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Writer's pictureCarolyn Cutillo

Insider’s Look at Therapy: The Stages of Change

Updated: Jan 19


You might come into therapy because you think you want to work on one thing, but another underlying issue rises to the surface. Or you might know you want to change something about yourself, you’ve committed to working on that change, but you could use a little support. Or you might be somewhere in between.


Psychologist James Prochaska developed a model called the Stages of Change, which therapists use to inform how to best support a client based on where the client is on their change journey right now. Interested in what got smokers to quit smoking, Prochaska found that there are five stages that people go through in making a behavioral change:


There’s Precontemplation, where people do not intend to take action in the foreseeable future (measured as the next 6 months). They are not ready to change yet, but maybe have heard from loved ones that they should “quit smoking already!” Etc.


Then there’s Contemplation, where people are intending to make the change in the foreseeable future. They’re getting ready, weighing the pros and cons of making the healthy behavior happen. When the pros win…


Preparation is the next stage, in which people intend to change in the immediate future (the next month). For instance, they’ve bought the workout clothes and the gym membership, but haven’t made it to the gym yet. But they’re ready.


Action comes next, where people have made specific, overt modifications in their lifestyle (within the past 6 months). This is the doing of the thing.


And Maintenance is the stage in which people have made the modifications and are working to prevent relapse (about 6 months to 5 years later). This is where working on the change becomes less active and more habitual.


If there is no question of going back to the old ways, then they’re off the charts—they’ve reached Termination.


Ask yourself: “what are the patterns I want to change in myself, and which stage am I in for each of them? What could help boost me into the next stage?”


If you’re contemplating a change and don’t know how to proceed, tell your therapist about it. She can help guide you in a way that doesn’t push you into action before you’re ready. Ultimately, whether or not you change (and how) is up to no one else but you!


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