Many professionals who help people with behaviour change will know it can be useful to target interventions according to what stage someone has reached on a model called ‘the wheel of change’. A 2011 study that looked at the results of multiple studies found that matching treatments to the client’s stage of change increased effectiveness.
The wheel of change was the brainchild of two authors, James Prochaska and Carlo de Clemente. Research has found that people tend to cycle through specific stages in the process of change. I’ll use the example of problem drinking to illustrate.
The first stage is pre-contemplation, i.e. the person who is not aware that they have a problem and no intention of changing. Others (partners, friends) are often aware of the extreme moods, hangovers and decreased work performance that drinking is causing. If you try to force someone in this stage to do something about their behaviour, you’re likely to encounter arguments or avoidance. But perhaps they might keep track of their drinking by writing down what they use and when and how they were feeling.
The next step is contemplation, where the person has awareness that their behaviour is a problem and is seriously considering the idea of changing their behaviour. However, at this point, the effort involved in changing can seem enormous. Strategies that may be useful include asking, “What do I need in order to be able to change?” Think about what’s most important to you (e.g., family, health). How does problem drinking affect it?
The next stage is preparation, where individuals are intending to take action and are in the planning stages of doing so. It might be that a problem drinker investigates which program they will commit to, with the idea of starting within the next month.
Action is the stage where individuals change their behaviour to overcome their problems, which requires time and energy. Attend a treatment program and avoid people and places that put you at risk.
People then move to the next stage, maintenance. This stage extends from six months to an unspecified period past the initial action. It is common for people to cycle through the stages of change multiple times. It’s important to recognise that this is normal and each time you go through the cycle, you are building more skills.
Dr Mary Grogan is a clinical psychologist.