By Dr. Larry Pfaff
Counselors and therapists often observe widely different results when two individuals with the same skill deficiency, problem behavior or emotional difficulty receive the same intervention. Why? What prompts one person to change while another does not, even though they receive the same treatment or try the same activities? The answer may be found in some very interesting psychological research.
A New Model for Change
Traditionally, we have relied on a model that implicitly defined change as the movement from unproductive or inappropriate behavior to productive or appropriate behavior. Change is seen as a dramatic shift from one stable state (inappropriate behavior, unproductive, unskilled) to another stable but more appropriate state.
What is wrong with this conceptualization of change? First, it leads us to expect people to change quickly. So people attend one-day seminars to change their lives and are disappointed with the results. Or, people are promised that reading one self-help book will change their lives forever. Or, if we just knew the “Secret” then life would be perfect. Unfortunately, life-long behavior cannot be changed quickly.
Our traditional conceptualization leads us to expect change to be a dichotomous event. We think people should shift instantaneously from poor skills to good skills. We expect people to instantaneously shift from being shy and reserved to outgoing and gregarious. This is supported in the media and society in general, where change looks easy (usually taking place in one half-hour episode). So, we expect change to be almost instantaneous, whether the change has to do with weight loss, smoking, exercise, relationships, or work behavior.
Research has been done that shows a more accurate view of how people actually change. It can also help us in our counseling efforts. The central concept of this model is the notion of stages of readiness to change. Four categories of readiness have been defined: precontemplation, contemplation, action, and maintenance. The stages of change were first identified in a 1982 study comparing the processes of change used by smokers quitting on their own and smokers participating in two commercial treatment programs. Subsequent research has established that the amount of progress people make in changing behavior depends on their stage of change readiness.
Precontemplation. Individuals in the precontemplation stage have no intention of changing their behavior in the near future, usually defined as within the next six months. Many precontemplators deny they need to change, or they do not feel their situation is serious enough to change. They are resistant to acknowledging that a problem even exists. It isn't that they can't see the solution, they can't see the problem. For them the cost of changing behavior clearly outweighs the benefits. Precontemplators may feel that they are being pressured to change. Coerced change is rarely successful. When the pressure is off, they revert to old behavior patterns. The precontemplator is the client who during counseling says, "I don't understand why I'm here. I don't need any of this." This stage is most evident in the addicted individual, where the addict does not see addiction as a problem, but rather a solution.
Contemplation. Individuals in the contemplation stage acknowledge that they need to change, and they are seriously considering change. Movement to this stage is critical for change to occur. An individual must acknowledge that he/she has a problem and know what the problem is for productive change to take place. Contemplators weigh the pros and cons of the problem and examine possible solutions. An individual who is at this stage has somehow gained a new awareness of his/her current behavior. They are not ready for change yet, but they are willing to think about the alternatives and examine current behavior patterns.
Action. This stage is a period of active effort to change behavior. Action involves overt changes and requires considerable commitment of time and energy. Seminars and training programs can only help people at this stage. Unfortunately, action does not always equate to permanent change.
Maintenance. This is the stage in which people work to consolidate gains and prevent relapse. Traditionally, this is viewed as a static stage. However, maintenance can be a continuation, not the absence, of change. For an individual, maintenance often occurs after counseling is terminated where the environment, family and friends support the changes the individual is making. When this stage is missing there is often relapse.
Making Change Efforts More Effective
The model described above gives insight into the effectiveness, or ineffectiveness, of individual change efforts. It can help us understand why one client has changed his/her behavior after therapy (or any intervention) while another has not. The changing client most likely comes to therapy at the contemplation (or sometimes action) stage. The non-changing client is often at the precontemplation stage and probably did not understand why he/she was even in therapy. This often occurs when someone is set to therapy or forced to obtain counseling. Note: seminars, training programs and self-help books are most effective for people who are already at the action stage. They can occasionally help move an individual from contemplation to action, but the vast majority will only help those who are ready to take action.
Individuals must be moved from precontemplation to contemplation before or at the beginning of therapy. To move ahead in the cycle of change, precontemplators must acknowledge the need for personal change. What causes people to begin to think seriously about change? Research shows that the individuals need "consciousness raising" in order to progress. Consciousness raising is defined as a systematic method of confronting the person with observations about his/her behavior. In other words, the person must be helped to see his/her behavior from the perspective of others. Only then can we increase the likelihood of training success.
Discussing the difficulty of modifying problem behavior, Mark Twain commented: "Habit is habit, and not to be thrown out the window but coaxed downstairs a step at a time." Thus, human behavior does not occur with one bold effort. Change requires movement through discrete stages. Proper awareness and monitoring of the entire development effort is critical to counseling effectiveness. Otherwise, we are delivering counseling that is likely to fail.