Understanding the 5 Stages of Change to Improve Healthy Behaviors
Examining the Stages of Change
Understanding some basic concepts about the process of change can be helpful to keep in mind as we move our patients/clients forward on their path to discovering better health.
Learning to recognize where our clients are in this process can not only help to move them forward from one stage to the next, but also help both you and the client learn how to handle any “backslides” that are bound to occur along the way.
There is more than one theory on how health behavior change occurs. The Transtheoretical Model of Behavior Change developed by James Prochaska and colleagues which began in 1977 is a popular model currently used in many health and wellness practices. Prochaska’s book, Changing for Good along with research using this framework have made it a dominant model used for health behavior change.
What are the 5 Stages of Change? 
- 1. PRECOMTEMPLATION –the patient or client has no interest in change– they may state I’m not even thinking about it, “I Won’t” or “I Can’t”
- 2. CONTEMPLATION – Statements such as “I May” or “I’ve thought about – getting more active, improving my eating habits or changing other health behaviors but haven’t done so yet, indicate they are in the contemplation stage. They are ambivalent about changing. During this stage, patients assess barriers (e.g., time, expense, hassle, fear, “I know I need to but …”). They are sizing up, or contemplating the barriers versus the benefits. People can stay in the contemplation stage for months to even years!
- PREPARATION STAGE – If the patient has been increasing their activity level, exercise, or eating better but it has been inconsistent, they are in the “I Will” or Preparation Stage. During the preparation stage, patients are starting to make a specific change. They may experiment with small actions or changes as their determination to change that specific behavior increases.
- ACTION STAGE – If the patient has been exercising, eating better, or engaging in other activities to improve your overall health status consistently, but for less than 6 month. They are in the “I AM” or Action Stage. This stage can last up to 6 months while they are establishing your new habit
- MAINTAINANCE STAGE – If the patient/client has been engaging in their new healthy activity for more than 6 months, they are in the Maintenance Stage, or “I Still Am!”. It is in this stage that the new behavior change has become a habit. They are more confident in their ability to maintain the new behavior
Early in my career as a physical therapist, I struggled trying to figure out why some patients progressed more easily than others. We all know those patients or clients that we love to work with – they listen to you, are more compliant with their treatment or rehabilitation program, and seem to get better with less difficulty.
Then there are the ones that I asked “what on earth can I do to help you, why aren’t you doing what you need to get better? Learning to incorporate the Stages of Change into practice was instrumental in determining how to approach that particular individual, what information might be best for them at that particular time, and what might be the best intervention strategy for them to help move them forward along the spectrum of change.
Now that you know the basics of the stages of behavior change, in the next post, we’ll discuss how to incorporate them into your practice to help your clients achieve a healthier lifestyle.
This is the second in our series on Leading your Clients to Good Health. If you missed the first one, go here: http://www.healthpathtoday.com/?p=504
