It’s All About Change

By Eric Dean JD, MBA, MA, MA, LPC, CADC

Change is hard, especially for habits and activities with which we are deeply familiar. Even when we are sure that change would be beneficial, the comfort and safety of familiarity can outweigh any of those perceived positive effects. Sustaining motivation to change is also difficult. For example, if I wanted to start exercising regularly, I may do so for a few weeks and then lose motivation to continue that behavior. Thus, there is a three-step process of first identifying the change you would like to make, implementing the change, and then maintaining it.

In the 1970’s James Prochaska and Carlo Di Clemente created a widely used model that describes stages for an individual’s motivation to change. There are 5 stages:

1. 1. Precontemplation – People in this stage are not thinking about change or are strongly against it
   2. Contemplation – People in this stage are “on the fence” or ambivalent about making change. They may identify their current behavior as unhealthy, but also have reasons for not changing it. If you broke it down to a percentage, they are 50/50.
   3. Preparation – People in this stage start taking small steps to make change. There may be still be some trepidation, but they decide to proceed slowly. 
   4. Action – People in this stage have implemented the change.
   5. Maintenance – People in this stage have sustained the change for at least 6 months and plan to continue doing so.
   6. Relapse – This is a return to the old behavior after a period of stopping. 

Not everyone will pass through the all the stages.  

I am going to take you through an example of what each stage could look like for someone who is struggling with alcohol abuse:

• The person, despite numerous negative consequences from drinking, does not want to stop drinking and/or does not think they have a problem. 

• The person has started to reflect on things that happened while they are drinking and can identify reasons to stop. However, they have been drinking consistently for a decade and it is what they are familiar and comfortable with, even with negative consequences. 

• The person has started to take steps to get help. Perhaps they have done online research or called to make an appointment with a counselor.

• The person is actively engaged in the therapy process for 6 months.

• The person continues to apply what they learn in therapy to sustaining this change. The person continues to build an environment and lifestyle that are conducive to this change.

• After 9 months of not drinking, the person drinks heavily over the course of the weekend. 

After the person relapses, they may return to the contemplation stage – perhaps losing motivation to change after the relapse. They could return to the preparation stage by immediately reaching out to various resources to set up appointments. They could also return to action stage by being honest with their counselor about what happened and making appropriate changes. Perhaps their motivation to stop drinking increased after the relapse – they had a reminder of what they do not want to go back to. Not everyone’s change process will include relapse, but if it does happen you are not starting over.

This model gives you a tool to analyze where you or others are in the change process. Of course, you may be in different stages for different behaviors. For example, someone may be in the preparation stage for abstaining from alcohol, the contemplation stage for beginning to exercise, and the action stage for being faithful to their significant other. 

If you are unsuccessful with making the change at first, that is okay. You can use this experience as a learning opportunity to come up with a new plan. You have not lost what you gained when you tried the first time, so do not give up.