The 5 Stages of Change

Module 3 – The Stages of Change

This 6 module course teaches the skills of the Trans-theoretical Model of Change. 5 distinct stages and 10 distinct processes that help move us through to the next stage in the change process. This process is one of the most studied and effective change processes ever developed. We not only teach you the process, but follow up with automated reminders that support you through the process.


  • Pre-contemplation (Not Ready) – “People are not intending to take action in the foreseeable future, and can be unaware that their behaviour is problematic”
  • Contemplation (Getting Ready) – “People are beginning to recognize that their behaviour is problematic, and start to look at the pros and cons of their continued actions”
  • Preparation (Ready) – “People are intending to take action in the immediate future, and may begin taking small steps toward behaviour change”
  • Action – “People have made specific overt modifications in modifying their problem behaviour or in acquiring new healthy behaviours”
  • Maintenance – “People have been able to sustain action for at least six months and are working to prevent relapse”
    – Termination – “Individuals have zero temptation and they are sure they will not return to their old unhealthy habit as a way of coping”

Processes of change.

The 10 processes of change are “covert and overt activities that people use to progress through the stages.” To progress through the early stages, people apply cognitive, affective, and evaluative processes. As people move toward Action and Maintenance, they rely more on commitments, conditioning, contingencies, environmental controls, and support. The originators of the process and colleagues state that their research related to the trans-theoretical model shows that interventions to change behaviour are more effective if they are “stage-matched,” that is, “matched to each individual’s stage of change.”

In general, for people to progress they need:

  1. A growing awareness that the advantages (the “pros”) of changing outweigh the disadvantages (the “cons”)—the TTM calls this decisional balance
  2. Confidence / Resilience that they can make and maintain changes in situations that tempt them to return to their old, unhealthy behavior—the TTM calls this self-efficacy
  3. Strategies that can help them make and maintain change—the TTM calls these processes of change. The ten processes include:
    1. Consciousness-Raising—increasing awareness via information, education, and personal feedback about the healthy behavior.
    2. Dramatic Relief—feeling fear, anxiety, or worry because of the unhealthy behavior, or feeling inspiration and hope when they hear about how people are able to change to healthy behaviors
    3. Self-Reevaluation—realizing that the healthy behavior is an important part of who they are and want to be
    4. Environmental Reevaluation—realizing how their unhealthy behavior affects others and how they could have more positive effects by changing
    5. Social Liberation—realizing that society is more supportive of the healthy behavior
    6. Self-Liberation—believing in one’s ability to change and making commitments and recommitments to act on that belief
    7. Helping Relationships—finding people who are supportive of their change
    8. Counter-Conditioning—substituting unhealthy ways of acting and thinking for healthy ways
    9. Reinforcement Management—increasing the rewards that come from positive behavior and reducing those that come from negative behavior
    10. Stimulus Control—using healthy interventions – reminders and cues that encourage healthy behavior as substitutes for those that encourage the unhealthy behavior.


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