Alec Wilson, PsyD, Individual and Couples Therapist - Portland Oregon

Therapist Portland Oregon Individual Couples

Stages of Change

stages of Change Therapist Portland OregonIn this article I’ll discuss stage of change theory and how the different stages of change can impact a person’s experience in therapy.

Stage of change refers to a person’s readiness for change and their relationship to their own change process — their ability to identify a problem, to understand something about its roots, to appropriately take responsibility for elements of it, and to begin active work toward the outcomes they want.

People enter therapy in different stages of change.

Before discussing the different stages, I want to point out that the simple act of asking, “Where am I in my change process?” can help a person increase their readiness for change and help them move toward taking action. Even the awareness that change usually happens as a process (rather than as a black-and-white event) helps people to identify where they are in relation to change and provides an indicator of what they might find helpful to move forward.

Hopefully by the end of this article you’ll have some new tools that will allow you to conceptualize where you are in your own change process and identify what you might do to move forward.

People most commonly enter therapy in the Contemplative, Preparation, or Action Stages of Change.


In the Contemplative stage, a person has begun to identify a problem in their life. They may not have completely zeroed in on the problem, and they probably feel ambivalent about change, that is, they are aware of competing forces on both sides of the problem. (I.e., “I don’t like feeling this way, but it’s going to open a big can of worms if I start to tinker with my life.”)

People in contemplation may not be considering change in the next month and they may need to explore their issues before they are ready to act. If you are feeling conflicted about change, this is an indicator that the exploration process is a necessary and valuable step. It will increase your clarity and increase the likelihood that you will follow through with an active game-plan when you are ready for one.

An aside: Many people enter therapy with the hope that it will provide them with tools to take action in their lives. Indeed, therapy does exactly that for many people. There is a risk, however, in jumping straight into change before taking some time to understand the problem and the impact that change will have. People who have not explored these issues are more likely to abandon their change process in midstream. This is because change takes hard work and commitment. It also frequently causes anxiety. Those who have not developed a clear sense of their own values and of the stakes involved with change often internalize these challenges as reasons to discontinue their efforts.

Some of the vital therapeutic work for the Contemplation stage includes identifying a problem, clarifying that the decision to change is yours, evaluating of pros and cons of change, and identifying and promoting positive expectations for new outcomes.


People in the Preparation stage have identified a problem and are testing the waters with initial changes. They may be planning to actively work on their issue(s) within a month. They have come to some understanding of the roots of their problem and are actively considering both sides of the issue—What will happen if I change? What will happen if I don’t? People preparing for change have often moved beyond blaming others and have begun to take responsibility for the part of the situation they have control over—themselves.

In therapy, work in the Preparation stage includes identifying obstacles to change and working to solve these problems, identifying social supports to help with the change process, validating the underlying skills that you bring to the equation and drawing on your past experience working through difficulty, and encouraging small initial steps toward real change.


People in the Action stage have been practicing making real changes in their lives. They have identified problems and understand something about their origins, have accepted responsibility for the elements of these problems that they can control, have worked to clarify their long-term values and reasons to change, and have accepted that hard work and anxiety often accompany change.

In therapy the work of the Action stage often includes:

  • Incorporating new skills and patterns into daily life.
  • Support to commit to long-term values (which often hold the key to long-term benefits) in order to cope with the inevitable stresses and losses that occur during change.
  • A focus on building new, healthy connections with the self (i.e., through new activities), with others (i.e., through positive social outlets), and with the world (i.e., through getting a new job, travel, etc.).
  • A focus on the assertiveness and self-efficacy required to both identify individual needs and take action toward fulfilling those needs in new, direct ways.

Other Stages of Change

Other stages include Pre-contemplation and Maintenance.

Pre-contemplation is characterized by a lack of awareness of the problem or externalization of the problem. “Ignorance is bliss.” “I don’t have a problem, it’s others who have the problem.” People in the Pre-contemplation stage are not currently considering change. As a result, they rarely seek out therapy, but may be referred by others.

Work in the Pre-contemplation stage includes: Validating the person’s lack of readiness, helping them clarify that the decision to change is theirs, encouraging their re-evaluation of current behavior, encouraging self-exploration rather than action, and exploring and personalizing the risk associated with change.

People in the Maintenance stage have shown a continued commitment to sustaining their new behaviors. They often benefit in therapy from support to continue with their plan and renew their commitment to long-term goals and values.

After my clients have completed their initial piece of therapeutic work, many return periodically for this kind of maintenance work–“check in” sessions they use to stay on track with their goals.

Thanks for reading. As always, if you have questions about this article or want to schedule an appointment, here’s my contact info:

Alec Wilson, PsyD


Phone: (503) 757-6259


3050 SE Division, Suite 260, Portland, OR  (In the ‘D Street’ building.)