Using Prochaska’s Stages of Change

You are not ignorant.

Health information appears daily in the media nationwide. You’d have to be living in a closet not to know what’s good for you. For most of us, ignorance isn’t the problem. So if we know what to do, why don’t we do it? The apostle Paul knew this struggle: “For what I am doing, I do not understand. For what I will to do, that I do not practice; but what I hate, that I do.” (Romans 7:15)

“There are individuals whose minds are prepared to recognize the importance of things that unprepared minds ignore or throw away,” say James Prochaska, John Norcross and Carlo DiClemente in their book Changing for Good. These researchers uncovered a predictable pattern of change by studying thousands of individuals who changed successfully.

Successful “self-changers” followed this pattern whether they overcame smoking, depression, low self-esteem, or obesity. Precontemplators typically deny their problem and resist change. Contemplators acknowledge their problem and, though perhaps not ready to act, know what overcoming it will take. When they begin to contemplate the solution rather than the problem, they progress into preparation, intending to act within the next month. The action stage begins when they make the move they’ve prepared for. However, without maintenance, relapses to contemplation or precontemplation often occur. A maintenance plan is crucial to long-term success. Finally, successful maintenance leads to termination: the problem is solved when they have reached the criteria that eliminate risk (i.e., smoking cessation, ideal body weight, or cholesterol below 200).

This six-stage program offers hope to previously unsuccessful self-changers. Prochaska and his associates also discovered distinct processes used during each stage, giving the self-changer control over the cycle of change: Learn what stage you are in and apply the appropriate processes for that stage. It’s not about having the willpower to say “no”; it’s about making use of every available tool. Even those who aren’t ready to act can begin the process.

How does this research relate to health? People who feel they have tried everything without success often resign themselves to “fate”. Others believe their health is pre-determined by genetics, and their actions don’t matter. But this concept is not Biblical. “Do not be deceived, God is not mocked; for whatever a man sows, that he will also reap.” Galatians 6:7 Thousands of studies reveal the link between our choices and our health. Heredity loads the gun, lifestyle pulls the trigger! The leading causes of death in America are lifestyle-related. These and many other diseases can be prevented, even reversed, through nutritional excellence and regular exercise.

Your first step is to assess what stage you’re in.

1.      Did you solve your problem more than six months ago?

2.      Did you take action on your problem within the past six months?

3.      Do you intend to take action in the next month?

4.      Do you intend to take action in the next six months?

Precontemplators answer no to all four questions. Contemplators answer yes only to question 4. People in the preparation stage answer yes to 3 and 4. Those in the action stage answer yes to 2, and those in maintenance answer yes to question 1.

Next apply the appropriate processes. Precontemplators and contemplators use consciousness-raising to recognize their problem and learn more about the topic. What risks does your behavior entail? How have others overcome a similar problem?

Precontemplators begin using social liberation and continue through the action stage. Social liberation involves modifying your environment to facilitate change. For example, instituting a no-smoking area at home or work.

Emotional arousal and self-reevaluation are employed during contemplation and preparation. Emotional arousal may be a sudden emotional experience surrounding your problem, alerting you to your defenses against change. Self-reevaluation involves careful analysis of your problem. What might life be like if you overcame it? Does your behavior conflict with your values?

Commitment begins in preparation and must be maintained through action and maintenance. Commitment involves stating, privately and publicly, that you are choosing to change. Doing so acknowledges that you, not your circumstances or other people, are responsible for your behavior.

Use rewards during action and maintenance to recognize your hard work! Rewards can be simply self-praise, or a purchase made with money you might otherwise have spent on your problem behavior.

Countering, environment control, and helping relationships facilitate your change during action, maintenance and beyond. Countering substitutes new behaviors for the one you want to overcome. Environment control involves changing your environment to encourage healthy behaviors and discourage your problem behavior. Self-change does not preclude the encouragement and nurturing of a support system. Whether they be your family, friends, church or a formal support group, helping relationships are vital to your success.

Whatever your goals—lose weight, exercise regularly, save money, or floss daily—you have more than “willpower”, you have the tools for success!

The Six Stages of Change Are

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Termination

Adapted from Changing For Good: A revolutionary six-stage program for overcoing bad habits and moving your life positively forward by James O. Prochaska, Ph.D., John C. Norcross, Ph.D., and Carlo C. DiClemente, Ph.D.