The stages of change model, also known as the Transtheoretical Model, is the model used to describe how behaviors are modified. The stages of change can be defined as the series of stages a person goes through to modify or eliminate problematic behaviors. Ultimately, this model focuses on people’s decision-making and intention to change. According to the stages of change, behavior change does not occur rapidly or easily. Instead, it is an ongoing process. The five stages of change are often used in health promotion and disease prevention and can be applied in any setting and by anyone. There are five stages of change, each with different strategies and interventions. Although progression to the next stage of change is the goal, it is not uncommon for a person to regress to a previous stage. There is no timeline for the stages of the change model. A person may spend more or less time in one stage than another. The five stages of change are pre-contemplation, contemplation, determination, action, and maintenance. The Stages of Change Model ( or Transtheoretical Model) explains an individual’s readiness to change behavior. It describes the process of behavior change as occurring in stages.
These stages include:
- Pre-contemplation: There is no intention of taking action. The first stage of the stages of change model is pre-contemplation. During this stage, a person has no intention of taking action or changing a behavior. The pre-contemplation stage is often characterized by denial and a lack of awareness of problematic behavior. The person may not be aware of the consequences related to the behavior or not see the behavior as a problem. A person may stay in the pre-contemplation stage due to the four R’s: rebellion, reluctance, resignation, and rationalization.
- Contemplation: There are intentions to take action and a plan to do so shortly. Contemplation is characterized by a person admitting there might be a problematic behavior that needs to change. Although the person may consider changing behavior, they have not yet committed to it. The contemplation stage can last several months or years due to conflicted emotions. A person may be aware of the benefits of changing behavior but also mindful of the barriers. Barriers may include time, money, or accessibility.
- Preparation (or determination): There is the intention to take action, and some steps have been taken. Determination is the third stage of the five stages of the change model. During this stage, a person admits to themselves that there is a problematic behavior they want to change. The person becomes determined to make the necessary changes and prepares to act within the next month. Preparation may include researching, seeking professional help, or developing an action plan. In addition, a person may seek support from family, friends, or a support group.
- Action: Behavior has been changed for a short period of time—the fourth stage of the stages of the change model. For the first time, a person admits openly that a problematic behavior needs to change. During this stage, the person has taken direct action to modify the problematic behavior, and changes become visible. The action stage generally lasts approximately 3 to 6 months.
- Maintenance: Behavior has been changed and maintained for the long term. The fifth stage of change is maintenance; during this stage, the person retains the changes they have made to their behavior. The person avoids engaging in the old behavior by reducing temptation or creating a plan to prevent relapse. It can be beneficial to reward oneself after avoiding temptation or relapse. While in the maintenance stage, the person continuously develops strategies to reduce or prevent relapse. The maintenance stage generally lasts six months to 5 years.
- Termination: There is no desire to return to prior negative behaviors. Termination occurs after the maintenance stage and refers to the person’s lack of desire to return to the old behavior. Termination may also refer to the ending of a therapist-patient relationship. This occurs because of the person’s ability to handle the maintenance stage independently.