The 5 Stages of Change

Educating my clients on the Stages of Change is an important building block of my working relationships with them, especially because my clients’ success in completing the program is heavily dependent on their willingness and ability to change. Below are examples of how I describe each stage to my clients and examples of how they can be reflected in a client’s engagement.

1. Precontemplation: This stage is marked by a lack awareness that a behavior is harmful and that there is a need for change. There is no awareness of how their behaviors are impacting them and the people around them, and an absence of intention on changing behavior.
Ex: A youth is referred for counseling after being arrested for possession of marijuana. This is their fourth arrest, they’re on probation, and during your assessment the youth reports that they have no issues.

2. Contemplation: Is often triggered by an event/consequence that makes us reflect on the impact a behavior is having on our functioning. In this stage we beacon aware that there is a problem, however no commitment is made to take action.
Ex: Youth comes in for session, reports that they are tired of going to the tent (detention), and that they want to get off of probation. Youth reports “I don’t know” when asked what steps they need/are willing to take towards staying out of detention. May also not show up for session and/or continue to catch new charges.

3. Preparation: This is the planning stage. In this stage a client is likely able to identify the steps needed to bring them closer to where they want to be. In this stage one is intentional about taking action steps towards addressing the problem. Goal objective development is an example of what this may look like – I find it helpful to ask, “What are some of the things that you would need to do more of in order to meet your goal?”
Ex: Youth reports that they have decided to show up for session today because if they complete counseling, they will be closer to getting off of probation. Youth reports that in order to avoid detention they must attend school, not hang around certain friends, follow their curfew, go to counseling and learn how to not argue with their parent.

4. Action: This stage is marked by active modification of behavior, or as I would tell my kids, “You are doing the work.” The action steps/objectives identified in the preparation stage are being put into practice.
Ex: Youth has had no absences from school and no new arrests in the last 30 days. Youth’s mother reports that they are home by curfew 5 out of 7 days a week (was 2 out of 7 at intake) and that they have completed a majority of their community service hours required by probation. Youth reports that they continue to struggle with temptation, however remains motivated to complete the program.

5. Maintenance: By this stage, the new behavior has replaced the old and there is sustained change.
Ex: Youth has completed 10 consecutive counseling sessions and has had no rearrests or probation violations in the last 60 days. Mother reports noticed change in youth’s attitude, has no complaints.

6. Relapse: Occurs when we fall back into old patterns of behavior that present as barriers to the change we want to make. Relapse can occur in any stage, and the goal is to learn from each relapse and continue progression through the stage you’re in.
Ex: Youth misses curfew and is picked up on a Violation of Probation (VOP). Youth spends one night in detention and returns to school, resumes counseling and completes remaining community service hours.

I typically provide this education and awareness building during the treatment planning stage. We work to identify a goal and then to identify problems that they are hoping to be alleviated by them meeting this goal. Educating my kids  on what the stages of change are and then guiding them towards identifying where they are in the cycle has been helpful with exploring barriers to their ability to make change, and with developing goal objectives to be addressed in treatment. I find that this helps with normalizing the challenges that come with making any behavior change (CHANGE IS NOT EASY, but gets more comfortable with time and practice), and I often find that my kids feel increasingly empowered to do the work when this is done.

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