James Prochaska, Ph.D. and Carlo DiClemente, Ph.D. and the Stages of Change Model

This is the second in a series of postings on Innovators in Behavioral Health. They are people I have admired from afar for many years. They have changed the lives of millions of others around the world and while they have received many awards and are highly regarded by their peers, they are hardly household names. They should be. Perhaps you or someone you know can benefit from the innovative programs and tools they have created. 


In a recent interview, Dr. Prochaska reflected on his father's problems with bipolar disease, alcohol, and violence and the helplessness he felt as child trying to help his father change. "Not wanting to feel helpless when faced with very important problems," he said, is what led to his interest in psychology and later his development—with Carlo C. DiClemente, Ph.D.—of the Transtheoretical Model of Behavior Change, commonly known as the Stages of Change Model.

Dr. Carlo DiClemente

"There are lots of theories about how people change," Dr. DiClemente explains. The Transtheoretical Model "brings together these different perspectives [thus its name] and tries to integrate them around the idea that change happens over time." Changing a problem behavior, then, is seen as a journey through a series of continuous stages of readiness to change:

Precontemplation: Many people in this stage are unaware that they have a problem and they have no intention of changing behavior in the foreseeable future. 

Contemplation: People are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action. 

Dr. James Prochaska

Preparation: People intend to take action in the next month. 

Action: People modify their behavior or environment in order to overcome their problems. Considerable commitment is required at this stage.

Maintenance: People work to prevent relapse and build on the gains they achieved during the action phase.

When and how we move through these stages is affected by certain activities and experiences we engage in when we attempt to modify the problem behavior, e.g., seeking new information, self-reflection, feeling and expressing emotions, support and caring of others, rewarding positive change, reassessing values, accepting problem-free lifestyle, and controlling triggers.

Dr Prochaska is Director of the Cancer Prevention Research Center and Professor of Clinical Psychology at the University of Rhode Island. Dr. DiClemente is Professor and Chair, Department of Psychology at the University of Maryland.

Their groundbreaking and bestselling book, written with Dr. John Norcross, Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward offers self-assessments you can use to determine which stage you are in and then gives advice about how to:

• Create a climate where positive change can occur
• Maintain motivation
• Turn setbacks into progress
• Make good habits a permanent part of your life

Dr. Prochaska and DiClemente's research has also been used by the Change Companies® to create a number of programs and tools that are designed to help people make positive life changes. These programs—which cover criminal justice, mental health, impaired driving, and health improvement, among others—feature the Interactive Journaling® Process, a structured method of self-reflection and self exploration. Please see links below to learn more and to preview the Change Companies® products and services.

References and Resources

DiClemente, CC. Evaluating Readiness to Change: The Transtheoretical Model. PowerPoint presentation available at www.ahqa.org/pub/uploads/DICLEMENTE.ppt

Summary and Overview of the Transtheoretical Model. Cancer Prevention Research Center, University of Rhode Island. Available at http://www.uri.edu/research/cprc/TTM/summaryoverview.htm

Interview with Dr. DiClemente, University of Maryland: http://youtu.be/lyZJbP6inzY

The Change Companies® Product Previews are available at http://www.changecompanies.net/health-improvement.php

Behavior Change Basics: http://changeu.net/library/

Archives: http://changeu.net/archives.php