Select your language

Suggested languages for you:
Log In Start studying!
StudySmarter - The all-in-one study app.
4.8 • +11k Ratings
More than 3 Million Downloads
Free
|
|

All-in-one learning app

  • Flashcards
  • NotesNotes
  • ExplanationsExplanations
  • Study Planner
  • Textbook solutions
Start studying

Six Stage Model of Behaviour Change

Save Save
Print Print
Edit Edit
Sign up to use all features for free. Sign up now
Six Stage Model of Behaviour Change

In 1983, Prochaska and DiClemente found smokers’ termination behaviour changes in stages. From this observation, they developed Prochaska and Dicemente’s stages of change model, a six-stage model of behaviour change. The model views quitting as a complex process that is not linear but involves switching back and forth between stages until reaching the end.

Two key findings influencing this model are:

  • Addicted people differ in how willing they are to change their addictive behaviour

  • Interventions vary in effectiveness depending on what stage the person has reached

Six Stage Model of Behavior Change, Drunk Addiction Six Stage Model Prochaska, StudySmarterDrunk addiction behaviours, freepik.com/vectorjuice

Prochaska’s six-stage model of behaviour change (transtheoretical model stages of change)

The following diagram illustrates Prochaska’s six-stage model of behaviour change, also known as the transtheoretical model (TTM) of the stages of change.

Six Stage Model of Behaviour Change, Prochaska's Six Stage Model of Behaviour Change, StudySmarter Prochaska’s Six Stage Model of Behaviour Change in Addiction, Tyler Smith, StudySmarter Originals

A person receives help and support from peers and professionals at each stage, which is crucial on the road to recovery.

In summary, Prochaska’s six-stage model of behaviour change includes the following stages:

  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Relapse

Prochaska and DiClemente’s stages of change model

As we discussed above, the model includes six stages. These six stages each have their characteristics and the type of support they receive depending on how far along they are in each stage. Let us look at the stages of change examples.

Pre-contemplation

Ignorance is bliss.

People in this stage are not thinking about changing their behaviour soon (in the next six months). They are in denial about their behaviour (they do not believe they are addicted) or because they are demotivated (they have tried to change their behaviour a couple of times before but have not succeeded).Intervention helps the addicted person recognise the need to change.

Contemplation

Sitting on the fence.

At this stage, the addict is thinking about change. They are undecided about changing but are increasingly aware they need to change. They are aware of the costs and benefits of change. Thinking so can cause people to be stuck in this stage for a long time.Intervention helps individuals realise the benefits of overcoming addiction outweigh the disadvantages, as do the pros and cons of remaining addicted.

Preparation

I’m ready for this.

Now the addict believes the benefits of quitting outweigh the costs, and they decide to change their addictive behaviour (within the next month). They know they want to change soon, but not how or when. So they start making plans and goals.At this stage, the best form of intervention is to plan or present some treatment options, such as seeing a counsellor or making an appointment with a doctor. Encouragement to take the first steps toward change helps immensely.

Action

Let’s do this.

People at this stage have changed their behaviour in the last six months, such as attending CBT therapy or seeking substance abuse treatment, as described in previous articles. However, it does not have to be formal treatment.They can also do things like throw away all cigarettes or alcohol. However, the action must reduce their risk to be effective, meaning that they do not just switch from hard alcohol like whiskey to the less alcoholic option – beer. Overall, they are actively changing their addictive behaviour.The intervention includes developing coping skills necessary to quit smoking and maintain behaviour change.

Six Stage Model of Behaviour Change, Seeking substance abuse treetment Prochaska Model, StudySmarterAddiction help services, freepik.com/vectorjuice

Maintenance

Stay on track.

The addict has already been abstinent for at least six months. Therefore, the focus is on relapse prevention, such as avoiding cues and situations that could lead to relapse, giving the addict confidence that their addiction will not return and that abstinence is a way of life for them.The intervention involves the addict using the coping strategies they have learned and accessing the support available.

Relapse

I've relapsed, but I will learn from this.

At this stage, the person has relapsed into their addictive behaviour despite successful abstinence. Giving continuing support is incredibly important for the addict to learn from the causes of the relapse. The person evaluates why they relapsed to avoid doing so in the future.Intervention includes continued support, and reflection is encouraged. Learning is a crucial component of this stage.This stage can also be considered termination (the addictive behaviour is no longer present), but as many healthcare professionals observed, termination is rare, and relapse is more likely. Most people tend to stay in the maintenance stage as the last step.

