Skip Navigation
Text Size:
Share/Bookmark

Training

Motivational Interviewing and the Stages of Change

People go through a series of stages when they change health behavior. The stages are cognitive and behavioral. In the early phases, people tend to focus on thinking about change-whether change is something they need to consider. In later stages, people are actively doing things to change or maintaining the changes that they have been able to make.

The Stages of Change Model has five phases:

  • Pre-contemplation: Avoidance. That is, not seeing a problem behavior or not considering change.
  • Contemplation: Acknowledging that there is a problem but struggling with ambivalence. Weighing pros and cons and the benefits and barriers to change.
  • Preparation/Determination: Taking steps and getting ready to change.
  • Action/Willpower: Making the change and living the new behaviors, which is an all-consuming activity.
  • Maintenance: Maintaining the behavior change that is now integrated into the person's life.

The Stages of Change Model describes five stages of readiness and provides a framework for understanding the change process. By identifying where a person is in the change cycle, interventions can be tailored to the individual's "readiness" to progress in the recovery process. Interventions that do not match the person's readiness are less likely to succeed and more likely to damage rapport, create resistance, and impede change. Anything that moves a person through the stages toward a positive outcome should be regarded as a success.

Motivation is multidimensional.

Motivation is multidimensional and not easily assessed. In addition to readiness to change, practitioners should also consider the key factors of "importance" and "self-efficacy." Importance is determined by what value a person places on making the change. Self-efficacy is the belief or confidence in one's ability to achieve change.

When individuals think that change is beyond their capabilities, they may not try. People who are high on importance but low on confidence need encouragement that change is possible. They also need specific ideas about how to do it. This approach promotes engagement and allows greater self-efficiency and identifies the person's greatest needs and goals.


Resources and Links

  • This review article summarizes Prochaska and DiClemente's work on TTM, including core constructs, processes and stages of change, decisional balance, self-efficacy and temptation, and model applications. A practical one-page cheat sheet.

  • This review article summarizes Prochaska and DiClemente's work on TTM, including core constructs, processes and stages of change, decisional balance, self-efficacy and temptation, and model applications. A practical one-page cheat sheet.

  • This free two-part Webinar discusses the characteristics of the Stages of Change model, which is commonly used when working with individuals with co-occurring disorders.