Prochaska DiClemente stages of change
The Prochaska DiClemente cycle, also called the transtheoretical model, describes the stages a person moves through when changing something they do, such as smoking, diet or exercise.
Remember
Place a person by their intentions and plans: no intention to change is precontemplation, thinking about it without a plan is contemplation, a plan to act soon is preparation, and actively changing is action. Support should be matched to that stage.
In precontemplation (no thought of changing), the person has no intention to change in the foreseeable future. In contemplation (thinking about it), the person is aware of a benefit and weighs up the pros and cons, but has made no commitment or plan. People here often feel ambivalent, meaning torn between two views.
Preparation comes next, when the person intends to act soon, in the smoking example within about the next 30 days, and has started planning, for example by choosing a date or buying equipment. In action, the new behaviour is under way and the person is actively changing it. Then comes maintenance, the stage of keeping the change going.
It is called a cycle because people often relapse (slip back) and go round again. After a relapse the person can re-enter the cycle at an earlier stage.
Each stage needs different support, matched to the person's readiness. In precontemplation, the most appropriate focus is to raise awareness of the risks and make them personally relevant, rather than to ask for action. Motivational interviewing, which draws the motivation to change out of the person, fits well here.
Key facts
- Precontemplation
- The person is not planning to change in the foreseeable future, which does not always mean ignorance.
- Contemplation
- Thinking about change and weighing the pros and cons, with no commitment or plan yet.
- Preparation
- Intends to act soon and has started planning, in the smoking example within about the next 30 days.
- Action
- The person is actively changing the behaviour, which in the smoking example means up to six months of quitting successfully.
- Maintenance
- Sustaining an established change and preventing relapse.
- Relapse
- A slip back to the old behaviour, after which the person can re-enter the cycle at an earlier stage.
Exam traps
- Someone with no intention to change is not in contemplation, which means thinking about change, and setting a quit date with an action plan is matched to a person who is ready to act.
- Relapse prevention is for people who have already changed, so it does not belong with preparation, where the person intends to act soon and has begun planning.
- Going back to the old behaviour after an attempt to change is relapse, which is not a stage of making a change, although the person can then go back into the cycle at an earlier stage.
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