Written by Marissa Hoen | June 22 2021
Have you tried to change a behaviour, only to find yourself right back to your old habits the very next day? You may set your goals, but then life comes in and presents you with a new idea or challenge that can feel like a roadblock diverting you right back to your original path. When you take a look at your daily habits, you may find areas that you have been trying to change for years but old habits seem almost impossible to overcome. A classic example comes around every year: the New Years Resolution.
Changing ingrained habits is hard- no doubt about it. But there are ways to make our lifestyle changes more doable based on where we are in the stage of that change. If you have a hard time sticking to a behaviour change, it’s possible that you’ve jumped too quickly into action, without taking steps to support the current stage of change that you are in! To ensure the change you want will actually stick, it is helpful to know where you are starting from so you can take steps appropriate for that stage.
http://www.pharmatimes.com/thought_leadership/the_concordance_conundrum_the_value_of_improving_patient_experience_1343288
The Stages of Change
(Hadjistavropoulos & Hadjistavropoulos, 2019)
Precontemplation: This first stage occurs before you decide to change a habit. Thought to last around 6 months, folks may remain in this stage due to lack of knowledge about the outcomes of their unhelpful habit.
Contemplation: This stage involves the want to change a behaviour, usually over another 6 month span. If you are thinking about a change, but don’t yet see that the benefits outweigh the costs, you may be in this phase.
Preparation: Those in the preparation stage are doing just that, preparing to take action in the direction of their goal behaviour. One might prepare by creating a plan or by gaining more knowledge on the habit. These individuals are usually planning to take action steps in the next month.
Action: In this stage, the individual takes actionable steps to change their habits. This stage may take 6 months, and is not indicative of the habit being established. Many in this stage revert back to old habits if the processes of change (see below) were not engaged in during the preparation phase.
Maintenance: People in this stage have made great efforts to change their behaviour, and have done so successfully for some time. The goal of this stage is to keep up with the newly formed habit and prevent relapse. Estimated to last anywhere from 6 months to 5 years.
Termination: It is not always possible to reach this phase depending on the goal chosen. This phase consists of no longer being tempted to revert back to old habits, almost as if the old habits didn’t exist.
https://www.change4health.org/it-begins-with-you/motivation-and-readiness/frameworks/
Processes of Change
Evidence has shown that certain processes of change allow for more effective movements through the stages of change (DiClemente et al., 1991). Table 5.1 connects the processes (or strategies) that are appropriate for each stage (Hadjistavropoulos & Hadjistavropoulos, 2019). There are many strategies to choose from, so here I will highlight a few of my favorites:
Consciousness Raising: increasing your knowledge about the behaviour you want to change. This will help you break through precontemplation and is an important aspect in increasing the pros and decreasing the cons of changing. One can increase awareness through reading articles on the topic, learning from experts, and getting feedback from those around them.
Pros of Changing > Cons of Changing: evidence suggests that a person is more likely to progress beyond contemplation to Action when they perceive the upsides to changing as outweighing the challenges presented ( Hall & Rossi, 2007).
Self-reevaluation: altering the way that you view yourself, “creating a new self image” (Hadjistavropoulos & Hadjistavropoulos, 2019). Identify the words you use to describe yourself and clarify how you would like to view yourself. It may be helpful to think of yourself as already being that healthy person, and ask “how would this person act? What actions would they take at this moment?”
Self-liberation: commit yourself to your habit change. Whatever the habit change is, write it down, make it noticeable, and remind yourself why you want this change. Make plans for the times when you may relapse, and know that you can recommit to your plan. This can help you get ready for the challenges that always arise during the action stage.
Counter Conditioning: find and use healthy alternatives to your habit. The more you enjoy these alternatives, the better! For example, if you are trying to quit smoking, common alternatives include the nicotine patch, breathing techniques, or keeping your hands occupied with another task (knitting, cooking healthy foods, writing in a journal, gardening, the list goes on!).
While all of these processes focus on behaviours that put our health at risk, I agree with Psychology Professor Dr. Barb Bryden who also suggests taking time to also focus on what we are already doing right! Anytime you are listing your behaviours that may be harmful, also list those things you do that are supportive of your health. Only fixating on the improvements we need to make can leave us feeling like we aren’t enough or that we are neglecting health in its entirety! There are endless ways to improve health, and you are most likely doing many of these things without realizing! So of course, work on your challenges, but also be aware of your strengths and how far you have come.
Key Takeaways
A behaviour change is more likely to be successful if:
The first stages are supported by improving knowledge, preparing emotionally, and critically thinking about the causes and consequences of the unhelpful habit
The following stages address environmental factors, foster social support, and improve self efficacy and commitment
References
DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59(2), 295-304. https://doi.org/10.1037/0022-006X.59.2.295
Hadjistavropoulos, T., & Hadjistavropoulos, H. (Eds.). (2019). Fundamentals of health psychology. Oxford University Press.
Hall, K. L., & Rossi, J. S. (2007). Meta-analytic examination of the strong and weak principles across 48 health behaviors. Preventive Medicine, 46(3), 266-274. https://doi.org/10.1016/j.ypmed.2007.11.006