The six-step model of behaviour change is like a staircase that you can climb up or down. The stages are not travelled in only one direction. You can go up or down a stage depending on how well things are going or what is needed.

Evaluation of Prochaska’s six-stage model of behaviour change

Now that we know the phases in detail let us evaluate the strengths and weaknesses of the models.

Weaknesses

Below are the weaknesses of Prochaska’s six-stage model of behaviour change.

Contradictory research evidence

In a meta-analysis of data from the National Institute for Health and Care Excellence (NICE), Taylor et al. (2006) concluded that stage-based approaches are no more effective than other forms of treatment in treating nicotine addiction. Cahill et al. (2010) reached the same conclusion in their analysis of four studies of nicotine addiction treatment comparing the same intervention in stage-based and standard versions.

West (2005) also criticised the model, stating that:

the problems with the model are so serious that it should be discarded... it has been little more than a security blanket for researchers and clinicians.

Arbitrary nature of the stages

Sutton (2001) points out that the differences between stages are too subtle and arbitrary. For example, if someone plans to quit in 30 days, they are in the preparation stage, but they are in the contemplation stage if they plan to quit in 31 days.

Bandura (1997), who you may know from the Attachment module, states that the preparation and contemplation stages differ only in the individual’s motivation to change. The stages vary only qualitatively since this is a quantitative measure (how much they want to change).Kraft et al. (1999) suggest we could transform the model into two useful stages: pre-contemplation and the rest combined.

Description, not a prediction

Most research on the six-stage model describes the stages of recovery that people are in and relates them to treatment-seeking behaviour. However, this has not only produced mixed results but also suggests that the model is not a good predictor of behaviour change, which was its primary goal.

Overestimates logic

At many stages, Prochaska claims addicts will weigh the costs and benefits of their addiction. However, we know addicts often have faulty thinking patterns and cognitive biases. In addition, some logical abilities may be impaired by addiction (e.g., an alcoholic may be heavily intoxicated or a drug addict may be high), so they cannot make such logical calculations. This is a drawback of the model because it cannot apply to all addicts.

Strengths

Now let’s consider some strengths.

Dynamic model

This model is dynamic because it does not view recovery as a sudden, one-time event but recognises recovery as a process. Each stage may take different lengths of time for different people, and people may go back and forth between stages, which is a more realistic view of recovery, giving the model real-world validity.

Attitude to relapse

The dynamic nature of the model also means it takes relapse into account, which is very realistic. As DiClemente et al. (2004) state, ‘relapse is the rule rather than the exception’. Thus, the model does not view relapse as a failure but rather as part of recovery. Nevertheless, relapse is seriously considered an obstacle to the recovery process in this model because recovery takes many attempts before it succeeds.


Six Stage Model of Behaviour Change - Key takeaways

  • Prochaska’s six-stage model of behaviour change states that recovery from addiction is a gradual, dynamic process in stages. A person can jump up and down these stages throughout the recovery process.
  • The stages are pre-contemplation, contemplation, preparation, action, maintenance, and relapse. Termination is sometimes considered the sixth stage, but termination is rare, and people are much more likely to stay in the maintenance stage or relapse.
  • The willingness of addicts to change their behaviour varies, and the benefits of intervention depend on the stage reached.
  • Support is provided at all stages to encourage behaviour change.
  • The model recognises relapse is likely.

Frequently Asked Questions about Six Stage Model of Behaviour Change

According to Prochaska and DiClemente (1983), the six stages of behaviour change are:


  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Relapse

Prochaska and DiClemente (1983).

The sixth stage stipulated by Prochaska’s model for change is relapse. Although some may refer to it as termination, many healthcare professionals have observed that termination is rare and relapse is more likely. Most people tend to stay in the maintenance stage as the final step.  

The model is known as the six-stage model, more formally known as the Transtheoretical Model (TTM). It is used to treat/reduce addictive behaviours.

It provides a guided process that identifies specific stages those seeking addiction treatment go through, which improves the knowledge of the area for all involved. It provides a path for future research to explore the issue. 

Final Six Stage Model of Behaviour Change Quiz

Question

What year did Prochaska and DiClemente come up with the behaviour change model?

