Researchers in the 1970s created a “model of change” to help people stop harmful behaviors. Today, the model is useful for preventing habits from worsening.
When the transtheoretical model (TTM) was developed in the 1970s and early 1980s by researchers James O. Prochaska and Carlo DiClemente, it was revolutionary in its explanation of how behavioral change can take root and how it’s maintained over time.
TTM became popular in substance use disorder treatment.
But research from the early 2000s questioned whether TTM was helpful in this way, because of the difficulty in pinpointing a person’s readiness to change.
Another criticism was that TTM excluded people who succeeded in quitting an addiction cold turkey. Yet another criticism noted that TTM may oversimplify substance use disorder and recovery.
Recent research indicates that TTM may be best suited for people who need to take preventive action to better their health, rather than rewiring entrenched behaviors.
The TTM gauges a person’s readiness to change and the likelihood they will continue that change forward.
There are six stages of change in this framework. It begins with no desire to change and ends with maintaining new behavior and the completion of treatment.
There’s evidence that TTM works by changing behaviors preemptively in people at risk of developing chronic diseases and before negative thought patterns can contribute to the development of mental health issues.
The stages of change may be most effective by defining what each level means to you, how your experience fits into a stage, and whether you can preemptively adopt a behavior change.
To make a long-term behavioral change using TTM, first identify your present stage. A therapist or psychologist may be best able to help identify which stage you’re in:
Once you’ve done that, you can speak with a professional who specializes in the type of change you want to make.
You can learn about behavior-changing programs and which one will assist you in your particular path, and you might be motivated to commit to following it.
Like G.I. Joe says, “Knowing is half the battle.” TTM helps you know where you are, and what stages you can look forward to next.
The stages of change identify a person’s readiness to make behavioral changes in their life. The stages range from denial to acceptance. Going back to the behavior, or relapse, may occur. A person may cycle through the stages of change more than once on their journey, too.
Share on Pinterest Print Design and Illustrations by Maya ChastainThere are six stages of change in the TTM:
This stage is marked by denial. Folks at this juncture have not acknowledged that there’s problematic behavior.
Someone, like a therapist, friend, or family member, may have hinted at there being an issue or cause for concern, but you don’t believe them yet.
The indecision is real at this stage. You might be wavering if you can or should try to change the behavior, and what losing it may mean for everyday life.
You could be making a pros and cons list. Maybe you’re speaking with a therapist, family member, or friends about what might change in your life.
When considering changing a behavior, visualizing yourself having made the change — or not — in the future can help you decide next steps.
When you’ve decided to make a behavior change and are ready to take action, you’re in the prep stage.
You might still be gathering facts about the exact method you will use to make your change, such as finding a support group.
You’re actively changing in this stage! You’ve put the pedal to the metal.
You may be attending a support group, openly discussing your new behaviors with family and friends, referencing the negative behavior in the past tense, and keeping track of your progress.
In the maintenance stage, you’re focused on keeping the changes you’ve made for the long term. You’ll be working to keep your forward momentum so you don’t regress to old habits.
Your focus may shift from making changes and reinforcing them to changing your environment and enlisting support. At this point, you likely understand that life stressors may make adhering to the changes you’ve made more difficult, and so you may create action plans to help you manage stress.
In this stage, you might, after a length of time, stop active treatment.
In this stage, the old behavior is fossilized in your past. The habit may have lost its appeal entirely. You’re certain you won’t go back to it.
Not all TTM programs agree that termination is the final stage, as lapses are understood to be part of the journey in ongoing recovery.
Stages of change examplesLet’s say a doctor tells someone that they’re at risk of developing heart disease unless they make healthier choices, like daily walks and a better diet. Here’s what the stages may look like for them:
