3 minute read
Mental Health Corner
Stages of Change
By Rabbi Azriel Hauptman
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As human beings, we all have behaviors that we would like to change. This can range from unhealthy habits to full-blown addictions. Researchers have theorized that there are different stages of change, and that the proper intervention for someone who needs to change depends on what stage of change they are presently in.
In this model, there are five stages of change: precontemplation, contemplation, preparation, action, and maintenance. (There is a sixth stage called relapse which we will discuss later.)
• Precontemplation – People in the precontemplation stage are either in denial of their problem, or they believe that the benefits of change are not worth the effort. They are not even thinking about the possibility of developing a plan of action. • Contemplation – During this stage there is recognition that there is a problem and that it would be worthwhile to develop a plan to change, but they have not yet taking any steps towards developing a plan. This stage can last a very long time,
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and sometimes people will be stuck in this stage for years. • Preparation – In the preparation stage, there is a clear intention to develop a concrete plan in the very near future and usually some baby steps have been taken towards the development of a comprehensive goal. For example, the addict has contacted a therapist and gathered information about support groups and has even refrained a couple of times from engaging in the harmful behavior. • Action – This is the stage where real change begins. There is a comprehensive plan in place and that plan is being followed. Since the plan is new, it is not yet a natural part of one’s life. • Maintenance – The comprehensive plan has been followed and observed for an extended period of time and the new behavior feels more like a natural part of one’s life. • Termination – The change is such an ingrained part of one’s new life that there is no temptation or fear that one will return to the old behaviors. This stage of change is not always achievable.
There is another part of this model and that is relapse. When one has a relapse, he falls off of the action or maintenance stage and returns back to one of the earlier stages of change. The relapse might merely put him back in the preparation stage, but, unfortunately, sometimes relapse can bring someone all the way back to the precontemplation stage.
When working with someone who needs to change, it is very important to recognize what stage the person is in. What you would say to someone in the contemplation stage is very different than what you would tell someone in the action stage.
Here is an overview of the differences in intervention between the various stages of change. The reality of addiction intervention is much more complicated than this, and these examples are just for illustrative purposes.
In the precontemplation stage, since their problem is often the inability to see the benefits of change, the intervention can possibly include guidance into the proper way how to make a risk-benefit analysis and teaching them how to properly recognize the harm that they are causing their family and friends. In contemplation, since they are already weighing the pros and cons of change but have not yet committed to “taking the plunge”, intervention can include support in seeing even more clearly the benefits of change, pointing out the discrepancy between what they want to be and what they are actually doing, and instilling hope that change is possible. During the preparation stage, intervention would include developing a comprehensive plan, setting attainable goals, and encouraging the decision to make a change. In the action stage, people need reinforcement and to be shown the positive aspects to the change that have already occurred. In the maintenance stage, there is a major focus on strategies of relapse prevention.
Change is very difficult and painful. But not changing is even more painful. Essentially, every test that Hashem sends us boils down to whether we can actualize the recognition about the importance of change.
