Stages of Change

In the words of Antoine de Saint-Exupéry "A goal without a plan, is just a wish."  

I listened as a fellow coach sadly told his story.  A client he had been partnering with for the last 3 months had left him to go to another coach. And now, that client was finding success- AFTER he left! The coach thought he had been doing a great job, offering lessons, advice, motivation and inspiration, and now, he felt that he hadn't done his job well enough and honestly, was beating himself up. I knew he had done a great job, because every coach I've ever met cares 150% for their clients.

Behavior Change Takes Dedication

I asked the coach, “Is it possible that you helped your client move through the stages of change, and now they are ready to actually make change?  That in fact, all your effort helped.  You don’t get the ‘glory’ of hearing, ‘thank you for helping me change’, but you did the hardest part- laying the groundwork so he could walk through the stages of change easier."

Change is Difficult


Change does not happen lickity-split.  Ever watch a plant grow?  It takes determination, attention, education, fertilization and time.  Change is difficult. Change is complex, and while no one theory can explain all the nuances of behavior change, there are a few models that describe how many people cycle through stages of adaptation. Today's blog discusses the most common one and how you may feel as you walk through each stage.

Transtheoretical Model of Behavior Change

Prochaska and DiClemente (1995) developed the Transtheoretical Model (TTM) of Behavior Change, including the 5 Stages of Change which are: Precontemplation (not ready for change), Contemplation (thinking about change), Preparation (preparing for action), Action (taking action), Maintenance (maintaining a new behavior). 

The Stages and How We Talk to Ourselves

Here’s how each stage might sound in your own head:

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1.        Precontemplation: “silence”.  There are no thoughts of the change at all, because you don’t even know or think you need to change.  Or, you might say, “I won’t”, or “I can’t”.

You don’t even notice there is a problem.  You wonder what your loved ones are so worked up about, and you may even place blame on other things, like ‘it’s my genetics’, or, ‘I’m supposed to be like this- it’s my destiny.”  You don’t see any reason to change.  If you go to a doctor, or a coach it’s only because someone is nagging you and you might even say, “my spouse is the one who said I should come see you”.


2.        Contemplation: “I may” or, “I might”.  Or, “Some day I will change”.  Or, “I wonder why I feel so unwell?”. 

In the contemplation stage you begin to realize you’d like to make a change, but you’re not sure what direction to go, or how to do it, or even if you want to do it.  A sense of ambivalence tends to drive this stage, kind of like you are sitting on the fence, looking in both directions. 

The ideas and concepts are brewing, and you may even create a pros and cons list, but your cons list is probably longer than the pros. You may have even started investigating some options.  For example, if you want to lose weight, you may have looked at a gym’s website, or checked out one of their Trainer’s biographies.  People may even say you are procrastinating.



3.        Preparation: “I plan to…”, “I will”, or “I can”, or, “I’ve got to do something about this, this is serious!”, or "I want to learn about...".

In the preparation stage, you are developing a strong sense of belief that you almost ready to make the change. This is a research phase-you are aware of the barriers to change and have already developed some plans to over come the challenges. 

In some cases, you may have already taken some bigger steps toward action, like visiting a gym you want to go to, or researched a nurse coach you’d like to see soon.  You are more interested in listening to others who want to help you- but just a little bit.


4.        Action: “I am…”  “I’m doing…”

In the action stage you believe you can make a change and are actually modifying, adjusting and practicing new patterns and learning to facilitate your desired behavior.  This stage requires a significant amount of energy, and commitment.  You’ve already made plans on how to sustain the change, and how to mitigate the environment or others that may throw you off course.  You are ready to receive help from others and willing to take advice.


5.        Maintenance: “I still am”.

You are continuously committed to maintaining the change and have adjusted to notice the benefits of it. You are greatly aware that your effort is worthwhile, as actions become more habitual.  You have confidence that your new behavior will be sustainable.  You have thoughts of returning to old behaviors but believe the change is better than a relapse and resist the temptations.  Sometimes you think of relapsing numerous times in a day and have to reevaluate your progress from moment to moment.  The temptations begin to reduce as time goes on.

The Truth...

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The truth is, it is absolutely normal to go through lapses, and to recycle through the stages again and again, even with the same behavior change in mind! You might go through half the stages and then relapse, begin again and then finally you are sustaining your change!  Things that can set you off are, a life changing event, like a new job, a baby or an illness, maybe you become bored, or feel like things are too good, or something you hadn’t planned for sets you off. 

Understanding this is important, because, it’s not like you don’t have the willpower or can’t make the change- it’s just that your mind has to learn a new pattern and behavior- and that takes time!

When you have feelings and experiences like these- it’s important to try not to be too hard on yourself, because you’ve come so far already!  Instead it’s time to reinforce your strengths, appreciate your dedication and rigor, and support yourself with positive talk.  And you must give yourself SELF-LOVE- just like a parent would do!  Or maybe it’s time to set a new goal to reinvigorate you towards something fresh.  And if you need a Nurse Coach to partner with you and to develop an Action Plan, I’ve always got your back.  Let’s Talk!


Nicole Vienneau (said like piano with a 'V') MSN, RN, NC-BC is a registered nurse, board certified nurse coach, personal trainer & group fitness instructor who specializes in helping you use your power & wisdom to enhance your health& prevent disease. When she's not coaching clients, she loves playing in the mountains, sitting with her cats or traveling with her awesome husband.