What are the Stages of Change?
The Brady Bunch might have been inspired by Peter’s changing voice, but I like to think they had health coaching in mind when they wrote the hit “Time to Change”. The lyrics, “When it’s time to change, you’ve got to rearrange. Who you are and what you’re gonna be.”, have taken on a new meaning for me since becoming a well-being coach.
Change, even a change with possible great benefits, can be intimidating and overwhelming. The one thing our brains desire most is certainty, so it is only natural that change is challenging because it is unknown. Habits are well-worn, well-traveled pathways in the brain. These pathways consist of brain cells called neurons. When two neurons connect, they form dendrites. The frequency of a behavior in turn increases the number of dendrites and connections made with other brain cells, making the behavior automatic. Before thinking neuroscience makes change impossible, think of change as strength training the brain, just like an athlete trains for competition. We can rewire the brain by first becoming aware and then taking action through repetition.
Similar to stages of strength training, there are Stages of Change, also referred to as The Transtheoretical Model, developed by Prochaska and DiClemente in 1977. The duo studied smokers who quit on their own versus smokers who required the assistance of treatment to quit. They determined smokers quit smoking only if they were ready to do so. The Transtheoretical Model focuses on the decision to intentionally change. This decision is not instantaneous or decisive but rather a cyclical process. The model consists of six stages of change and they are as follows:
Precontemplation - (“I can’t/I won’t”) not ready; not intending to take action in the next six months. The individual is often unaware their behavior is problematic or has negative consequences. They place emphasis on the cons while underestimating the pros of changing their behavior.
Contemplation - (“I may”) getting ready; intending to take action in the next six months. The individual acknowledges their behavior is problematic. They place equal emphasis on both the pros and cons of changing their behavior but still feel ambivalent toward the change.
Preparation - (“I will”) ready; ready to take action in the next thirty days. As the individual begins to take small steps toward the changed behavior, they feel determined and believe they are changing for the better.
Action - (“I am”) has made the behavior change but for less than six months. The individual has changed their behavior and plans to keep moving in the forward direction of behavior change.
Maintenance - (“I still am”) doing the new behavior for more than six months. The individual is sustaining the behavior change with the intention of maintaining the behavior while working to prevent relapse to previous stages.
Termination - (“I did it”) confident with the change; not tempted to relapse. The individual no longer feels tempted to return to the previous habit.
Prochaska and DiClemente’s research determined the number one reason why people are unsuccessful with change is that they don’t know how to change. Prochaska adds to this theory by explaining one of the top reasons that most US physicians do not practice behavioral medicine is that most do not believe their patients can or will change their behavior. This is where a health and well-being coach can help. Trained in behavior change, a coach can bridge the gap between medical/health recommendations, and the client’s understanding and engagement in making the change.
Sha na na na na na na na na
Sha na na na na
Be well,
Sarah
