Stage of Change

Characteristics

Techniques

Pre-contemplation

Not currently considering change: "Ignorance is bliss"

Validate lack of readiness

Clarify: decision is theirs

Encourage re-evaluation of current behavior

Encourage self-exploration, not action

Explain and personalize the risk

Contemplation

Ambivalent about change: "Sitting on the fence"

Not considering change within the next month

Validate lack of readiness

Clarify: decision is theirs

Encourage evaluation of pros and cons of behavior change

Identify and promote new, positive outcome expectations

Preparation

Some experience with change and are trying to change: "Testing the waters"

Planning to act within 1month

Identify and assist in problem solving re: obstacles

Help patient identify social support

Verify that patient has underlying skills for behavior change

Encourage small initial steps

Action

Practicing new behavior for

3-6 months

Focus on restructuring cues and social support

Bolster self-efficacy for dealing with obstacles

Combat feelings of loss and reiterate long-term benefits

Maintenance

Continued commitment to sustaining new behavior

Post-6 months to 5 years

Plan for follow-up support

Reinforce internal rewards

Discuss coping with relapse

Relapse

Resumption of old behaviors: "Fall from grace"

Evaluate trigger for relapse

Reassess motivation and barriers

Plan stronger coping strategies