The Stages of Change and How to Identify ThemStage 1: Precontemplation (Not Ready)People at this stage are often either unaware of the risks of their behavior, or they mentally minimize the concern of others about the risks. For this reason, clients will often say things like, “I don’t see anything wrong with what I do, but I guess my wife wanted me to come here,” or, “I think I’m fine, but my doctor said I should see you.” Statements such as these indicate that the person is in the precontemplation stage and has not thought much about making the change, and does not have any concrete plans to start a new healthy behavior in the near future (i.e., within the next 6 months). Further, those in the precontemplation stage have a decisional balance that doesn’t support change (they see more cons than pros), and may not feel a high sense of self-efficacy about making a change.
Stage 2: Contemplation (Getting Ready)People in the contemplation stage are more aware of the pros and cons associated with the change, and at this stage they weigh them up equally. Because of this, the decisional balance (where they see the pros as being equal to the cons) can often cause a stalemate, with change behavior put off for some time. At this stage, a person may also have a high degree of ambivalence, while their sense of self-efficacy is not quite developed. People at this stage will often say things like, “I know I will feel better if I lose weight, but I just don’t know if I can”, or, “I know I will be happier if I start working out, but I’m not sure I can fit it in.”
Stage 3: Preparation (Ready)People in the preparation stage see the pros as being greater than the cons, meaning that the decisional balance has shifted in favor of change and they are now ready to take action. In this stage, people will often begin to plan out and initiate small steps toward making the change; however, they will usually still experience some doubt about their success as their sense of self-efficacy is still low. For this reason, this stage is characterized by thinking about and planning change in preparation for taking action. Here, people will often say things like, “I am going to start working out three times a week, starting from next week, but I’m still not sure how I will fit everything in,” or, “I am planning to eat lowcarb from here on out, but I don’t know what I will order when I eat out with friends.”
Stage 4: ActionPeople in the action stage will have taken measurable steps toward changing their behavior, within the last six months. In this stage, people give more weight to the pros of changing, and less to the cons, which further shifts the decisional balance toward change. Also, as a positive and measurable change has already been made, their sense of self-efficacy is higher, and hence people will speak with greater confidence about the change; albeit at the same time, they may still express some doubt. They may say things like, “I’m really happy that I’ve been able to maintain my diet for the past few weeks, I just hope I can keep it up,” or, “I can see my body changing, and I like it, but I just hope I keep on losing weight.”
Stage 5: MaintenanceAs people in the maintenance stage have maintained their positive changes for more than six months, they will speak with greater confidence about themselves, experience higher levels of self-efficacy, and will consistently rate the pros of change as being greater than the cons. Now that their behavior is more stable, they are much more likely to continue their healthy behavior; however, there is still a risk that people in the maintenance stage may relapse toward unhealthy behavior when in stressful situations. They may say things like, “I’m feeling really confident with my weight now, so I’m wondering if I can start eating some of the things I used to really like,” or, “I thought that maybe because I’ve been doing so well in my exercise, I could take a few days off.”
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