AO1 - Prochaska's Six Stage Model of Behaviour Change

• This model explains the process involved in behavioural change that can be used to explain how individuals overcome an addiction. It has a cyclical nature, and takes a positive and dynamic approach to changing addictive behaviour as opposed to an all or nothing approach

  • It recognised that people differ in how ready they are to give up their addiction and how useful a treatment intervention will be depends on which stage the individual is at
• Stage 1: Pre-contemplation

  • Individual does not consider themselves as having a problem and isn't thinking about changing their behaviour even though they know it is not healthy - this could be due to denial or demotivation
  • Useful intervention at this stage focuses on helping the addict to consider the need to change so they are aware it is not healthy
• Stage 2: Contemplation

  • Individual is now thinking about changing their behaviour and have an awareness that they need to take action, they are aware of the costs and benefits to changing
  • Useful intervention at this stage is helping the individual understand the pros of overcoming the addiction, outweighing the costs - drug treatment at this stage would not be helpful
• Stage 3: Preparation

  • The person believes the benefits of changing behaviour are outweighing the costs, they decide to change within the next month but maybe not exactly what they will do to change
  • Useful intervention at this stage is support in constructing a plan, e.g. making a GP appointment
• Stage 4: Action

  • This is when the plan is put into action - the individual has usually done something to change their behaviour in the last 6 months, e.g. behavioural therapies or pour away alcohol and is continuing with their behaviour change
  • Useful intervention at this stage is developing coping strategies that the individual will need to quit and maintain their change of behaviour
• Stage 5: Maintenance

  • The individual has maintained some change of behaviour for more than 6 months, the focus is on relapse prevention such as avoiding situations that might trigger the addiction. This stage can be lengthy and the individual needs to keep focussed on the long-term goal of termination
  • Useful intervention at this stage is applying the coping strategies they have learnt and use the sources of support available to help prevent relapse
• Stage 6: Termination

  • Newly acquired behaviours such as abstinence become automatic, the individual no longer turns to the addictive behaviours to cope with stress, anxiety, etc. They are confident in their ability to resist the behaviour
  • The final stage may not be possible for all people to achieve - it may be that the most appropriate goal is to prolong maintenance for as long as possible, accepting that relapse may be inevitable and providing them with skills to work through earlier stages of the process quickly
  • There is no intervention required
• According to this model, relapse is not considered as failure to changing addictive behaviour, and can occur at any time apart from the termination stage, where the individual will simply return to earlier stages such as contemplation and preparation