DiClemente & Prochaska (1998) described a six-stage model for understanding behavior and intervening to effect change. These stages are as follows.

1. Precontemplation – the patient is not intending to change, either because of a failure to recognize the behavior is a problem or because the pros of change are viewed as less than the (often over-estimated) cost.
2. Contemplation – the patient has made the decision to change, but has not prepared for or initiated the change.
3. Preparation – the patient is ready to initiate the change.
4. Action – the patient has initiated the change and intends to continue with the changed behavior.
5. Maintenance – the patient has sustained the changed behavior and intends to keep doing so.
6. Termination – the patient continues to sustain the changed behavior and are certain they will not relapse.

It is not difficult to see that for each stage of change, different intervention strategies would be most effective at moving the person forward. Indeed, a meta-analysis of studies by Noar, et al (2007) found that stage-specific programs of behavior change are more successful. Of course, it must be remembered that relapse is a real possibility, so the movement forward may be more cyclical than linear.

In addition to the stages, the model proposes the following ten processes to be used to move the individual forward through the stages.

1. Consciousness-raising (Get the facts) — increasing awareness via information, education, and personal feedback about the healthy behavior.
2. Dramatic relief (Pay attention to feelings) — feeling fear, anxiety, or worry because of the unhealthy behavior, or feeling inspiration and hope when hearing about how people are able to change to healthy behaviors.
3. Self-reevaluation (Create a new self-image) — realizing that the healthy behavior is an important part of who they want to be.
4. Environmental reevaluation (Notice your effect on others) — realizing how their unhealthy behavior affects others and how they could have more positive effects by changing.
5. Social liberation (Notice public support) — realizing that society is supportive of the healthy behavior.
6. Self-liberation (Make a commitment) — believing in one’s ability to change and making commitments and re-commitments to act on that belief.
7. Helping relationships (Get support) — finding people who are supportive of their change.
8. Counterconditioning (Use substitutes) — substituting healthy ways of acting and thinking for unhealthy ways.
9. Reinforcement management (Use rewards) — increasing the rewards that come from positive behavior and reducing those that come from negative behavior.
10. Stimulus control (Manage your environment) — using reminders and cues that encourage healthy behavior and avoiding places that don’t.

To a large degree these processes correspond to types of interventions.

References:

DiClemente, C. C., & Prochaska, J. O. (1998). Toward a comprehensive, transtheoretical model of change: Stages of change and addictive behaviors. In W. R. Miller & N. Heather (Eds.), Applied clinical psychology. Treating addictive behaviors (p. 3–24). Plenum Press.

Noar, S.M., Benac, C.N., and Harris, M.S. (2007). Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological Bulletin, 4, 673-693.