See an overview regarding, and links related to, patient self-management.
The change process model—pre-contemplation to maintenance—is a useful way of understanding the process of behavioral change. It can help health professionals assess a patient’s current level of motivation and effectively address current readiness to change.
The model indicates that five stages occur in the change process:
Person has no intention to change behavior in the foreseeable future. The person may not be aware of the problem.
Person is aware of a problem but has not made a commitment to take action.
Person has intention to make changes. May try preparatory small changes—i.e., cut down on number of cigarettes smoked per day.
Person makes changes to behavior and/or environment.
Person maintains health behavior change. Many first attempts to change are not successfully maintained.
For addictive behaviors, maintenance is defined as more than six months of sustained behavior change. Chronic illness and addictions require lifetime maintenance.
People who are unready to change have ambivalence about changing behaviors. This is a natural process and how the healthcare professional interacts with the patient can help the patient decide to explore behavior change. When the patient is ambivalent or expresses resistance, it is more appropriate to use a guiding style (alternatives are offered in support of the patients’ ability to choose) than a directive approach (simply telling a patient what to do).