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Understanding behaviour change

To support changes in behaviour we must first understand where our client is in their 'change journey'.

The stages of change model can help you to understand this journey. It shows change as a complex process and explains why providing the ‘right advice’ is often not enough (Prochaska et al 1986).

stages of change model

The stages of change model

The model above shows that before any change can take place, a person needs to believe there’s an advantage to changing and must be willing to put an effort into making this happen by deciding when, what and how to do it.

Pre-contemplation stage (contented)

People at this stage usually have no intention of changing their behaviour. They see advantages in their current behaviour or deny they have a problem. Although their families, friends, neighbours, doctors, or co-workers can see the problem quite clearly, the typical pre-contemplator can't.

They may change if there is enough constant external pressure, but once the pressure is removed, they will quickly revert. Pre-contemplators are often avoid thinking about their problem as they feel their situation is hopeless. 

Recognising that this is a natural feeling that accompanies this first stage can be a powerful way to motivate clients. They realise that their resistance is natural and that by working through this, and all stages, they can change.

Contemplation stage (considering change)

In the contemplation stage, people acknowledge that they have a problem and begin to think seriously about solving it. They acknowledge the dangers and risks of their current behaviour and consider the pros and cons of changing. 

While people in this stage may have vague plans to make changes, they are often not ready to take action yet. The person will still have reasons for continuing their behaviour. Many people remain in the contemplation stage for years.

Preparation stage (acknowledging the benefits of change)

People in the preparation stage have realised that change is beneficial and possible to achieve, and start to make concrete plans to change.

Most people in this stage are planning to make changes within the next month and an important first step is to make their intention public.

Although they are committed to action, they may still need to convince themselves that this is the best step. This last minute resolution is necessary, as people who cut the preparation stage short, lower their chances of success. It's important to develop a firm, detailed scheme of action.

Action stage (ready for change)

The action stage is where people most overtly modify their behaviour and surroundings. They stop smoking, remove all desserts from the house or pour their last beer down the drain.

Maintenance (maintaining change)

The maintenance phase involves successfully avoiding former behaviours and keeping up new behaviours. During this stage, people must deal with temptation in order to avoid relapse but will become more assured that they will be able to continue their change.

Relapse

In any behaviour change, relapses are a common occurrence. When a patient goes through a relapse, they might experience feelings of failure, disappointment, and frustration.