Have you ever decided to make a change in your life to improve your health, only to return to the unhealthy behavior you were doing before? We’ve all done it at one time or another – maybe it was trying to improve our sleep routine, giving up cigarettes, or maybe improving our diet. For a time, we’re doing a good job of sticking to our new regimen, but then for some reason, we go back to doing the unhealthy habit. That backslide into the old, unhealthy habit can be discouraging, but we shouldn’t let that deter us from trying again. According to experts, that backslide, or “relapse”, is a normal part of the habit-forming process.
One of the most intensely studied areas of psychology and health is a field called Behavior Modification, which studies the process that individuals go through when developing new habits. In the 1990s, after decades of research, behavior modification experts developed a model that can help us understand how habits are formed. This model is called The Stages of Change, and one of the key concepts that it’s built on is that positive, long-lasting change does not happen overnight. The main developers of this model were James Prochaska and Carlo DiClemente.
The Stages of Change model emphasizes that change occurs through a multi-step process that could last from months to, in some cases, a lifetime. It takes into account many factors, such as a person’s feelings about the new habit, whether the cost of changing is worth the benefit, and how confident they are about resisting the temptation to relapse. Over the last two decades, this model has been tested in studies dealing with everything from weight management to serious drug and alcohol addictions.
I’ll illustrate how the Stages of Change is structured and how we could apply it in an everyday situation. Let’s say someone, (we’ll call him Mark) has the habit of stopping by a fast food place every afternoon after work and getting a large milkshake for the drive home. Mark notices he’s putting on extra weight and he’s concerned, and even his doctor advises him to lose weight. Despite his doctor’s warning, he doesn’t see his daily milkshake as a problem and hasn’t thought about this habit as something he might need to change. In this scenario, behavior modification experts would say Mark is in the Precontemplation stage – he is not even considering a behavior change at this point.
Then one day, Mark reads an article that points out how many calories are in the average milkshake and that spurs him to weigh the 
cost of giving up something he enjoys versus the health benefit of losing those extra pounds. Even though he enjoys the daily milkshake, he knows it’s not healthy in the long run and he might need to change. In the Stages of Change model, this thought process of comparing the pros and cons of adopting a new, healthy habit is called the Contemplation stage.
Next, after deciding he wants to eliminate those extra calories, Mark circles the next Monday as the day he’ll start a new, after-work habit. That step, in which we designate a starting date, is what’s known as the Preparation stage. Mark then does some comparisons of different brands and purchases a supply of healthier drinks that he can bring to work instead of stopping at the drive-through. In other words, he’s progressed from just contemplating a change to actually doing something about it – he’s taken the Action step, which is the fourth Stage of Change.
After a few weeks, Mark has stuck to his plan of skipping the high calorie milkshakes, and he senses the health benefits this change has brought. However, he feels like his weight is under control and for a few days he gives in to the temptation of his milkshake craving. This goes on for awhile, but Mark realizes he’s gaining weight again so he returns to the healthier alternative. This little relapse that Mark experienced is known as the Maintenance stage and is considered a part of the change process as well. In fact, it’s not uncommon for us to have many relapses before the new habit sticks. Fortunately, it’s often easier to return to the new, healthier habit than it was to adopt it in the first place.
Keep in mind that the Stages of Change are thought to occur when an individual tries to make any positive behavior change, not just a diet-related one, as in the example above. I hope by reading this, you will contemplate starting a new, healthy habit yourself. The important thing to remember is that an important, personal change rarely happens in one step. Another key point is to not let a relapse back to the old, unhealthy habit get you down. Remind yourself that change takes time and it’s perfectly okay to make several attempts until the new habit sticks. Did you find anything in this article that might motivate you start a healthy habit? Do you think I left out an important point about change? I’d love to hear your thoughts.
Health professional/writer living in Richmond, Virginia. Graduate of the University of South Carolina. My interests include film, art, technology, and travel.
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