Prochaska's six-stage model

• Prochaska's non-linear model of behavioural change includes the following stages:

  • precontemplation - individual does not consider they have a problem - may be in denial
  • contemplation - individual considers changing potential - no decision made
  • preparation/action - making plans to change behaviour - booked appointment
  • maintenance - change in behaviour continues - over 6 months
  • termination - no longer addicted - Prochaska determined only 20% achieve this
  • relapse - return to earlier stages
• pre-contemplation


  not considering changing behaviour, could be in denial/don't believe they have a problem

  -

  intervention: drawing attention to their behaviour and their addiction e.g., the number of cigarettes smoked per week
• contemplation


  thinking about making a change but no change has been made, may be worried about drawbacks

  -

  intervention: focus on pros of behavioural change and recognition of impacts on self and others
• preparation


  decided to change behaviour some time in the next month

  -

  intervention: helping them explore options e.g., making an appointment/ringing a helpline, helping them formulate a plan of action/plan for support that will be needed
• action


  have done something to change behaviour in last six months -binned cigarette lighters

  -

  intervention: development of coping strategies (CBT), positive substitutes for addictive substances, rewards for positive steps
• maintenance


  maintained the change in behaviour for over 6 months - not smoking

  -

  intervention: focus on relapse prevention e.g., avoiding high-risk situations/people, spending time with people who behave in healthy ways, using alternative coping strategies
• termination


  abstinence automatic - no longer returns to addictive behaviour to cope

  -

  no intervention - may not be possible/realistic for some, Prochaska thought only 20% reached this stage - prolonging maintenance may be reality for some - relapse may be inevitable
• ao3 - dynamic/flexible


  recovery from addiction is not a single 'all-or-nothing' event - non-linear, it accepts relapse as a part of the recovery process and encourages people to continue trying to recover even when they may have felt it to be useless

  -

  different periods of time on each stage - a more realistic view of the process of addiction - does not seem as daunting

  -

  knowledge they may remain in maintenance stage - emphasises importance of alternate coping methods
• research evidence


  Baumann (2015) - investigated recovery of alcoholics not intending to change their behaviour and found few ppts subsequently gave up drinking completely, but 35% decreased quantity and frequency of drinking - there was no significant difference between an experimental group who received an intervention tailored to their stage and a control group with minimal intervention

  -

  this concluded that the advantages of Prochaska's six-stage model may have been overstated
• arbitrary


  differences between stages too arbitrary, it is claimed that the precontemplation and contemplation stages are not even qualitatively different, but only quantitatively measures how much an individual wishes to change - it has also been argued that it could be turned into a two stage model, precontemplation and all the others