultimately every form of planning is designed to increase the chances of success.
Once the preparations have been made, it’s time for action. In relation to smoking cessation, planning may represent removing ashtrays from the home and developing strategies for the desire to be holding things in one’s hands. Action is where the last cigarette is smoked.
Maintenance and Relapse
The maintenance stage of change is focused on preventing relapse. In addiction recovery and individual behavior change, relapse is common. Key to the stages of change model is the awareness of this possibility and the need to make investments to prevent the relapse from becoming permanent thereby derailing the change.
Termination
Termination is the cessation of the desire and the belief that the person will never return to their old behaviors. Both maintenance and termination are encompassed in Lewin’s Refreezing stage in his model. Collectively, they address the short-term risk of “falling off the wagon” and achieving the long-term change.
The termination phase of stages of change is criticized by other models, particularly twelve-step models, because they recognize that there’s always a risk of return to old patterns of thinking and behaving. Despite these concerns, the Stages of Change model can be effective at helping individuals change even stubborn behaviors like addictions.
Resources
- William R. Miller and Stephen Rollnick’s Motivational Interviewing