Stages of Change


By Dr Jessica Brands, Director & Clinical Psychologist

Therapy can be a very intense thing to undertake, full of highs as well as challenging points. Change is hard, and humans are inclined to stay the same and return to a state of ‘homeostasis’ even if this state is maladaptive. Everyone will be in a different stage of change when it comes to undertaking therapy to change their behaviour. This is very apparent in addictions, such as alcohol or drug misuse, gambling, or eating addiction, where there is a physiological dependence or psychological compulsion to continue the behaviour.

state of change

Outlined below is the Stage of Change cycle:

Stage 1 – Precontemplative:

The person is not ready to change and do not recognise they have a problem. Often they attend therapy at the request of third parties, such as loved ones or court-mandated therapy.

Stage 2 – Contemplative:

The person recognises there are some problems with their behaviour. They are in ‘conflict’, where part of them wants to change, and another part does not want to change. This is a common entry point for therapy. Motivational Interviewing can be an effective intervention for people in this stage of change.

Stage 3 – Preparation:

In this stage, the person is ready to change and are making plans to do so. This could be seeking out a rehabilitation service or discussing medication with your GP.

Stage 4 – Action:

The person is actively taking steps to change their behaviours. Perhaps they are in the middle of intervention, or reducing problematic behaviours. They may be changing their relationships, or changing beliefs within themselves that cause problems.

Stage 5 – Maintenance:

In this stage, the person has achieved all their desired change, and are maintaining their gains.

An extra stage – Relapse:

Hopefully, people can maintain their changes for several years after the action stage. However, from time to time, people will go off track, relapse or return to problematic behaviours. Before ending therapy, your therapist will discuss relapse prevention strategies to help you stay well. The best thing you can do if you find yourself in this stage is return to treatment.

For more information on addiction; see