By Director
of Mental Health Services Griselda Williams
As a mental health provider I am trained to remain aware of
those we are trying to help and their readiness for change. A professor of
psychology named James O. Prochaska, in the 70’s, developed the “Stages of
Change Model” to identify the process that humans go through when making
changes in their lives. Since the 70’s, the model has been used in counseling,
health care, substance abuse treatment, domestic violence intervention and many
other settings because it is backed by research, but also it has credibility
due to its effectiveness in gauging readiness for change. How many times have
we in our personal lives said that we were going to start an exercise program,
end an unhealthy relationship, take a class, change careers or maybe even just
eat healthier, but it takes some time for us to put into motion the goals we
discuss.
The stages that Prochaska identified were:
•
Pre-contemplation---not currently considering change or aware
that change would be helpful
•
Contemplation—not considering change within the next month,
ambivalent about change
•
Preparation—some experience with change and testing making
some change, plans to act within 1 month
•
Action—practicing new behaviors and new thinking, putting
plans into action
•
Maintenance—continuing commitment to sustaining new behavior,
new change
•
Relapse—resumption of old behaviors
Prochaska states that humans may not pass through each stage
easily and may move backward and forward and even relapse as that too is part
of the human reaction to the process of change. I think it is interesting that
the stage that involves putting change into action is 4th; indicative sometimes
just how long it takes us as humans to put new behaviors into motion. John
Fisher developed “The Process of Transition” in the 90’s but revised his theory
in 2012. He identified that the reason humans have difficulty with change is
due to feelings like anxiety, anger, fear, denial, guilt, depression and
others.
At Community LINC, we help our program participants work
through the challenges associated with change and transition. Through counseling and coaching meetings,
most program participants attribute their greatest barriers to change as fear
of the unknown, not knowing what to expect or not knowing what will happen if
change is made. Recently, I met with one of our program participants, Ms.
Gretta who appeared to be at the stage of relapse. During her weekly counseling meeting focusing
on employment, I learned she was no longer actively seeking employment. She shared frustrations of securing the
interview with employers selecting other candidates over her. We were able to see that our perception of
the situation was having an impact on her sense of self (anxiety and
fear). This small impact had rapidly
dropped her self-confidence and negative self-image leaving her not knowing
which way to turn – Who am I? In any
behavior change, relapses are common occurrences. A person’s stage of change is used to decide
which strategies are most appropriate to promote or maintain change. We took the opportunity to reassess a new
plan of action and resources to set realistic goals that would match her interest
and skills. This allowed us to go a
step further to ensure sustainable success by making contingency plans to cope
with difficult situation.
Applying Prochaska’s stages of change model combined with
Fishers process of transition to our residents at Community LINC is vital to
understanding their readiness to make change, appreciating barriers to change,
and helping them anticipate relapse. At
Community LINC, our programs focus on making sure that each program participant
learns valuable skills by working through challenges, celebrating successes,
and to gain invaluable skills necessary for maintaining self-sufficiency.
We hope that when each program participant leaves the program
they can each leave by saying, “I still
have a long way to go but I’m already so far from where I used to be and proud
of the change.”
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