Webb Therapy Uncategorized The stages of change model

The stages of change model

‘The stages of change model’ was developed by Prochaska and DiClemente. Heard of them? It informs the development of brief and ongoing intervention strategies by providing a framework for what interventions/strategies are useful for particular individuals. Practitioners need an understanding of which ‘stage of change’ a person is in so that the most appropriate strategy for the individual client is selected.

There are five common stages within the Stages of Change model and a 6th known as “relapse”:

1. In the precontemplation stage, the person is either unaware of a problem that needs to be addressed OR aware of it but unwilling to change the problematic behaviour [or a behaviour they want to change. It does not always have to be labelled as “problematic”].

2. This is followed by a contemplation stage, characterized by ambivalence regarding the problem behaviour and in which the advantages and disadvantages of the behaviour, and of changing it, are evaluated, leading in many cases to decision-making.

3. In the preparation stage, a resolution to change is made, accompanied by a commitment to a plan of action. It is not uncommon for an individual to return to the contemplation stage or stay in the preparation stage for a while, for many reasons.

4. This plan is executed in the action stage, in which the individual engages in activities designed to bring change about and in coping with difficulties that arise.

5. If successful action is sustained, the person moves to the maintenance stage, in which an effort is made to consolidate the changes that have been made. Once these changes have been integrated into the lifestyle, the individual exits from the stages of change.

6. Relapse, however, is common, and it may take several journeys around the cycle of change, known as “recycling”, before change becomes permanent i.e., a lifestyle change; a sustainable change.

(Adapted from Heather & Honekopp, 2017)

Related Post

What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

  • Physical and biological processes (e.g., genetic inheritance).
  • Growth of the body and its organs.
  • Functioning of physiological systems (e.g., brain).
  • Health and wellness.
  • Physical signs of ageing and changes in motor abilities.

Cognitive development includes:


Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

Age or StageConflictExampleResolution or “virtue”Key Question to be answered
Infancy (0 to 18 months)Trust vs. MistrustBeing feed and cared for by caregiver.HopeIs my world safe? Will I be cared for?
Early Childhood (2 to 3 years)Autonomy (personal control) vs. Shame and DoubtToilet training and getting dressed.Will I would add self-efficacy here too.Can I do things for myself, or will I always rely on others?
Preschool (3 to 5 years)Initiative vs. GuiltInteracting with other children and asserting themselves in their environment e.g., during play.Purpose Taking initiative, leading others, asserting ideas produces a sense of purpose.Am I liked by others or do I experience disapproval by others?
School Age (6 to 11 years)Industry (competence) vs. InferiorityStarting formal education and participating in activities.CompetenceHow can I do well and be accepted by others?
Adolescence (12 to 18 years)Identity vs. Role Confusion (uncertainty of self and role in society)Developing social relationships with peers and sense of identity.Fidelity (loyalty) The ability to maintain loyalty to others based on accepting others despite differences.Who am I and where am I going in my life? What are my personal beliefs, values and goals?
Young Adult (19 to 40 years)Intimacy vs. IsolationDeveloping intimate relationships.LoveAm I loved and desired by another? Will I be loved long-term?
Mature Adult (40 to 65 years)Generativity vs. StagnationVocation and parenting, typically.Care Contributing to the world to demonstrate that you care.Will I provide something to this world of real value? E.g., children or valuable work, art, a legacy etc.
Maturity (65 year to death)Ego Identity vs. DespairReflection of your life. Feelings of satisfaction and wholeness.WisdomWas I productive with my life? Can I accept my life and have a sense of closure and completeness?

Fact. Truth. Belief. They are related but distinct. Here’s a clear explanation showing how they differ and interact:Fact. Truth. Belief. They are related but distinct. Here’s a clear explanation showing how they differ and interact:


1. Fact

Definition:
A fact is something that is objectively real and can be proven to be true. It exists independently of what anyone thinks or believes.

Example:

  • It is a fact that Australia is in the Southern Hemisphere.

Key Points:

  • Facts don’t change based on opinion.
  • They can be verified with evidence (e.g. scientific data, observation, reliable records).
  • Facts are the foundation upon which truth claims and beliefs can be tested.

2. Truth

Definition:
Truth is a quality of a statement or belief that accurately reflects reality or fact.

Example:

  • “Australia is in the Southern Hemisphere” is a true statement because it corresponds with the fact.

Key Points:

  • Truth depends on alignment with facts.
  • Truth is often expressed in language or claims (“That’s true”, “That’s not true”).
  • Something can be true even if no one believes it (e.g. the Earth orbited the Sun even when most people thought otherwise).

3. Belief

Definition:
A belief is something a person thinks or accepts as true, whether or not it actually is.

Example:

  • Someone might believe that kangaroos can be kept as pets in all Australian states — but that belief isn’t necessarily true or factual.

Key Points:

  • Beliefs are subjective — they vary between individuals and cultures.
  • A belief can be true or false, depending on whether it aligns with facts.
  • People often act based on their beliefs, regardless of whether they are accurate.

How They Interact

  • A belief can be true or false:
    → If your belief aligns with fact, it’s true.
    → If not, it’s false — even if sincerely held.
  • Truth depends on fact:
    → A statement is true if it correctly describes a fact.
  • Facts stand alone:
    → They are not changed by belief or opinion.

