Prochaska's six stage model

Question 1

What are the key assumptions of the model?

Answer 1

Does not view change as a single event but emphasises the gradual nature of change. Includes pre-action and post action stages and is cyclical - individuals move through the stages in order, but relapse to a prior stage may occur at any point. The final stage was added to allow for the fact that individuals can finally break out of the cycle and be free of the undesirable behaviour.

Question 2

What are the six stages?

Answer 2

Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination

Question 3

What is the precontemplation stage?

Answer 3

Stage 1 is the precontemplation stage, where the person has no intention of changing their behaviour in the near future, possibly because they are unaware that it is a problem.

Question 4

How would you move on from the precontemplation stage?

Answer 4

Explain and personalise the risk. Encourage re-evaluation of current behaviour and clarify the decision must be theirs.

Question 5

What is the contemplation stage?

Answer 5

Stage 2 is the contemplation stage, where the person is aware their behaviour is problematic, but are not quite yet committed to do anything about it.

Question 6

How would you move on from the contemplation stage?

Answer 6

Encourage evaluation of pros and cons of behavioural change. Identify new positive outcome expectations.

Question 7

What is the preparation stage?

Answer 7

Stage 3 is the preparation stage, where those who are prepared to change their addictive behaviour start to make small changes (e.g. cutting down the number of cigarettes they smoke). There is determination / commitment to action

Question 8

How would you move on from the preparation stage?

Answer 8

Identify social support. Verify that the individual has the skills required for behavioural change to occur. Encourage small initial step

Question 9

What is the action stage?

Answer 9

Stage 4 is the action stage which involves the most change and is where the person modifies their behaviour in order to overcome their problems (e.g. stops smoking). They are classified as being in this stage when they have changed their behaviour for between 1 day and 6 months

Question 10

How would you move on from the action stage?

Answer 10

Focus on reconstructing cues and social support, bolster self-efficacy and reiterate long term benefits

Question 11

What is the maintenance stage?

Answer 11

Stage 5 is the maintenance stage, where the person has to work hard to prevent relapse (e.g. continue to not smoke).

Question 12

How would you move on from the maintenance stage?

Answer 12

Plan for follow-up support, reinforce internal rewards and discuss coping with relapse

Question 13

What is the termination stage?

Answer 13

Stage 6 is the termination stage, and once the person enters this stage they are no longer tempted to revert to their previous behaviour (e.g. start smoking again) and often add new goals to achieve more success.
Prochaska claimed only about 20% of people ever make it to this stage.

Question 14

PROCHASKA’S SIX STAGE MODEL: Research support?

Answer 14

For example, Velicer et al 2007 conducted a Meta analysis and found that there was a robust 22–26% success rate for reducing addictive behaviours using this model. There were no demographic differences (e.g. age etc.) BUT success was dependent on the smoking habits (e.g. frequency)

Question 15

PROCHASKA’S SIX STAGE MODEL: Practical applications?

Answer 15

For example, appropriate interventions can be administered depending on the stage and treatment can be personalised to suit the needs of the individual.
For instance, someone in the contemplation phase may be advised to think more about moving on to act on to actually start committing to the decisions
Whereas someone in the action phase may be helped to move to the maintenance stage to help stop relapse

Question 16

PROCHASKA’S SIX STAGE MODEL: Contradicting research evidence?

Answer 16

For example, Aveyard et al. (2009) found no increase in effectiveness if an intervention was tailored to the stages of change to the individual trying to stop smoking.

Question 17

PROCHASKA’S SIX STAGE MODEL: Simplistic?

Answer 17

A weakness of Prochaska’s stage model is that the divisions between the stages may not be as clear cut as suggested by Prochaska.
Littell and Girvin, 2002 suggests that the stages are not mutually exclusive and that there is limited evidence of sequential movement through the stages in studies of specific problem behaviours, such as smoking and substance abuse.

Question 18

PROCHASKA’S SIX STAGE MODEL: Culturally relative?

Answer 18

Daoud et al (2015) found that, in Arab cultures, social smoking as a ritualised part of formal occasions, made it more difficult for people to quit. 62% of a sample of male smokers were still in the precontemplation stage and only 14% in the preparation stage, compared with studies in the US and Europe which have found averages of 40% in precontemplation and 20% in preparation.