How We Change, Stages of Change

Home / Campus and Medical Center / ( Published on 2014-08-14 )

The one constant in life is change, and those changes come in a variety of ways. Often we focus on changes that happen to us and how we are going to adapt or cope with something new. Other times, we initiate a change ourselves. 

Often, starting a change can be an anxious undertaking. We are afraid what the consequences might be if we do change, and also wary of how things will be if we don’t change. Some changes are small and don’t require much thought or effort, like buying a new pair of pants or going to a new restaurant for dinner. These don’t inspire much anxiety in most people. Other changes, however, are "life changes" that will have a more profound effect upon us and maybe those around us. We make these changes anyway, because we feel that they are for the better, whether it is quitting smoking, getting more exercise, applying for a new job, moving, or any goal that we think and feel will benefit us. 

Maybe you are thinking about making a change, or want to encourage someone else with their efforts. It is helpful to have a model of how people begin to change and how they see it through to the conclusion. There is a very useful model of the stages of change that can be applied to almost any context, developed by Prochaska (1992):

  • Precontemplation: The initial stage, where there is no thought about changing.  In this beginning stage, people are likely to resist the idea of changing as they aren’t motivated to do so. 
  • Contemplation: In this stage, people begin to think about changing, and are weighing pros and cons, considering if the long term benefits will surely outweigh the short term costs. Usually in this stage people will state their intention to change within six months. 
  • Preparation: In this stage, people actually begin to look into what steps they could take to make the change. They gather information about what resources are available. Usually when someone is in the preparation stage they are intending to make an effort within the next 30 days.
  • Action: This is the stage where we actually do something for the sake of change. This can take many forms, but probably will be using one or several of the available resources discovered in the preparation phase. (This stage can also represent significant one-time changes but more likely reflects a series of actions and behaviors toward a long-term goal.)
  • Maintenance: In this stage, people try to consolidate and maintain gains from the actions taken in the previous stage. It can be viewed as trying to preserve the momentum of any changes.

It is important to note that while these stages are presented and discussed in a linear fashion; one does not necessarily have to proceed through them in order. It is entirely possible and natural to jump around and shuffle back and forth. People certainly start at "Precontemplation" and move to "Contemplation" to "Preparation," then back to "Contemplation" and then jump up to "Action." Especially if the first attempts at change fail, people move back into "Preparation" and "Contemplation," hopefully to try again with a better plan. 

Knowing these stages can help us with our peers, especially when trying to encourage a change in someone else, because then we can tailor our interactions. If someone is in the "Precontemplation" stage we know the person is likely to resist a change, so we’ll not spend hours trying to be convincing. If in the "Contemplative" we can join the person with thinking about all the aspects of a possible change ahead. During "Preparation" we can help add information and point out resources. We can be supportive during the "Action" phase, and help someone execute the change. And lastly, during the "Maintenance" stage, we can help someone stay on the chosen path by continuing to be supportive, reminding the person of everything they are accomplishing. 

At some point after "Maintenance" the changed behaviors become the norm and the person is through the stages of change. Sometimes there is a relapse, where old ways of behaving resurface. An example could be an addict who after a long period of abstinence relapses, or someone who has worked hard at overcoming depression having severe negative feelings again. This is a natural part of life, and is not so much as starting over as it is continuing a process. Sometimes changes happen to us and we have to adapt in order to incorporate something new into our lives. Other times, we are the instruments of our change, going beyond reaction to action in order to better ourselves and our environment. One of the great things about being who we are is that we can always simply choose to change. But those changes don’t happen all at once – they unfold in stages, which we can learn to work our way through. 

The Faculty and Staff Assistance Program (FSAP) at UCSF provides confidential assessment, counseling, referrals, and consultation services that support the well being of both the individual and the organization. For more information or to make an appointment contact us at 415/476-8279 or visit the FSAP website.

References:

  1. Prochaska, J. O., DiClemente, C. C., & Norcross, J. (1992). In search of how people change. American Psychologist, 47, 1102-1114.