Stages of Change Model

The Transtheoretical Model which also goes by the Stages of Change Model, was developed by psychologists James Prochaska and Carlo DiClemente in the 1970s. They observed multiple studies that examined smokers who decided to quit on their own and tried to understand why they were capable of quitting on their own accord. A key factor they discovered was that the decision to change a habitual behavior does not occur quickly. Instead, in order for a change in behaviour to occur, a process needs to take place.

The first stage is called Pre-contemplation which is when a patient is unaware or does not believe that there is a problem or may believe that there is a problem but is not considering changing it. The patient does not plan to make any changes pertaining this problem within the next 6 months. Patients usually focus more on the cons of addressing and changing this problem rather than the pros and long-term effects.

The next stage is Contemplation where the patient is ambivalent about recognizing a problem and shies away from changing it. They become motivated to address this problem within the next 6 months. Patients are also willing to see more pros in changing their behavior.

Once a patient is ready, they start the Preparation stage, where they are ready to make a change within the next 30 days and are beginning to take small steps. At this point, they also believe that making this change would lead to a more positive lifestyle.

Eventually, after about 6 months, a patient enters the Action stage where they take steps to implement the specific behavior changes. After 12 months from preparation, a patient enters the Maintenance stage, where the patient works to maintain and sustain their changed behaviour.

It is important to remember that this model is not linear nor is recovery. There will be trials and errors within the process so restarting the cycle should not be means for losing motivation. This is a lifestyle change. You cannot change something overnight that took years to build.


*Thank you to our intern Krystal Dujon-Riboul for her help with this blog post.

*Sources: Psychology today & Boston University School of Public Health

Wayne W. LaMorte, MD, PhD, MPH


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