ProchaskaandDiClemente.docx
Prochaska and DiClemente’s Transtheoretical Stages of Change Model
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Stage of Change
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Characteristics
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Techniques
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Pre-contemplation
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Not currently considering change: "Ignorance is bliss"
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Validate lack of readiness
Clarify: decision is theirs
Encourage re-evaluation of current behavior
Encourage self-exploration, not action
Explain and personalize the risk
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Contemplation
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Ambivalent about change: "Sitting on the fence"
Not considering change within the next month
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Validate lack of readiness
Clarify: decision is theirs
Encourage evaluation of pros and cons of behavior change
Identify and promote new, positive outcome expectations
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Preparation
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Some experience with change and are trying to change: "Testing the waters"
Planning to act within 1month
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Identify and assist in problem solving re: obstacles
Help patient identify social support
Verify that patient has underlying skills for behavior change
Encourage small initial steps
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Action
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Practicing new behavior for
3-6 months
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Focus on restructuring cues and social support
Bolster self-efficacy for dealing with obstacles
Combat feelings of loss and reiterate long-term benefits
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Maintenance
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Continued commitment to sustaining new behavior
Post-6 months to 5 years
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Plan for follow-up support
Reinforce internal rewards
Discuss coping with relapse
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Relapse
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Resumption of old behaviors: "Fall from grace"
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Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies
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Motivational Interviewing Algorithm
Sample Scripts for Stages of Change
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