“Changing For Good: A Revolutionary Six Stage Program for Overcoming
Bad Habits and Moving Your Life Positively Forward” by James O.
Prochaska, John C. Norcross & Carlo C. Diclemente
This book is based on collaborative research about how human beings
make change in their lives, presenting a model for positive change
based on this research. They take a transtheoretical approach, meaning
they do not espouse one theory over another, instead trying to look for
the underlying common characteristics of every school of thought. The
authors argue that people progress through the same stages of change,
regardless of the type of behaviour they want to change, or the
severity of their use / misuse of the behaviour. They have successfully
applied the model toward helping others overcome smoking, substance
abuse, overeating, gambling, smoking, anxiety, over-caretaking,
self-harm, and others, at every level of use / misuse. They claim that
the reason so many people fail at changing behaviour is that they lack
the guidance and information for how the process is best applied.
The authors describe nine major processes of change found in their
research, with six distinct stages of change. They begin by describing
the nine major processes of change: consciousness-raising, social
liberation, emotional arousal, self-reevaluation, commitment,
countering, environmental control, rewards, and helping relationships.
They present the stages of change as a spiral model, noting that most
people relapse throughout the process and feel as if they are going in
circles; the authors argue that the relapses are an expected part of
the change process. The six stages of change with a brief description
of each follows:
Precontemplation: this stage is characterized by denial – people
have no intention of changing because they think they do not have a
problem.
Contemplation: this stage shows people becoming aware that they have a
problem behaviour, and they are beginning to consider trying to find a
solution.
Preparation: this stage is where a person is planning to take action within the coming month, and are making the plans to do so.
Action: the stage where the person is actively and overtly changing their behaviour and surroundings.
Maintenance: the stage where the task is to maintain gains achieved, and plan for and prevent relapse.
Termination: this stage would represent the reaching of a goal where
the behaviour no longer represents a threat or temptation. Change
has truly occurred.
The first step is to know which stage of change we are currently at, so
that we can take action in an appropriate manner – the authors argue
that most addictions services offer programs that are only relevant to
those who are at the action stage, resulting in high drop out and
relapse rates. Using case studies to illustrate, the authors guide the
reader through the application of each stage of change to their own
process, providing techniques for self-help, and for other professional
and non-professional helpers to assist the changer. This model has
since been widely adopted as a model of change for high-risk
behaviours, notably by the (American) National Cancer Institute as a
model for quitting smoking.
This book is also commonly used as a text for courses in addictions, as
was my experience when teaching a Social Work course in Addictions. It
was easy to build a curriculum around, and the students found it an
approachable, helpful, and realistic model. I found it had laypersons’
language, the research seemed solid, and it achieved its neutral
transtheoretical perspective.