Show answer

Answer

1983

Show question

Question

What observation was the six stage model of behaviour change based on?

Show answer

Answer

Observation of smokers' behaviour when quitting, specifically noticing the changes developing in a series of stages.

Show question

Question

What are the six stages of Prochaska's Model of Behaviour Change?

Show answer

Answer

  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
  6. Relapse

Show question

Question

What other stage can the sixth stage be, but is not often reached and is dismissed in most cases?

Show answer

Answer

Termination. 

Show question

Question

Describe the stage, precontemplation.

Show answer

Answer

People in this stage are not contemplating changing their behaviour in the near future (the next six months). This could be because they are in denial (they don't believe they are addicted) or demotivated (they have tried to change a few times and have not succeeded). 

Show question

Question

Describe the stage, contemplation. 

Show answer

Answer

At this stage, the addict is thinking of making changes. They are ambivalent about changing but are increasingly aware of the need to change. They are aware of the costs and benefits of change, and this contemplation can lead to people being stuck in this stage for a long time. 

Show question

Question

Describe the stage, preparation.  

Show answer

Answer

Now the addict believes that the benefits of quitting outweigh the costs and they decide to change their addiction-related behaviour (within the next month). They know they want to change soon but not how or when. So, they begin to make plans and goals. 

Show question

Question

Describe the stage, action.   

Show answer

Answer

People at this stage have made changes to their behaviour in the last six months such as attending CBT or receiving drug treatment as outlined in earlier articles. However, the action doesn't have to be formal treatment. 


They may also do things like throwing away all their cigarettes or alcohol. But crucially the action MUST reduce their risk to be effective, e.g., not just switching from hard liquor such as whiskey to the less alcoholic option- beer. Overall, they are actively changing their addictive behaviours. 

Show question

Question

Describe the stage, maintenance.    

Show answer

Answer

The addict has been abstinent for at least six months. Therefore, the focus is on relapse prevention, e.g., avoiding cues and situations which could lead to relapse. This gives the addict confidence that their addiction will not return, and that abstinence is a way of life for them. 


Show question

Question

Describe the stage, relapse. 

Show answer

Answer

In this stage, the person has relapsed into addictive behaviours despite successfully abstaining from their addictive behaviours. It is incredibly important that support is given and continued, as this is where encouragement to learn from what caused the relapse occurs. The person evaluates why they relapsed, to avoid it in the future.  

Show question

Question

What stage are addicts more likely to remain in towards the end of the model?

Show answer

Answer

The maintenance stage.

Show question

Question

What is important to maintain throughout each stage of the model?

Show answer

Answer

Support. Social, peer, and professional. 

Show question

Question

What type of intervention occurs during the maintenance stage?

Show answer

Answer

Intervention includes the addict applying the coping skills they have learned and receiving the support available to them.  

Show question

Question

Can a person go up and down the Prochaska model of behaviour change when going through the steps?

Show answer

Answer

Yes. The best way to think of the six-stage model of behaviour change is by picturing it as a staircase that you can go up or down on. The stages are not completed in one direction only. You can go up or down a stage depending on how well it is going or what is needed.  

Show question

Question

What did Cahill et al. (2010) find in their study on smoking addiction treatment?

Show answer

Answer

They concluded that stage based approaches are no more effective than standard versions of treatment. 

Show question

More about Six Stage Model of Behaviour Change
60%

of the users don't pass the Six Stage Model of Behaviour Change quiz! Will you pass the quiz?

Start Quiz

Discover the right content for your subjects

No need to cheat if you have everything you need to succeed! Packed into one app!

Study Plan

Be perfectly prepared on time with an individual plan.

Quizzes

Test your knowledge with gamified quizzes.

Flashcards

Create and find flashcards in record time.

Notes

Create beautiful notes faster than ever before.

Study Sets

Have all your study materials in one place.

Documents

Upload unlimited documents and save them online.

Study Analytics

Identify your study strength and weaknesses.

Weekly Goals

Set individual study goals and earn points reaching them.

Smart Reminders

Stop procrastinating with our study reminders.

Rewards

Earn points, unlock badges and level up while studying.

Magic Marker

Create flashcards in notes completely automatically.

Smart Formatting

Create the most beautiful study materials using our templates.

Just Signed up?

Yes
No, I'll do it now

Sign up to highlight and take notes. It’s 100% free.