Applying the stages of change

Abstract

From a transtheoretical perspective, PROCHASKA, NORCROSS and DICLEMENTE summarise prescriptive and proscriptive guidelines for improving treatments based on five stages of change the client may progress through - precontemplation, contemplation, preparation, action, and maintenance. Change is not viewed as a linear progression through the stages; rather, most clients move through the stages of change in a spiral pattern. While people progress from contemplation to preparation to action to maintenance, most will relapse. Fortunately, most move back to the contemplation stage and into preparation and action. Eleven practice recommendations are advanced against the central need to assess the stage of a client's readiness for change and to tailor interventions accordingly. A small and finite set of change processes or strategies have been identified across hundreds of psychotherapy techniques and across diverse disorders. Eight change process are outlined in detail. In the transtheoretical model, change processes associated with particular therapeutic models are applied optimally at each stage of change accompanied by stage-matched 'relationships of choice'. Guidance is given on how to avoid mismatching stages and processes. Smoking is used as an illustrative problem behaviour.