Stages of change and how to motivate

Precontemplation: Not ready to change: patient does not acknowledge negative consequences
Encourage patient to evaluate consequences of current behavior
Explain & personalize the risk
Recommending action is premature

Contemplation: Thinking of changing: patient acknowledges consequences but is ambivalent
Encourage evaluation of pros & cons of behavior change
Promote new, positive behaviors

Preparation: Ready to change: patient decides to change:
Encourage small initial steps
Reinforce positive outcome expectations

Action: Making change: patient makes specific, overt changes:
Help identify appropriate change strategies & enlist social support
Promote self-efficacy for dealing with obstacles

Maintenance: Changes integrated into patient’s life; focus on relapse prevention
Follow-up support; reinforce intrinsic rewards
Develop relapse prevention strategies

Identification: Behavior is automatic: changes incorporated into sense of self
Praise changes