In daily life, we sometimes experience situations where we lose our motivation and do not feel ready enough to take action. During therapy sessions, Motivational Interviewing is conducted to address and resolve the problematic situation or behavior experienced. These interviews facilitate the client’s expression of their current state and, by addressing the pros and cons of change, help motivate the client toward modifying the problematic behavior.
The Stages Of Change model explains the process of change in individuals through five stages.
Precontemplation Stage
The first is the Precontemplation Stage. In this stage, the client is not aware of the problematic behavior and does not consider change. Sometimes, we encounter clients who are resistant to change, and in such cases, as therapists, we need to identify the source of this resistance. We focus on strategies that can reduce this resistance. The client may not want to experience the potential discomfort that might arise from leaving their current situation. This may cause the client to fear change and approach it with resistance.
At this stage, the therapist should listen to the client carefully, provide summaries, and use reflection strategies. When the client expresses counterchange thoughts, the therapist should not take a defensive or persuasive stance. The client must decide to change not under pressure, but of their own free will. Our main goal is not to force clients to change but to motivate them to begin considering change. For example, helping the client recognize the discrepancy between their current behavior and their goals can be an effective step.
It is important to offer the client various options and encourage them to make their own decisions, allowing space to think about change. This becomes especially valuable when working with defiant clients in the precontemplation stage, as such clients do not like being told what to do by others. Some clients, on the other hand, have lost their belief in change and feel defeated in the face of their problems. In this case, the therapist should focus on increasing the client’s Self-Efficacy and suggest starting the change process with small steps. This process can be difficult and time-consuming, but it is not impossible.
After discussing the positive aspects of their usual behavior, the client becomes more open to considering its negative aspects as well. In this way, both the advantages and disadvantages of the situation and the change are thoroughly addressed. Throughout this process, the therapist should maintain a stance that does not judge, pressure, or argue with the client. The therapist should strive to understand the client’s perspective and adopt approaches that strengthen the client’s self-efficacy.
Contemplation Stage
The second stage is the Contemplation Stage. In this phase, the client acknowledges the existence of the problem and begins to think about possible solutions. It should be remembered that not every individual who begins to contemplate change proceeds to action. Determination plays a crucial role in taking action.
When working with a client in this stage, aspects such as how long they have been considering change and whether there have been any previous attempts at change should be evaluated. According to research, clients in the Contemplation Stage tend to weigh the pros and cons of the behavior approximately equally (Prochaska et al., 1994). The therapist’s task is to emphasize the positive aspects. If the behavior had no benefit for the client, they would not continue it. Therefore, it is important for the client to recognize the gains they derive from this behavior.
A person cannot be fully ready for change without acknowledging these positive aspects (such as relaxation or stress reduction), as they would not be prepared to cope with the resistance that may arise during the process.
Preparation Stage
The third stage is the Preparation Stage. The therapist helps the client develop a feasible, realistic, and effective action plan. The decision-making process continues throughout the preparation phase, and the therapist evaluates the client’s commitment to change.
It can be helpful to create an emergency plan for potential triggering situations that the client may encounter once they move into action. In this way, the client gains awareness of when additional support may be needed, aiming to manage the process more effectively.
Action Stage
The fourth stage is the Action Stage, which represents the period in which the client takes action and clearly begins to change. In this phase, the client takes concrete steps toward change. Examples of such steps may include enrolling in a new course or pouring out all the alcohol bottles at home.
When the client succeeds in taking these steps, it is crucial for the therapist to acknowledge and reinforce this progress, as doing so plays an important role in strengthening the client’s self-efficacy.
Maintenance Stage
The goal of the fifth stage, the Maintenance Stage, is to help the client maintain their state of action and prevent relapse. Reinforcing the successful steps taken during the action stage is of critical importance. Strong motivation is encouraged to help consolidate the change.
Properly conducted motivational interviews enable the client to begin the change process with greater determination and motivation. Through the use of various motivational strategies, this process also strengthens the client’s sense of self-efficacy. Even when the achievements are small, it is important to help the client recognize these successes and convey the message that they are capable of accomplishing their goals.
References
Bundy, C. (2004). Changing behaviour: Using motivational interviewing techniques. Journal of the Royal Society of Medicine, 97(Suppl. 44), 43–47.
https://doi.org/10.1258/jrsm.97.suppl_44.43
DiClemente, C. C., Bellino, L. E., & Neavins, T. M. (2003). Motivational interviewing and the stages of change approach: Integrating best practices for behavioral change in professional training. Journal of Substance Abuse Treatment, 24(1), 29–36.
https://doi.org/10.1016/S0740-5472(02)00250-9