Stages of change Prochaska/ DiClemente (addiction) model and Elisabeth Kübler-Ross model (grief).

1. Stages of Change
“Change can be made by you or made to you.”
Gavin Webber
LUCIA MERINO, LCSW
NOVEMBER 2012

2. Stages of Change:
DiClemente and Prochaska Model
Pre-contemplation:
Not aware. Can’t see the problem.
Contemplation:
Problem acknowledgment.
Thinking about changing.
No specific plans in place.
Preparation:
Focus on solution (vs. problem) and future
(vs. past). Small behavioral changes.
Action:
Observable behavioral changes
Maintenance:
Old behavior is still a temptation (possible
relapse).

3. Pre-contemplation
Characteristics:
 The person is not even considering changing. They
may be "in denial" about their problem, or not
consider it serious. They may have tried
unsuccessfully to change so many times that they
have given up.
Strategies:
 Education on risks versus benefits and positive
outcomes related to change

4. Contemplation
Characteristics:
 The person is ambivalent about changing. During
this stage, the person weighs benefits versus costs or
barriers (e.g., time, expense, bother, fear, loneliness).
Strategies:
 Identify barriers and misconceptions
 Address concerns
 Identify support systems

5. Preparation
Characteristics:
 The person is prepared to experiment with small
changes.
Strategies:
 Develop realistic goals and timeline for change
 Provide positive reinforcement

6. Action
Characteristics:
 The person takes definitive action to change
behavior.
Strategies:
 Provide positive reinforcement

7. Maintenance & Relapse Prevention
Characteristics:
 The person strives to maintain the new behavior over
the long term.
Strategies:
 Provide encouragement and support

8. Seven Stages of Change
Elisabeth Kübler-Ross Model

9. Shock
 This reaction is usually
immediate and it can be
within a few hours of
getting the news of the
need for a change. Even
if you have planned this
change, the fact that it is
actually upon you will
give you a strange feeling
of disorientation. This
stage will last longer if it
is unexpected.

10. Disbelief/Denial
 You have usually managed
to get back to everyday life
at this
point. Intellectually, you
know that the change has
happened and what may
happen, however
emotionally, you may block
out the new reality from
daily life. You will
probably be processing this
new reality in your sub-
conscious mind. Cognitive
Dissonance usually occurs
at this stage, and you are
more likely to get stuck in
this phase if you are change
resistant.

11. Self Doubt
 This is a very  You may doubt as to
uncomfortable stage. Old whether you have made the
habits and beliefs are no right decision or whether
longer relevant, as are you are up for the job. You
some of the things that also may want to seek
used to be important to isolation to mull it over
you. Your sense of identity further, and at the same
will be shattered. You feel time feel unmotivated.
a sense of nothingness until
you develop a new way of
'being'. Your confidence
will be low, and you may be
fearful of the
future, become
angry, depressed, and have
an overwhelming sense of
guilt.

12. Acceptance
 You have come to the decision
to accept the change and face
the future. By letting go of
the past reality, the pain goes
away and finding your new
way of being becomes exciting
and a challenge rather than a
loss. Your energy levels will
be going up, as this stage
usually begins just after rock
bottom on the emotional
scale. You still might not
know what you are going to
do, but at least you know that
your reality has changed.

13. Experimentation
 You try something new from
the new paradigm, but don't
be surprised if you can't stick
to the plan. You could be all
over the place, trying little
changes to fit with your new
reality. You will still be
working it out in your
mind, however your energy
levels continue to rise. Try
little things before attempting
any major change at this
stage, because you may slip
back to self-doubt if a large
experiment goes pear shaped.

14. Search for Meaning
 When you have embarked
on your journey towards
your new reality, you may
start to appraise where you
were before the change
occurred, what has
happened since, and
why. You will begin to fit
your experience into your
"life story" and re-examine
your view of yourself and
the world around you. You
will start to make sense of
it all.

15. Integration
 At the end of the change
process, and all being
well, you will be
comfortable, confident, a
nd a feeling that you
belong or are seeking
belonging in your new
way of life.

16. And remember that:
“Change can be made by you or made to you.”

17. Where are you in your process of change?

18. Sources
 http://www.thepursuitofsassiness.com/2012/02/06
/stages-of-change/
 http://www.greeningofgavin.com/2012/07/the-
seven-stages-of-change.html
 http://www.adultmeducation.com/FacilitatingBehav
iorChange.html