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Stages of Change

Precontemplation
(Not changing in foreseeable future)
Goal for Intervention: Encourage and assist clients to learn more about their health and understand more about their particular health risks

Client Profile
Timeline: Client not intending to change behaviour in foreseeable future.

  • pros for continuing behaviour outweigh cons
  • awareness of risks may be incomplete, inaccurate or vague
  • client may not believe the consequences are serious or will affect him/her
  • client likely not thinking much about this lifestyle behaviour

Intervention

  • advise about your caring concern as a health professional
  • use this opportunity to begin a supportive interaction
  • increase awareness of particular risks
  • encourage critical thinking about current behaviour including what is liked and not liked about it
  • foster belief that people are able to change behaviours
  • provide resource(s)

Contemplation
(Intending to change in next 6 months)

Goal for Intervention: Assist clients to examine the pros and cons of changing and to have the confidence to try for change

Client Profile
Timeline: Client intending to change behaviour in the next 6 months.

  • decisional balance changing - pros beginning to outweigh cons
  • may lack confidence in ability to change
  • looking for information

 Intervention

  • provide information
  • emphasize benefits of changing behaviour
  • assist client to talk about reasons for wanting to change
  • assist client to examine concerns and barriers to change
  • gently offer possible solutions that have worked for others
  • foster a positive belief in ability to change
  • provide resource(s)

Preparation
(Planning to change in next 4 weeks)

Goal for Intervention: Assist clients to replace one behaviour with another based upon personal experience.

Client Profile
Timeline:Client planning to take action in next 4 weeks.

  • pros for changing behaviour outweigh the cons
  • may have anxiety about failing to change or staying with it

Intervention

  • assist client to verbalize a plan which includes a specific start date
  • encourage client to consider family or peer support
  • discuss what has worked and not worked in the past
  • encourage client to avoid, change or remove cues that trigger the risk behaviour
  • normalize relapse as part of the process – relapse is a learning experience
  • focus on benefit most meaningful to client
  • encourage client’s efforts
  • provide resource(s)

Action
(In the process of changing for less than 6 months)

Goal for Intervention: Assist clients to set and meet daily goals .

Client Profile
Timeline:Client is in the process of changing or has changed a behaviour in past 6 months.

  • new behaviour being incorporated into lifestyle
  • changes may be increasing stress levels
  • concerns about relapse fluctuate

 Intervention

  • compliment client’s accomplishments and decision to change
  • encourage client to reward self
  • emphasize benefits
  • encourage identification of what worked and plans to deal with temptations or barriers
  • promote self-confidence
  • normalize relapse as part of the process – relapse is a learning experience
  • provide resource(s)

Maintenance
(Has changed for 6 months or longer)

Goal for Intervention: Assist clients to retain the new behaviour.

Client Profile
Timeline: Client has maintained change from 6 months to 5 years.

  • healthy behaviour incorporated into lifestyle
  • enjoying benefits of healthier lifestyle

 Intervention

  • support feelings of accomplishment
  • encourage ongoing awareness of triggers and pitfalls
  • emphasize the importance of continuing to reward self

Relapse
(Risk behaviour resumed)

Goal for Intervention:Assist clients to see relapse as a normal part of the change process.

Client Profile
Timelines:Client has resumed risk behaviour and may be in precontemplation, contemplation or preparation.

  • losing benefits of the healthier lifestyle
  • disappointed in self or frustrated by barriers

 Intervention

  • normalize relapse as part of the process of change
  • emphasize benefits that were gained
  • identify and discuss reasons for relapse and counter strategies for next try
  • reassess client’s current stage of change and intervene accordingly at next contact

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