A Brief Overview of the Stages of Changes

and How to Move to the Next Stage

Stage 1: Precontemplation (Not Ready)

Clients at this stage do not intend to change behaviors within the next six months, and dont
want to change or are not aware of the potential benefits of change. They may think change is
too hard, may not think change will help, or do not fully understand the effect of their behaviors
on others.
To help move client to the next stage:
1. Use Influential Questions to help motivate
2. Help them increase their awareness of how decisions they make effect self and others.
3. Help them process the pros and cons of their life decisions.
Therapeutic Stance and Interventions: Accept client where they are, provide concrete care,
exercise good engagement skills, build trust, rapport, and consistency with client.

Stage 2: Contemplation (Getting Ready)

Clients at this stage, intend to change behaviors within the next 6 months. They are often
ambivalent about the pros and cons of change causing them to lose motivation, avoid thinking
about or taking action, or procrastinate making changes.
To move to the next stage:
1. Use Influential Questions to help motivate
2. Help clients explore the kind of person they could be if they changed and look for
healthy models
3. Increase the pros and reduce the cons of behavior change
Therapeutic Stance and Interventions: Motivational Interviewing, raise ambivalence, positive
reinforcement for movement towards change, instilling hope.

Stage 3: Preparation (Ready to Take Action)

Clients at this stage are ready to take action within the next 30 days. They often worry they will
fail, so hesitate to tell others about their change just in case they arent successful. They need
to have a clear plan with contingencies for when habit kicks in.
To move to the next stage:
1. Use Influential Questions to help motivate
2. Help clients create a written plan that anticipates contingencies and includes support
people
3. Use good counseling techniques already in your toolbox to address and resolve
concerns
4. Create increased accountab ility until the client feels more familiar with the change
Therapeutic Stance and Interventions: Encourage small, concrete steps, problem solve
obstacles, build skills
Stage 4: Action (Taking Action)
At this stage clients have changed their behavior within the last 6 months and continue to be
aware of old habits and behaviors vs. the new ones they are developing. They need ongoing
support to perpetuate these changes.
To move to the next stage:
1. Use Influential Questions to help motivate
2. Help and support clients through the change process in the ways that best work for
them
3. Continue to evaluate and/or create other behaviors to substitute for the unhealthy ones
4. Help clients look for triggers for the unhealthy behavior and avoid them
Therapeutic Stance and Interventions: Help client process loss and change, emphasize the
long-term benefits of their change, teach self-monitoring and self-soothing techniques, focus
on the big picture.
Stage 5: Maintenance (Monitor Actions)
Clients have changed their behavior for 6 months or more. Recovery literature informs us that
it takes five years for clients to incorporate change to the point that their relapse rate drops to
15% (compared to 50% at two years). The skills clients developed in the first four stages are
needed in this stage, especially an awareness of situations that may trigger former unhealthy
behaviors with a contingency plan should this occur.
Therapeutic Stance and Interventions: Continue offering support, process concerns, proactive
relapse prevention.