Posted by: leslielpc | December 29, 2009

Are you ready to make a change?

James O. Prochaska, Ph.D. et al helped to identified and conceptualized five stages of change that can be applied to a variety of challenging and problem behaviors. The five stages of change identified are pre-contemplation, contemplation, preparation, action, and maintenance.
1. Pre-contemplation is the stage at which there is no intention to change behavior in the near or foreseeable future. Often times if you are in this stage you are unaware or under-aware of any problems or challenges. In many cases, those around you are very aware of the problem or challenge and may have repeatedly attempted to help you see the need to change your ways! Examples might include but are not limited to, excessive drinking, smoking, overweight and overeating, procrastination, depression, anxiety, overuse of the internet, shopping, or TV, etc. For some people, you may have made prior attempts to make a change with the problem or challenge and have been unsuccessful. As a result, you may have resigned yourself to having the problem or challenge.

How to recognize if you are in this stage: you avoid the subject and may get very defensive about it; presence of defense mechanisms such as denial and rationalization, etc.; not being informed about the problem or challenge.
How to move on to next stage: take responsibility; become informed about the challenge or problem; become aware of your defenses; get support and help from others.
2. Contemplation is the stage of change in which you are aware that a problem or challenge exists and you are seriously thinking about overcoming it but have not yet made a commitment to take action. You may be ambivalent about making the change/changes. You may be assessing the barriers or costs as well as the benefits to making the change.
How to recognize if you are in this stage: seriously considering doing something; may insist on the perfect solution before you are ready to take action; may be procrastinating about the change.
How to move on to next stage: look at the cost/benefits of the problem and making changes; look at the problem and the consequences of it more vividly.

3. Preparation is a stage that combines both intention and identification of specific behavioral changes. If you are in this stage you are intending to take action in the next month. You may have started to make small changes. In regard to weight loss, this may include sampling low-fat food alternatives, or seeing what it might be like to drink more water vs. soda.
How to recognize if you are in this stage: you have decided to take action and are now taking the steps necessary to prepare you to take action.

How to move on to next stage: make a commitment to make the change; announce it to others; take small steps; set up some time frames.

4. Action is the stage in which you modify your behavior, experiences, or environment in order to overcome your challenge or problems. You are now taking the steps required to make the change. The state of action involves the most overt behavioral changes and also requires considerable commitment of time and energy.
How to recognize if you are in this stage: you are taking the steps required to make the change!
How to move on to next stage: increase your coping strategies; control your environment; work to manage your thoughts; know what to do if you “slip”; have support.

5. Maintenance/Relapse prevention is the stage in which you work to prevent relapse to old behaviors and to consolidate and integrate the gains made during action stage. You are working to maintain the positive changes in behavior that you have learned and are utilizing. Remember that change is not linear in nature, but most of us zig-zag along the process. Don’t lose hope if you fall back to some old behaviors, but instead, ask yourself what you need to do to get back on track. Most people benefit from support, not only at this stage, but the prior stages as well.
How to recognize if you are in this stage: You have maintained your positive changes for several months.
How to move on to next stage: continue with support; review a list of the positive as well as the negative aspects of the challenge on a regular basis; have a written strategy to keep your self on course.
Consider what problem behaviors or challenges you might have, then go back through the stages and identify where you might be in the process of change. If needed, have a trusted friend or healthcare provider help you review your challenges and what you might need to do next. Get the support you need and muster your courage to take the needed steps to overcome whatever challenge or problem you are facing.

References: Changing for Good – James O. Prochaska, Ph.D. et al; A “Stages of Change” approach to helping patients change behavior – Gretchen L. Zimmerman, Psy.D. American Association of Family Physicians.

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