One of the most widely applied models of behaviour change in health is the transtheoretical model (TTM) which identifies 5 successive stages of change: Precontemplation > Contemplation > Preparation > Action > Maintenance. For successful change, we move from one stage to the next, progressing gently through each stage.
We are always in a stage of change - be it about exercise habits, our relationships, our self-acceptance, and all non-fixed aspects of our lives. Which stage do you think you're in?
Precontemplation
Who are you? You have no intention of making a change, whether through lack of awareness, information or through previous failure. You may believe that your excess weight around the middle simply "runs in the family", or that "it's hopeless". You tend to avoid reading, talking, or thinking about your unhealthy habits.
During this stage your interest may be sparked by outside influences, such as media, adverts, emotional experiences, illness, or a friend's concern.
How can you move to the next stage? You sense that the unhealthy habits are at odds with important personal goals, for example, not being healthy enough to play with your children or grandchildren. Or not fit enough to travel to new places.
Contemplation
Who are you? You are aware that your habits are not aligned to your goals and are contemplating doing something about it, but you are not committed to taking action yet. Ambivalence may make you play devils advocate with yourself! At this stage, someone may challenge your barriers to changing - either by overcoming the same barriers themselves, or by identifying a way you could get around them.
How can you move to the next stage? List the pros and cons of making the change, then think about ways to overcome the cons. For example, you may find it hard to squeeze in that 30 minute window to exercise. So, how about a 15-minute session twice a day? Could your child take a nap in the pushchair whilst you walk or even jog? Could you make larger batches of food every other night so you don't have to make supper the following night?
Preparation
Who are you? You know you have to change and believe you can. You are making plans to change soon.
How can you move to the next stage? Create a realistic step-by-step plan with achievable goals. If you want to increase your exercise levels, make it your goal to walk 20 minutes every day, working your way up to more ambitious goals. At the same time, identify potential barriers to your change - such as the summer holidays coming up which means you won't have time to exercise. Plan a way around this so it won't set you back, such as scheduling energetic activities in which you can all take part together.
Action
Who are you? You've changed. You are experiencing life without the old habits. You start to practice the actions to overcoming barriers which you identified during the previous stage.
How can you move to the next stage? It's important to be clear about your motivation to changing. Write them down and read them every day. Engage in other strategies to bolster your resolve such as "tapping", getting support from friends or a coach. Sharing your goals can make sticking to the path even easier.
Maintenance
Who are you? You've practiced the new behaviours for over 6 months. You are preventing relapse and integrating the change into your life.
How can you stay here? It may require other changes to avoid barriers or triggers associated with the old habit. Don't underestimate this stage. It can be tough as you work to fully integrate your new, healthier habits, but remember how worth it it really is.
So what?
We will always have setbacks, however understanding how to progress through change with the knowledge that you can identify and get over your barriers, make a plan and get back on track can be hugely motivating and has helped many of my clients continue with their progress. So, which stage of change are you in?
