The Transtheoretical Model of Behavior Change
Over 30 years of research in the area of “self-change” has revealed that people can and do
successfully make challenging life changes on their own. Although individuals will change
in different ways and at different rates, research has shown that they go through a set of five
stages in making changes.
Stage 1: Precontemplation or Unaware: Some people have not begun to move through the
stages of change. These individuals are in the unaware stage. They do not see that they have
a problem. They may be in denial that any problem exists despite evidence to the contrary.
Individuals in this stage will actively resist change or any discussion of the problem behavior
at hand.
Stage 2: Contemplation: In this stage, people begin to acknowledge that their behavior and
choices may be causing problems and they begin to think about solving them. Coupled with
the will to change however, is the fear and anxiety of change that pulls these individuals in
conflicting directions. Some people get stuck in this stage as they wait for a “magic moment”
for change. Others look for a way to maintain their current behavior while simply lessening
the severity of the consequences.
Stage 3: Preparation: Individuals in this stage begin to focus less on the past and more on the
future. Alternatives and solutions are the primary concern. Some anxiety may still persist,
but the individual possesses a growing confidence in the decision to change. It is important to
take time preparing for change before diving in. Individuals will want to consider a variety of
options and evaluate the benefits and consequences of each before making a decision about
what course of action to pursue.
Stage 4: Action: At this stage, people make a commitment to a specific change plan and
implement it. The focus of this stage is on effective countering – finding healthy alternatives
to old ways, problem-solving tough situations and focusing on the benefits of change.
Stage 5: Maintenance or Stick With It: This stage allows individuals the opportunity to
reevaluate their plans and make adjustments. Change rarely happens without some mistakes.
Mistakes do not equate with failure. This stage encourages individuals to continue to work
on their change plan despite frustration or “slips.” The support of others and the benefits of
change will help sustain motivation.
Recommended readings:
Changing for Good by James Prochaska, Ph.D., John Norcross, Ph.D., and Carlo
DiClemente, Ph.D.
Motivational Interviewing, Helping People Change (Third Edition) by William Miller
and Stephen Rollnick
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The Transtheoretical Model of Behavior Change (continued)
One of the most valuable components of
the change model is use of the 10 processes
ctrum
that support change. These processes can be Using the full spe hance
n
implemented through hundreds of techniques
of processes will ehances
an individual’s c ing
or methods. The key is to recognize that many
processes are available to support a person’s
change efforts. for making last ior
v
and positive beha
There are 10 processes of change that can
generally be broken up into two categories.
changes.
“Pre-action” processes are best used to
assist individuals in the precontemplation,
contemplation and preparation stages of change.
These processes focus on guiding the individual
toward the intention to change and include:
◆ Consciousness Raising: Gathering information
to allow an individual to better assess and make decisions about a problem behavior.
Example of use: This may include going to a local library and researching the behavior,
watching a video or program about it or asking a professional for help in understanding it.
◆ Social Liberation: Taking advantage of social structures that support the plan for change.
Looking for people and places in the community that support and promote positive life
change.
Example of use: Individuals may choose to join an organization, attend self-help
meetings or become involved in other community support activities for individuals who
are working on similar issues.
◆ Emotional Arousal: Experiencing and expressing feelings about problems and solutions.
Increasing awareness and depth of feelings about the changes an individual wishes to
make.
Example of use: This may include exploring feelings about past mistakes and choices an
individual has made due to a problem behavior and exploring the positive feelings an
individual hopes to gain by making changes.
◆ Self-reevaluation: Examining one’s own attitudes and behaviors.
Example of use: This may include taking a serious look at problem behaviors and how
they match or do not match up with an individual’s values.
◆ Environmental Reevaluation: Recognizing the effect one’s behavior can have on others
and acting as a positive role model for others who wish to change.
Example of use: Individuals may look at how their behavior has affected their
relationships with family members and friends.
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The Transtheoretical Model of Behavior Change (continued)
“Action” processes are best used in the action and maintenance stages of change. They include:
◆ Helping Relationships: Asking for and receiving help from others.
Example of use: This can include forming relationships with people who support their new
behaviors.
◆ Commitment: Choosing to take action and believing in one’s ability to change.
Example of use: Individuals can explore their options for change and share their goals for
positive change with others.
◆ Countering: Identifying healthy alternatives to a negative behavior.
Example of use: This may involve learning how to replace negative thoughts, feelings and
behaviors with positive, responsible ones and refocusing energy on what will help a person
to become happier and healthier (e.g., physical exercise, practicing relaxation techniques).
◆ Environment Control: Avoiding people, places and things that may encourage the behavior
the individual wishes to change.
Example of use: Individuals may consider changing their routine and daily patterns or
developing the skill of being aware of cues that lead to negative or irresponsible behaviors.
◆ Reward: Receiving rewards for making wise choices.
Example of use: This may include doing something special when an individual achieves a
positive goal. Rewards can be positive self-statements (for example, “Way to go,” “Good
job” or “Keep up the good work”) or material treats.
Studies of successful self-changers indicate that certain processes work best during certain
stages of change. The chart below demonstrates at which stages each process is most effective.
Adapted from Changing for Good by James Prochaska, Ph.D., John Norcross, Ph.D., and Carlo DiClemente, Ph.D.
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