People seek out therapy for various reasons. Sometimes people are seeking to change something in their life or to learn coping skills and tools to deal with a particular issue. Sometimes they want a safe place to talk and process things without necessarily doing anything different. It is also not uncommon for people to come to therapy with the intent to change, but not quite be ready to embrace a different way of behaving. It can be challenging as a therapist to meet each client where they are at and to have patience with clients who may want to change, but aren’t quite ready yet. It can be difficult for anyone to watch someone they care about keep repeating unhelpful or even destructive behaviours.
A popular model in health psychology, the transtheoretical model (TTM) of change, offers an explanation as to why a behavior change sticks or is unsuccessful. The model suggests that people move through five different stages as they replace one habit or action with another. The stages are:
1) Precontemplation: During this first stage, an individual is not seriously considering change. They may avoid talking about their behaviors and may defend them to others if they are pressured to do something different. At this stage, the individual does not feel their behavior is a problem.
2) Contemplation: At this stage, an individual is more aware that their behavior may be problematic, but is still hesitant to change it. They often go back and forth with the pros and cons of changing their behavior and some people may never progress past this stage.
3) Preparation: This stage is the turning point, with an individual making a commitment to change. This stage often includes research to find various resources that might be useful to facilitate change. Some people may try to skip this stage and are often setback as they are not adequately prepared to do something different.
4) Action: The individual is actively taking steps to change their behavior. This stage lasts up to six months before moving to;
5) Maintenance: In the last stage, individuals are working to prevent going back to their old behaviors. They are feeling more confident in their changed ways and are less likely to be tempted or fall back into old habits.
People can move back and forth through the stages before successfully sticking with a new behavior. Having a relapse doesn’t mean an individual isn’t working towards change, it is simply a setback that needs to be addressed and managed. It doesn’t discount the positive work that has already happened. While we may want someone to go through the stages of change, if an individual is stuck in the first stage, we can offer support and patience as it will be up to them to move through the stages.