Running head: PROCHASKA'S MODEL OF CHANGE
Prochaska's Model of Change Case Study
Sheldon Shaun Hankins
Kaplan University
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Running head: PROCHASKA'S MODEL OF CHANGE
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In about 1 page or 200 words, summarize the stages of the Prochaska Model of Change.
Prochaska's Model of Change can be summarized into the following areas. The first Model of
Change is called Pre-Contemplation. This stage has to deal with the patient being oblivious to the need
for a change. According to (Prochaska, DiClemente, Norcross, 1992, pg. 1103), “Pre-Contemplation is
the stage at which there is no intention to change behavior in the foreseeable future.” During this stage
many people are either unaware or under-aware of their behavior which is causing them to have a
problem in their lives. This stage can be treated by several different techniques. The first technique is to
validate the patient's lack of readiness. The second technique is to clarify that the decision to change is
theirs alone to make. The third technique is to encourage the patient to re-evaluate their current
behavior. The fourth technique is to encourage the patient to self-explore, but let them know that they
need not take any action at this time. The fifth technique is to explain and personalize the risks to the
patient.
The second Model of Change is called Contemplation. This stage has to deal with the patient
being aware of the need for change but not committing to it. According to (Prochaska, DiClemente,
Norcross, 1992, pg. 1103), “Contemplation is the stage in which people are aware that a problem exists
and are seriously thinking about overcoming it but have not yet made a commitment to take action.”
During this stage a person could be stuck into it for long periods of time. This stage can be treated by
several different techniques. The first technique is to validate the patient's lack of readiness. The second
technique is to clarify that the decision to change is theirs alone to make. The third technique is to
encourage the patient to evaluate the pros and cons of their behavior change that is needed. The fourth
technique is to help the patient to identify and promote new positive outcomes and expectations.
The third Model of Change is called Preparation. This stage has to deal with the patient
intending to change. According to (Prochaska, DiClemente, Norcross, 1992, pg. 1104), “Preparation is
a stage that combines intention and behavioral criteria. Individuals in this stage are intending to take
Running head: PROCHASKA'S MODEL OF CHANGE
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action in the next month and have unsuccessfully taken action in the past year.” This stage can be
treated by several different techniques. The first technique is to help the patient to identify and assist
them in their problem solving; also to help the patient with any obstacles that they may face. The
second technique is to help the patient to identify their social support. The third technique is to verify
that the patient has the underlying skills to change their behavior. The fourth technique is to encourage
the patient to take small initial steps when changing their behavior patterns.
The fourth Model of change is called Action. This stage has to deal with the patient showing
that they are being active in their behavior changing skills. According to (Prochaska, DiClemente,
Norcross, 1992, pg. 1104), “Action is the stage in which individuals modify their behavior,
experiences, or environment in order to overcome their problems. Action involves the most overt
behavioral changes and requires considerable commitment of time and energy.” This stage can be
treated by several different techniques. The first technique is to help the patient to focus on
restructuring their cues and social support. The second technique is to help the patient to bolster their
self-efficacy for dealing with obstacles. The third technique is to help the patient to combat their
feelings of lose and reiterate their long-term benefits.
The final Model of Change is called Maintenance. This stage has to deal with the patient
making their new behaviors their norms. According to (Prochaska, DiClemente, Norcross, 1992, pg.
1104), “Maintenance is the stage in which people work to prevent relapse and consolidate the gains
attained during action. Traditionally, maintenance was viewed as a static stage. However, maintenance
is a continuation, not an absence, of change.” This stage can be treated in several different techniques.
The first technique is to help the patient to continue on with their positive re-enforcement and their
social support. The second technique is to help the patient to remove their stimulus control. The third
technique is to help the patient to maintain their self-efficacy.
Is this a linear model (please take the time to examine the model closely before addressing this
Running head: PROCHASKA'S MODEL OF CHANGE
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aspect of the assignment)? If not, then why do you feel this way?
I would have to say no, Prochaska's Model of Change is not a linear model. My decision is
based off of the evidence in an article written by Prochaska, DiClemente, and Norcross. During the
development of the Model of Change the developers: Prochaska, DiClemente, and Norcross noted that
the process of the Model of Change is not a process that could be considered as linear. This decision by
the developers is based off of their evidence that the studies that they had ran found that the self-report
statements can put people in different stages of the Model of Change within a period of days, and even
place people in multiple stages of change at one time.
Think about your client in terms of the Prochaska Model of Change. You may interview your
subject further if you wish. Explain more about his/her problems and situation.
Jim is a 30 year old, Caucasian male, who lives in the suburbs of Indianapolis, Indiana. He is
not married nor does he have any children to provide for. Jim states to me in an interview that he is
having some major issues with the use of some illegal explicit drugs. These drugs that he has been
using are as follows: Alcohol, LSD, Cocaine, and Heroine. Jim stated to me that he knew he had a
problem for three months now but, he was afraid to seek help to control this problem. Jim said he
feared getting help because he did not want to be incarcerated in a mental hospital drying out. Jim does
show clear signs that he is a person who abuses substances and that he is a prime candidate for drug
treatment.
Tell what stage your patient is in the Prochaska Model of Change. What are the clues that tell you
the person is in that stage according to the Prochaska Model?
I believe that my patient is in the second stage of Prochaska's Model of Change. This stage,
Contemplation, is where the patient stands by the statements that he has made to me during the
interview. I find that the evidence of this stage is where Jim states that “he knew he had a problem for
Running head: PROCHASKA'S MODEL OF CHANGE
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three months now but, he was afraid to seek help to control this problem; and that he feared getting
help because he did not want to be incarcerated in a mental hospital drying out.” These two statements
shows that Jim has contemplated changing his destructive behaviors, but was not seeking any help in
the past due to his fear of being 'locked-up'.
What interventions will help your client most to move to the next stage in the model of change (be
specific with your recommendations and base them on what you have learned as a result of the
course reading materials)?
I feel that the techniques needed to treat this patient to help him move on to the next stage in the
Model of Change is for him and I to validate Jim's lack of readiness, help him to clarify that the
decision to change is his alone to make, encourage Jim to evaluate the pros and cons of his behavior
change that is needed, and help Jim to identify and promote new positive outcomes and expectations.
How is resistance affected when you are intervening and doing therapy from the Prochaska
Model?
During a therapy session when using Prochaska's Model of Change, it would be wise to prevent
resistance form your patient by not intervening with them in a negative way or a way that could cause
the patient to feel like treatment is a waste of time. It is very important to remember the resistance that
a patient can 'put-up' against you especially when you are dealing with a patient who is in the
Contemplation stage of the Model of Change. A patient in this stage is still considering treatment and is
weighing the pros and cons of change. If you try to force this patient to see your view to the reason why
they need to change then you have damaged the progress that you have already made. Your suggestions
will make the patient bring up all the reasons to why he or she should not change their behaviors and
why their changing would not be possible for them to complete. The worst thing that you can do is let
your patient talk themselves out of not changing their dysfunctional behaviors.
Running head: PROCHASKA'S MODEL OF CHANGE
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Reference
Prochaska, James O., DiClemente, Carlo C., Norcross, John C. (1992). In search of how people change
applications to addictive behaviors.
Washington, D.C.: American Psychological Association Inc.