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Putting prevention into practice (Green Book)

Stages of change

The Transtheoretical Model of Behaviour Change developed by Prochaska and DiClemente, is commonly referred to as the ‘stages of change’ (Figure 3) model and is widely used to determine patient readiness for change in many clinical settings. The model recognises that:

  • behaviour change does not occur in a linear fashion
  • patients progress through predictable stages of change before reaching an action stage
  • every stage of change is necessary because people learn from each stage, and
  • one intervention cannot be applied to all patients as some will be at different stages of ‘readiness’ than others.
Figure 3. Stages of change model

Stages of change:

  • Precontemplation: the patient is not intending to change their behaviour for at least 6 months
  • Contemplation: the patient has not begun to change their behaviour but intends to do so within 6 months
  • Determination: the patient has not begun to change their behaviour but intends to do so in the next 30 days
  • Action: the patient has changed their behaviour within the past 30 days
  • Maintenance: the patient has practised the new behaviour for at least 30 days.

Relapse occurs from time to time and patients may switch from maintenance to relapse to action in a continuing cycle.

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