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Stages of Change...


Gold Member
[FONT=Arial, Helvetica, sans-serif]Prochaska and DiClemente’s Stages of Change Model[/FONT]

[FONT=Arial, Helvetica, sans-serif]Stage of Change[/FONT]

[FONT=Arial, Helvetica, sans-serif]Characteristics[/FONT]

[FONT=Arial, Helvetica, sans-serif]Techniques[/FONT]

[FONT=Arial, Helvetica, sans-serif]Pre-contemplation[/FONT]
[FONT=Arial, Helvetica, sans-serif]Not currently considering change: "Ignorance is bliss"[/FONT]
[FONT=Arial, Helvetica, sans-serif]Validate lack of readiness [/FONT]
[FONT=Arial, Helvetica, sans-serif]Clarify: decision is theirs [/FONT]
[FONT=Arial, Helvetica, sans-serif]Encourage re-evaluation of current behavior [/FONT]
[FONT=Arial, Helvetica, sans-serif]Encourage self-exploration, not action [/FONT]
[FONT=Arial, Helvetica, sans-serif]Explain and personalize the risk [/FONT]
[FONT=Arial, Helvetica, sans-serif]Contemplation[/FONT]
[FONT=Arial, Helvetica, sans-serif]Ambivalent about change: "Sitting on the fence" [/FONT]
[FONT=Arial, Helvetica, sans-serif]Not considering change within the next month[/FONT]
[FONT=Arial, Helvetica, sans-serif]Validate lack of readiness [/FONT]
[FONT=Arial, Helvetica, sans-serif]Clarify: decision is theirs [/FONT]
[FONT=Arial, Helvetica, sans-serif]Encourage evaluation of pros and cons of behavior change [/FONT]
[FONT=Arial, Helvetica, sans-serif]Identify and promote new, positive outcome expectations [/FONT]
[FONT=Arial, Helvetica, sans-serif]Preparation[/FONT]
[FONT=Arial, Helvetica, sans-serif]Some experience with change and are trying to change: "Testing the waters" [/FONT]
[FONT=Arial, Helvetica, sans-serif]Planning to act within 1month[/FONT]
[FONT=Arial, Helvetica, sans-serif]Identify and assist in problem solving re: obstacles [/FONT]
[FONT=Arial, Helvetica, sans-serif]Help patient identify social support [/FONT]
[FONT=Arial, Helvetica, sans-serif]Verify that patient has underlying skills for behavior change [/FONT]
[FONT=Arial, Helvetica, sans-serif]Encourage small initial steps [/FONT]
[FONT=Arial, Helvetica, sans-serif]Action[/FONT]
[FONT=Arial, Helvetica, sans-serif]Practicing new behavior for [/FONT]
[FONT=Arial, Helvetica, sans-serif]3-6 months[/FONT]
[FONT=Arial, Helvetica, sans-serif]Focus on restructuring cues and social support [/FONT]
[FONT=Arial, Helvetica, sans-serif]Bolster self-efficacy for dealing with obstacles [/FONT]
[FONT=Arial, Helvetica, sans-serif]Combat feelings of loss and reiterate long-term benefits[/FONT]
[FONT=Arial, Helvetica, sans-serif]Maintenance[/FONT]
[FONT=Arial, Helvetica, sans-serif]Continued commitment to sustaining new behavior [/FONT]
[FONT=Arial, Helvetica, sans-serif]Post-6 months to 5 years[/FONT]
[FONT=Arial, Helvetica, sans-serif]Plan for follow-up support [/FONT]
[FONT=Arial, Helvetica, sans-serif]Reinforce internal rewards [/FONT]
[FONT=Arial, Helvetica, sans-serif]Discuss coping with relapse [/FONT]
[FONT=Arial, Helvetica, sans-serif]Relapse[/FONT]
[FONT=Arial, Helvetica, sans-serif]Resumption of old behaviors: "Fall from grace"[/FONT]
[FONT=Arial, Helvetica, sans-serif]Evaluate trigger for relapse [/FONT]
[FONT=Arial, Helvetica, sans-serif]Reassess motivation and barriers [/FONT]
[FONT=Arial, Helvetica, sans-serif]Plan stronger coping strategies [/FONT]
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Gold Member
So.. this is a model of change that we can all go through.. I was thinking I might look at it afresh in relation to my CD.. I'm doing fine, but starting to think again about how I'll cope when I move up from SS+ in a few week's time (hopefully).. I'm a little scared...

I stood in the fish and chip queue with my OH this evening.. obviously didn't get anything.. but I started realising how easy it would be to fall in to old ways once I'm off SS+ and it scared me.. I can see myself falling into my old habits within months of reaching goal, and I'm scared.......... I need STRATEGIES, PLANS, SUPPORT, NEW HABITS.. and I need to think about what they will look at in reality!!



Shut up Ethel
Useful, thank you. This made me think of the Kubla-Ross model, the change curve, which might also be useful...you know the one:


(plus all the little sub stages!)


Gold Member
ooh Liz, what lovely timing to be reminded of something so useful.. I've never related it to this context, but it fits!
If we go through all these stages when we contemplate the loss of comfort eating as our way of coping, then it's not surprising that we get stuck in a cycle..


Integration are the key! :)



Shut up Ethel
Yes I had never applied it to CD but I think it does fit (with a bit of jigging!)

I forgot shock....the shock of realising how big you are, perhaps? the shocker of being told you're pre-diabetic, and on track for a heart attack?

Anger - being cross at having to diet; being angry at not being like other people; being angry about 'not being able to have' certain things

Denial - perhaps this is what's behind blipping - the 'no, it'll be ok' mindset. Or perhaps 'oh bugger it I'm just destined to be fat'

Bargaining - I'll have this now, and make up for it later; I'll stick to it all week and then have a 'treat' for being good (wtf?!); if I do this then I can have that dress (works both ways I think, +ve and -ve)

Acceptance - I have to do this, and I choose to do this, and it works and its the best thing I can do right now, no thank you I won't have a pizza/cake/gin and tonic

Integration - learning to live with doing a vlcd; learning to adopt a good healthy diet for the rest of your life?

Kubler-Ross was spot on the money with this, wasn't she?! I just wish I could stay in one place on the curve, namely acceptance and/or integration, instead of bouncing about all over the place!


Gold Member
...so, what if, just maybe, integration is the stage in which we continue to experience the anger, denial, bargaining.. we continue to slide around in those stages of change.. in our heads (and occasionally in our actions).. and at the same time, we recognise that we don't have to be constrained by our turbulent emotions.. we can do what we most want to really do for our long term wellbeing, rather than just what we want to do in the moment/as a response to our immediate difficult emotions..

maybe integration is about being ok with ourselves WITH all these messy human emotions, and still being able to be kind to ourselves... Really kind.. giving ourselves what we most deserve for our best well being...

...maybe :)


Shut up Ethel
absolutely - how nicely put! I have the curve on my wall at work - I refer to it so often - I shall look at it in a different light now. And I'm going to print your initial post so I can look at it when I feel my resolve slipping (or I am battling those internal demons) as I think its a very useful way of refocusing.

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