Stages of Change – Transtheoretical Model

As a social worker, it is important to be aware of the process through which your clients may go as you build your relationship and help them achieve their goals. Every client has unique experiences, personalities, and circumstances. Learn more about transtheoretical model.

However, Prochaska and DiClemente (1983) determined a generalized cycle of change that most clients go through regardless of the presenting problem(s). Being knowledgeable on which stage your client may be in will best equip you to utilize the tools and techniques that work most efficiently within each stage.

However, knowing this cycle will also help you remain self-aware as the process of change may take education, patience, and perseverance.

The overall goal is to help your client change their behavior and/or achieve their goals.

Originally this was a study conducted in relation to smoking cessation; but, over years of research, it was determined that this cycle is found to be common with a wide variety of behaviors.

Related Reading: How Cognitive Behavioral Therapy is Used in Social Work

Stages

Pre-Contemplation

  • Reluctance: not wanting to consider change, potentially due to a lack of knowledge
  • Rebellion: “don’t tell me what to do” attitude
  • Resignation: overwhelmed by the problem
  • Rationalization: intellectualizing the problem

Contemplation

  • Paradoxical phrasing: “I want it … I don’t want it that bad”
  • Ambivalence can make contemplation chronic
  • Very frustrating phrase
  • What will the payoff be for change?

Preparation/Commitment

  • Commitment to action
  • Deciding to take the action necessary to make a change
  • Ambivalence begins to melt away but is not totally removed

Action

  • Implementation of the plan
  • Participating in the development of the treatment plan
  • Taking ownership of the “problem”
  • Taking action to resolve the identified problem

Maintenance, Relapse, Recycling

  • Last phase of a successful change
  • Continuing to develop new behavior
  • Risk of relapsing or recycling into old behavior
  • Utilization of relapse prevention techniques can be very helpful

Exit

  • Termination of counseling

Techniques

The first step is being educated and aware enough to identify the stage that your client is in. Once you are able to do this, there are certain techniques you can implement that are most successful within each stage. For the

For the Pre-contemplation stage techniques such as validating the lack of readiness, clarifying that the decision is theirs, encouraging your client to re-evaluate their current behavior and to utilize self-exploration and explaining and personalizing the risk are all useful tools. For the

Social Worker Transtheoretical ModelFor the Contemplation stage, you can validate the lack of readiness, clarify the decision is theirs, encourage your client to evaluate the pros and cons of the behavior change and identify and promote new, positive outcome expectations. For the

For the Preparation/Commitment stage, identify and assist in problem-solving, help the client identify social support, verify that the client already has underlying skills for the behavior change and encourage the small, initial steps.

In the Action stage you can focus on restructuring cues and social support, bolster self-efficacy for dealing with obstacles, combat feelings of loss and reiterate long-term benefits. Finally, for the

Finally, for the Maintenance/Relapse/Recycle stage you can plan for follow-up support, reinforce internal rewards, discuss coping with relapse, evaluate triggers for a relapse, reassess motivation and barriers and, if needed, plan stronger coping strategies.

 

 

Sources:

  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992, September). In Search of How People Change. American Psychologist, 47(9), 1102-1114.
  • Prochaska, J. O., & Velicer, W. F. (1997, May 05). The Transtheoretical Model of Health Behavior. The Science of Health Promotion, 12(1), 38-48.
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Social Worker: Stages of Change – Transtheoretical Model
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Social Worker: Stages of Change – Transtheoretical Model
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As a social worker, it is important to be aware of the process through which your clients may go as you build your relationship and help them achieve their goals. Every client has unique experiences, personalities, and circumstances. Learn more about transtheoretical model.
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