| QUICK ANSWER |
| The transtheoretical model describes behaviour change using precontemplation, contemplation, preparation, action, maintenance and sometimes termination. It offers a framework for discussing readiness and support needs, but people do not necessarily follow a linear sequence. Evidence that stage-matched interventions are superior is mixed. |
Table of Contents
Someone considering a change may be interested in its benefits without knowing how to begin. Another person may already have a plan but need help maintaining it. These differences make it useful to discuss readiness and practical barriers. The transtheoretical model provides a familiar vocabulary for doing so. Its stages should be understood as a theoretical framework rather than a test that determines which assistance a person is permitted to receive.
The Six Stages
The 1997 overview by Prochaska and Velicer describes six stages of health behaviour change. These categories organise different levels of intention and ongoing action, rather than identifying separate medical diagnoses. How stages are defined can vary according to the behaviour being studied.
Precontemplation describes not currently intending to make the particular change. This may reflect limited information, different priorities, earlier difficulties or a considered decision. It should not automatically be treated as denial or unwillingness to learn. If a person wants information or support, it can be appropriate to provide it regardless of the label. Read why limiting beliefs can be difficult to change.
Contemplation describes considering change while remaining undecided about whether or when to act. Someone may recognise possible benefits while facing significant costs or uncertainties. A useful conversation can clarify those concerns without pressuring them to commit. See personal growth.
Preparation involves intentions and preliminary planning. Someone hoping to walk regularly might identify an accessible route, time and suitable footwear. In health-related decisions, preparation may include discussing clinical options with an appropriately qualified professional.
Action describes actively changing the behaviour. In the original health behaviour model, the time since a change helps distinguish action from maintenance. These definitions are not a universal timetable: a particular activity may require different periods and forms of support.
Maintenance emphasises continuing the behaviour and adapting to obstacles. Someone who has established a routine may still need support when travel, work or health changes. A maintained routine does not need to be perfect or effortless.
Termination describes a proposed condition in which temptation to return to an earlier behaviour is absent. It is not necessary for every goal or population, and many applications use five stages rather than requiring termination. Continuing support can remain appropriate. Explore growth mindset versus fixed mindset.
| RESEARCH NOTE |
| A 2022 Cochrane review of 41 smoking-cessation trials involving more than 33,000 participants found that practical counselling and self-help support were useful compared with no intervention or usual care. Four direct comparisons did not establish an advantage for stage-matched versions over equivalent standard interventions. |
Relapse And Cycling
The model allows movement between stages and reconsideration of earlier decisions. A person might revise a plan after encountering an unexpected cost or recognise that additional assistance is needed. There is no guaranteed sequence or number of attempts.
A setback is useful information when it reveals a barrier that can be addressed. If someone misses a planned study session because of an urgent family responsibility, a different schedule or fallback arrangement may help. The appropriate response depends on the actual circumstances, not simply on stage classification.
Relapse can carry serious risks in some health contexts, particularly substance use. It should not be dismissed as a harmless or inevitable step toward success. Seek appropriate clinical guidance when a return to an earlier behaviour poses health or safety concerns. Related reading: identity-based goals.
Readiness can vary across activities and within a short period. Instead of assigning a permanent stage, ask what the person currently wishes to do, what barriers exist and what assistance would be useful. The Cochrane findings described above caution against withholding smoking-cessation advice from people classified in earlier stages.
For personal routines, consider a feasible next action and an alternative if the initial plan becomes impractical. Review whether the action supports the intended outcome and adapt as needed. The model can support discussion, but appropriate interventions should be guided by the evidence for the specific behaviour.
| KEY TAKEAWAY |
| Use the stages of change as a flexible discussion tool. Provide appropriate support without imposing a fixed timeline, assuming relapse is necessary or treating a stage label as a barrier to care. |
Frequently Asked Questions
What Are The Six Stages Of Change?
Precontemplation, contemplation, preparation, action, maintenance and termination.
Must People Pass Through Every Stage?
No, the model is not a universal linear sequence.
Are Stage-Matched Treatments Always Better?
No, direct comparisons in smoking cessation have not established a clear advantage.
Is Relapse A Required Stage?
No, setbacks can occur but are not necessary for successful change.
How Do I Identify My Current Stage?
Consider your current intentions, actions and support needs rather than assigning a fixed identity.
