What happens in the preparation stage?

In the preparation/determination stage, people have made a commitment to make a change. Their motivation for changing is reflected by statements such as: “I've got to do something about this — this is serious. Something has to change. What can I do?”

medicine.llu.edu - Stages of Change Model - Loma Linda University School of Medicine

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The Stages of Change

The stages of change are:

Precontemplation (Not yet acknowledging that there is a problem behavior that needs to be changed) Contemplation (Acknowledging that there is a problem but not yet ready, sure of wanting, or lacks confidence to make a change)

Preparation/Determination (Getting ready to change)

Action/Willpower (Changing behavior)

Maintenance (Maintaining the behavior change)

Stage One: Precontemplation

In the precontemplation stage, people are not thinking seriously about changing and are not interested in any kind of help. People in this stage tend to defend their current bad habit(s) and do not feel it is a problem. They may be defensive in the face of other people’s efforts to pressure them to change. In AA, this stage is called “denial,” but another way to describe this stage is that people just do not yet see themselves as having a problem.

Stage Two: Contemplation

In the contemplation stage, people are on a teeter-totter, weighing the pros and cons of modifying their behavior. Although they think about the negative aspects of their bad habit and the positives associated with changing, they may doubt that the long-term benefits associated with change will outweigh the short-term costs. It might take as little as a couple weeks or as long as a lifetime to get through the contemplation stage.

Stage Three: Preparation/Determination

In the preparation/determination stage, people have made a commitment to make a change. Their motivation for changing is reflected by statements such as: “I’ve got to do something about this — this is serious. Something has to change. What can I do?” This is sort of a research phase. They gather information (sometimes by reading things like this) about what they will need to do to change their behavior. Or they will check out websites, organizations and resources that are available to help them in their attempt. Too often, people skip this stage: they try to move directly from contemplation into action and fall flat on their faces because they haven’t adequately researched or accepted what it is going to take to make this major lifestyle change.

Stage Four: Action/Willpower

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This is the stage where people are motivated to change their behavior and are actively involved in taking steps to change their bad behavior by using a variety of different techniques. This is the shortest of all the stages. The amount of time people spend in action varies. It generally lasts about 6 months, but it can literally be as short as one hour! This is a stage when people most depend on their own willpower. They are making overt efforts to change the behavior and are at greatest risk for relapse. Mentally, they review their commitment to themselves and develop plans to deal with both personal and external pressures that may lead to slips. They may use short-term rewards to sustain their motivation, and analyze their behavior change efforts in a way that enhances their self-confidence. People in this stage also tend to be open to receiving help and are also likely to seek support from others (a very important element).

Hopefully, people will then move to:

Stage Five: Maintenance

Maintenance involves being able to successfully avoid any temptations to return to the bad habit. The goal of the maintenance stage is to maintain the new status quo. People in this stage tend to remind themselves of how much progress they have made. People in maintenance constantly reformulate the rules of their lives and are acquiring new skills to deal with life and avoid relapse. They are able to anticipate the situations in which a relapse could occur and prepare coping strategies in advance. They remain aware that what they are striving for is personally worthwhile and meaningful. They are patient with themselves and recognize that it often takes a while to let go of old behavior patterns and practice new ones until they are second nature to them. Even though they may have thoughts of returning to their old bad habits, they resist the temptation and stay on track.

Techniques to help you progress through your change plan.

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As you progress through your own stages of change, it can be helpful to re-evaluate your progress in moving up and down through these stages. (Even in the course of one day, you may go through several different stages of change). And remember: it is normal and natural to regress, to attain one stage only to fall back to a previous stage. This is just a normal part of making changes in your behavior. Characteristics Techniques Pre-contemplation Not currently considering change: "Ignorance is bliss" or “lack confidence” Evaluate your current behavior

Think about what you want

Self-explore

Explain and personalize the risk Contemplation Ambivalent about change: "Sitting on the fence" Not considering change within the next month Clarify decision

Evaluate pros and cons of behavior change

Identify and promote new, positive outcome expectations Preparation Some experience with change and are trying to change: "Testing the waters" Planning to act within one month Identify problem solving re: obstacles

Identify social support

List skills needed for change

Take small initial steps Action Practicing new behavior for 3-6 months Focus on restructuring cues and social support

Bolster self-efficacy for dealing with obstacles

Combat feelings of loss and reiterate long-term benefits Maintenance Continued commitment to sustaining new behavior Post-6 months to 5 years Plan for follow-up support

Reinforce internal rewards

Think about coping with relapse Relapse Resumption of old behaviors: "Fall from grace"

abandoning the new changes Evaluate trigger for relapse

Reassess motivation and barriers

Plan stronger coping strategies

Resource: http://www.cpe.vt.edu/gttc/presentations/8eStagesofChange.pdf

medicine.llu.edu - Stages of Change Model - Loma Linda University School of Medicine

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