Addiction – What You Need To KnowAddiction – What You Need To Know

Addiction fundamentally alters the brain’s reward and decision-making systems through well-documented neurobiological mechanisms. When substances like drugs (including alcohol and nicotine) are consumed, they trigger massive releases of dopamine in the brain’s reward circuit, particularly in areas like the nucleus accumbens and ventral tegmental area. With repeated exposure, the brain adapts by reducing natural dopamine production and decreasing the number of dopamine receptors, creating tolerance and requiring increasingly larger amounts of the substance to achieve the same effect. This neuroadaptation hijacks the brain’s natural reward system, making everyday activities less rewarding while the addictive substance becomes disproportionately important.

Over time, addiction also impairs the prefrontal cortex, the brain region responsible for executive functions like decision-making, impulse control, and weighing long-term consequences. This creates a neurological double-bind: the midbrain structures driving craving and drug-seeking behaviour become hyperactive, while the prefrontal systems that would normally regulate these impulses become weakened. Chronic substance use also disrupts stress response systems, making individuals more vulnerable to relapse during difficult periods. These changes help explain why addiction is recognised as a chronic brain disease rather than simply a matter of willpower – the neuroplastic changes can persist long after substance use stops, though the brain does have remarkable capacity for recovery with sustained abstinence and appropriate treatment.

The Challenge of Stopping

The challenge of stopping stems from the profound neurobiological changes addiction creates in the brain’s fundamental survival systems. The brain essentially learns to treat the addictive substance as necessary for survival, similar to food or water. When someone tries to quit, they face intense physical withdrawal symptoms as their neurochemistry struggles to return to homeostasis, combined with psychological cravings that can persist for months or years. The damaged prefrontal cortex makes it extremely difficult to override these powerful urges with rational decision-making, while stress, environmental cues, and emotional states can trigger automatic drug-seeking responses that feel almost involuntary. This creates a cycle where attempts to quit often lead to temporary success followed by relapse, which many interpret as personal failure rather than recognising it as part of the neurological reality of the condition.

Addiction appears progressive because tolerance drives escalating use over time, while the brain’s reward system becomes increasingly dysregulated. What begins as recreational use gradually shifts to compulsive use as natural dopamine production diminishes and neural pathways become more deeply entrenched. The condition typically follows a predictable pattern: initial experimentation leads to regular use, then to use despite negative consequences, and finally to compulsive use where the person continues despite severe impairment in major life areas. Additionally, chronic substance use often damages the brain regions responsible for insight and self-awareness, making it harder for individuals to recognise the severity of their condition. The progressive nature is also influenced by external factors – as addiction advances, people often lose social supports, employment, and housing, creating additional stressors that fuel continued use and make recovery more challenging.

Understanding addiction when you’re not “addicted” to alcohol or other drugs

The difficulty in understanding addiction, even among people with their own compulsive behaviors, stems from several key differences in how these conditions manifest and are perceived. While behaviors like sugar consumption, social media use, or shopping can indeed activate similar dopamine pathways, they typically don’t create the same level of neurobiological hijacking that occurs with substances like alcohol, opioids, or stimulants. Addictive drugs often produce dopamine surges 2-10 times greater than natural rewards, creating more profound and lasting changes to brain structure and function. Additionally, many behavioral compulsions allow people to maintain relatively normal functioning in major life areas, whereas substance addiction typically leads to progressive deterioration across multiple domains – relationships, work, health, and legal standing.

The social and cognitive factors also create barriers to understanding. Most people can relate to losing control occasionally – eating too much dessert or spending too much time scrolling their phone – but these experiences usually involve temporary lapses that can be corrected relatively easily through willpower or environmental changes. This creates a false sense of equivalency where people think “I can stop eating cookies when I want to, so why can’t they just stop drinking?” They don’t grasp that addiction involves a qualitatively different level of brain change where the substance has become neurobiologically essential, not just psychologically preferred. There’s also often a moral lens applied to addiction that doesn’t exist for other compulsive behaviours – society tends to view overconsumption of legal, socially acceptable things as personal quirks or minor character flaws, while addiction to illegal substances or excessive alcohol use carries heavy stigma and assumptions about moral failing, making it harder to see as a medical condition requiring treatment rather than simply better self-control.

A Word On Nicotine (Tobacco Products)

Yes, nicotine absolutely does release large amounts of dopamine, making it highly addictive despite being legal and socially accepted in many contexts. Nicotine causes an increase in dopamine levels in the brain’s reward pathways, creating feelings of satisfaction and pleasure.Research shows that nicotine, like opioids and cocaine, can cause dopamine to flood the reward pathway up to 10 times more than natural rewards.

This helps explain why nicotine addiction can be so powerful and difficult to overcome, even though people often view smoking or vaping as less serious than other forms of substance addiction. Repeated activation of dopamine neurons in the ventral tegmental area by nicotine leads not only to reinforcement but also to craving and lack of self-control over intake. The addiction develops through the same basic mechanisms as other substances – as people continue to smoke, the number of nicotine receptors in the brain increases, requiring more of the substance to achieve the same dopamine response.

What makes nicotine particularly insidious is its legal status and social acceptance, which can make people underestimate its addictive potential. The rapid delivery of nicotine to the brain (within 10-20 seconds when smoked) creates an almost immediate reward that strongly reinforces the behaviour. This is why many people who successfully quit other substances still struggle with nicotine, and why nicotine addiction often serves as a gateway that primes the brain’s reward system for addiction to other substances.