The stages of change model of behavior change includes six well-defined stages that people move through as they work to change a target behavior. It is important to determine what stage you are in now so that you can choose appropriate techniques for progressing through the cycle of change.

Target behavior/ problem:

Goal of behavior change:


Examples of target behaviors include smoking, eating candy bars every afternoon, and never wearing a safety belt; the goal of your behavior change program might be quitting smoking, eating only one candy bar per week, or wearing a safety belt every time you are a driver or passenger in a car.


Part I. Assess Your Stage

To determine your stage, select true or false for each of the following statements:

1. I changed my target behavior more than 6 months ago.
2. I changed my target behavior within the past 6 months.
3. I intend to take action in the next month and have already made a few small changes in my behavior.
4. I intend to take action on my target behavior in the next 6 months.

Find the stage that corresponds to your responses:
False for all four statements = Precontemplation
True for statement 4, false for statements 1-3 = Contemplation
True for statements 3 and 4, false for statements 1 and 2 = Preparation
True for statement 2, false for statement 1 = Action
True for statement 1 = Maintenance


Part II. Strategies for Change

To help you move forward in the cycle of change, try the techniques and strategies listed below for your stage. (You may find it helpful to work through the strategies for all the stages.) Put a check next to any strategy that you complete.

Precontemplation

Investigate your target behavior—make a list of the ways it affects you now and how it may affect you in the future:
 
Become aware of the mental defenses you use to resist change; examples of defenses include denying the consequences of your target behavior and rationalizing your reasons for not changing. List some of the key mental defense mechanisms that you use to resist change:
 
Enlist friends and family members to help you learn more about your target behavior and the defenses that block your progress. List the people you have spoken with, and briefly describe what they told you about the defense mechanisms you use:
 
Identify and list community resources that can help you change your target behavior—for example, a stop-smoking course or a stress-management workshop:
 

Contemplation

Engage your emotions through strategies such as imagining your life without changing, watching movies related to your target behavior, and becoming more aware of the current effects of your target behavior (for example, blow cigarette smoke or spit tobacco juice into a white handkerchief, have someone videotape you while you are drunk or hung over, or make a pile of the amount of candy or junk food you eat in a month). List the strategies you tried:
 
Keep a journal of your target behavior to establish a baseline. Examine the behaviors that lead up to and follow your target behavior (see Wellness Worksheet 4).
Complete a cost-benefit analysis of your target behavior:
 
Pros of current behavior: Cons of current behavior:
Pros of changing: Cons of changing:
Create a new self-image: imagine yourself and your life after you change your target behavior:
 
Enlist the help of friends and family members to support your efforts and help you identify the causes and consequences of your target behavior. List the people you've spoken with, and briefly describe what they told you about your target behavior:
 

Preparation

Make change a priority in your life; plan to commit the necessary time and effort to change.
Create a specific plan for change, and complete a contract (see Wellness Worksheet 5).
Tell the people in your life about the change you'll be making, and enlist their help. List the people you've spoken with and how they will help in your program for change:
 

Action

See Chapter 1 in your text for a detailed discussion of strategies for the action stage of change.
Use a journal to monitor your behavior.
Substitute healthier responses for your problem behavior. Complete Wellness Worksheet 4 to help you identify ways to break the chain of events that leads to your target behavior.
Manage your stress level, and don't let yourself get overwhelmed. (See Chapter 2 in your text for a detailed discussion of stress-management techniques.) List three strategies you'll use to help manage stress during your behavior change program:
 
Practice positive, realistic self-talk (see Chapter 3 in your text).
Make changes in your environment that will discourage your target behavior and encourage healthier choices. Identify cues that trigger your target behavior and develop strategies for avoiding them or making different choices (complete Wellness Worksheet 4).
Give yourself the rewards you named in your contract (Wellness Worksheet 5) as well as plenty of self-praise.
Involve the people around you. Find a buddy to work with you on change and/or find a role model who has already made the change you are working toward and who can provide both inspiration and practical advice.
 
Buddy:
Role model:
Keep a positive attitude about yourself and the change you are attempting. Don't get discouraged—the action stage typically lasts for at least several months.

Maintenance

Continue with all the positive strategies you used in the action stage.
Continue to monitor your behavior with a journal.
Continue to manage your environment.
Continue to practice realistic self-talk.
Guard against slips, but don't let a slip set you back. Be prepared for complications.
Help someone else make the change that you have just made. (Person to help: .)

Termination

If you complete the previous five stages and are no longer tempted to lapse back to your target behavior, you are in the termination stage. You have a new self-image, positive feelings of self-efficacy, and a healthier lifestyle.

For more on the stages of change model and many additional practical strategies, see the text Changing for Good by James Prochaska, John Norcross, and Carlo DiClemente (Avon Books).

For additional general information and strategies for behavior change, complete the activities in the Behavior Change Workbook at the Core Concepts in Health Online Learning Center (http://www.mhhe.com/insel10e or http://www.mhhe.com/inselbrief10e).

SOURCE: Prochaska, J. O., J. C. Norcross, and C. C. DiClemente. 1994. Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward. New York: Avon Books.