Change is hard. If it wasn’t, the diet pill industry alone would go out of business overnight. People who are desperate to make a change look for that quick fix solution because their past efforts have failed multiple times.
In Changing to Thrive: Using the Stages of Change to Overcome the Top Threats to Your Health and Happiness, James O. Prochaska and Janice M. Prochaska acknowledge that changing behaviors is easier said than done. Many have stated intentions to change, especially on January 1st, but don’t achieve lasting success. Changing to Thrive teaches the reader why past efforts have failed by walking through the different stages of change and what it takes to increase the likelihood of maintaining that change. Their motto is “Wherever you are at, we can work with that,” acknowledging that not everyone is at the same level of readiness.
The first step toward change is the precontemplation or the “not ready” stage. This describes people who don’t anticipate taking any action in the next six months. It is possible they have made attempts to change in the past and have become discouraged because of repeated failures. The cause of failure is often due to the method of change. It is very likely they had tried programs in the past that were action oriented, which does not work for people who are merely in the beginning stages of considering change. Success in action-oriented programs comes only after people move out of the precontemplation phase.
People getting ready to move forward are considered to be in the contemplation stage. They do intend to take some sort of action in the next six months. Getting closer to the action stage happens when people can look at the advantages and disadvantages of making a change versus staying in their current state and begin to see advantages outnumber the disadvantages. When people make a pro-con list and the positives outweigh the negatives in favor of change, then they are on the right track toward taking action.
As people prepare for change, they need to educate themselves on the problems that they’re having. For example, smokers preparing for action may find a reason to quit smoking once they understand the negative impact on their physical health. They can then consciously list the pros and cons of smoking and are able to really see all the cons because they do intend to change. Each person has to decide his or her personal pros for making a change and by doing so, the cons will slowly decrease in their impact. For example, one con for a change might be that it takes too much time. To decrease the impact of this particular con, a person may counteract it by saying that the time invested now will pay off later when better health is experienced.
Once a person decides to move into action, it is important to plan for what it will take to maintain that action. Habits — both good and bad — are learned over time, so it’s possible to learn new behaviors that can become more powerful than the old negative habits. Developing a new habit that sticks includes changing thought processes and the statements people make to themselves. Maintenance is also dependent on the need to proactively seek good social supports, rather than negative ones, such as hanging out with people in a smoking area where it would be too easy to continue smoking. It gets complicated because people are no longer impacted only by the people that are physically around them. Now the whole world is open to them through social media, so it’s important to have the right people online and offline as part of the support network.
None of these steps or stages are a clear-cut, linear process where people move from precontemplation to contemplation to preparation to action to maintenance. Rather people go back and forth between the different stages, and that’s important for people to know so they don’t get discouraged when they step back. Change happens one small step at a time and it is okay to not go through this process in a linear fashion.
After reviewing each of these steps, the authors then walk through how this would apply to behavior changes many struggle with, like smoking, alcohol use, eating habits and exercise. When it comes to eating, much of what people do is triggered by the presence or absence of some stimulus. The authors explain, “For example, most of us were conditioned by our parents to eat everything on our plates, after which we were reinforced and rewarded with more food, namely dessert .“ It seems very obvious now that this was a learned behavior that is definitely changeable. However, since most people engage in automatic behaviors, they don’t consciously think about what or why they do something.
When it comes to changing eating habits, the plan a person selects needs to be one they choose — not a single solution that’s dictated to him or her by a well-meaning expert or helping professional. For example, to eat the “right” number of calories, a person can eat 500 fewer calories per day, eat until they’re 80% full, or reduce calorie intake a little bit at a time. When people have three options to choose from they are more likely to stick with one they choose for the long-term rather than the one option that someone may provide. Once someone makes a commitment to change in the way that works for them, sharing commitments with others is important so willpower is not weakened.
The stages of change model is powerful for any area where behavioral change is desired. People who want to work through the book on their own will find a number of practical exercises they can do in each section to develop their pros and cons for changing a behavior and determine how ready they are for change. An honest look at how ready they are informs them on what steps they to take in order to move to the next level of the model rather than jumping right into action if they are not genuinely ready.
For those who work in the mental health field, this book can be a good reminder that not everyone is going to be in the exact same place in their readiness for behavioral changes. It can be less frustrating when clinicians understand that they’re working with someone who’s only in the precontemplation stage rather than assuming everyone is in the action stage. Even if someone comes for help, it does not mean that they are in the action stage. Someone else may be dictating the change. This individual may only be in precontemplation or contemplation stage and that is important to know in order to move forward with the appropriate planning. A good understanding of this model will change the way professionals work with clients and help people who have been frustrated with their failed efforts to change in the past.
Changing to Thrive: Using the Stages of Change to Overcome the Top Threats to Your Health and Happiness
Hazelden Publishing, October 2016
Paperback, 260 pages