Transtheoretical Model of Change

by Karen Kieffer *MA, USAWL 

Change is challenging. It is a gradual process that evolves over time and may take several attempts. Behavior and the process of change has been the subject of many studies and several theories. One theory, the Transtheoretical Model, divides the process of change into six unique stages that require different strategies for success.

Pre-contemplation stage: Not considering or wanting to change behavior. Typically, people in this stage deny having a problem and do not intend on initiating change unless pressured by others.
Strategy: Education is the most productive strategy. People may not understand how the behavior is negatively affecting their health and quality of life. Knowledge is power.

Contemplation stage: Although people in this are not quite ready for change, they acknowledge there is a problem and are seriously considering overcoming it.
Strategy: Education and peer support are very important at this stage. Creating a support system of friends and family to encourage, listen and motivate will be valuable, especially when self-motivation is low.

Preparation: In this stage, people are seriously considering and planning behavior changes within the next few months and may even engage in the new behavior for a short time.
Strategy: Strategies for this stage should focus on developing an action plan with specific objectives and completion dates, and creating a positive physical and emotional environment to support the new behaviors.

Action: In the action stage written objectives are followed and new behaviors are actively pursued. Relapse and regression are common in this stage.
Strategy: Don’t give up. Realize setbacks will happen and be aware of obstacles. Take this opportunity to recognize progress, acknowledge achievements, as well as re-evaluate action plan and refocus objectives.

Maintenance: Once the action stage has been maintained for six consecutive months, people move into the maintenance stage. During the maintenance stage, the new behavior continues to be sustained for up to five years.
Strategy: This stage requires continued adherence to specific objectives and reinforcement of accomplishments. People in this stage strive to prevent relapses.

Adoption: Once the new behavior has been maintained for more than five years, the behavior has been adopted. Many experts believe that at this stage compliance with the new behavior is no longer a challenge, and people successfully exit the cycle of change with out fear of relapse.


Karen Kieffer
Exercise Physiology Graduate student San Jose State University
FIT Personal Trainer

Reference:
Hoeger, Werner W.K., & Hoeger, Sharon. (2002). Behavior Modification. In
Lemons, April & Boyd, John (Eds), Principles and labs for fitness and wellness (pp. 32-35).
Ontario, Canada: Wadsworth/Thomson Learning.

Taylor, Barr C. & Miller, Nancy Houstion. (2001) Principles of health behavior change. In Darcy, Peter (Ed).
ACSM’s resource amnual for guidelines for exercise testing and prescription (4th ed.) (pp. 556-560).
Baltimore, Maryland: American college of sport medicine.