Name _________________________ Section ________________ Date ___________________

W E L L N E S S WO R K S H E E T 3

Stages of Change
The stages of change model of behavior change includes six well-defined stages that people move through as
they work to change a target behavior. It is important to determine what stage you are in now so that you can
choose appropriate techniques for progressing through the cycle of change.
Target behavior/problem: ____________________________________________________________________
Goal of behavior change:____________________________________________________________________
Examples of target behaviors include smoking, eating candy bars every afternoon, and never wearing a safety
belt; the goal of your behavior change program might be quitting smoking, eating only one candy bar per
week, or wearing a safety belt every time you are a driver or passenger in a car.
Part I. Assess Your Stage
To determine your stage, check true or false for each of the following statements:
True

False

_____

_____

1. I changed my target behavior more than 6 months ago.

_____

_____

2. I changed my target behavior within the past 6 months.

_____

_____

3. I intend to take action in the next month and have already made a few small changes
in my behavior.

_____

_____

4. I intend to take action on my target behavior in the next 6 months.

Find the stage that corresponds to your responses:

False for all four statements = Precontemplation
True for statement 4, false for statements 13 = Contemplation
True for statements 3 and 4, false for statements 1 and 2 = Preparation
True for statement 2, false for statement 1 = Action
True for statement 1 = Maintenance
Part II. Strategies for Change
To help you move forward in the cycle of change, try the techniques and strategies listed below for your stage.
(You may find it helpful to work through the strategies for all the stages.) Put a check next to any strategy that
you complete.
Precontemplation
_____ Investigate your target behaviormake a list of the ways it affects you now and how it may affect
you in the future:
________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
(over)
Insel/Roth, Connect Core Concepts in Health, Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 1
Insel/Roth, Connect Core Concepts in Health, Brief Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 1

WELLNESS WORKSHEET 3 continued

_____ Become aware of the mental defenses you use to resist change; examples of defenses include denying
the consequences of your target behavior and rationalizing your reasons for not changing. List some
of the key mental defense mechanisms that you use to resist change:
________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
_____ Enlist friends and family members to help you learn more about your target behavior and the
defenses that block your progress. List the people you have spoken with, and briefly describe what
they told you about the defense mechanisms you use:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_____ Identify and list community resources that can help you change your target behaviorfor example,
a stop-smoking program or a stress-management workshop:
________________________________________ ________________________________________
________________________________________ ________________________________________
Contemplation
_____ Engage your emotions through strategies such as imagining your life without changing, watching
movies related to your target behavior, and becoming more aware of the current effects of your target
behavior (for example, blow cigarette smoke or spit tobacco juice into a white handkerchief, have
someone videotape you while you are drunk or hung over, or make a pile of the amount of candy or
junk food you eat in a month). List the strategies you tried:
________________________________________ ________________________________________
________________________________________ ________________________________________
_____ Keep a journal of your target behavior to establish a baseline. Examine the behaviors that lead up to
and follow your target behavior (see Wellness Worksheet 4).
_____ Complete a cost-benefit analysis of your target behavior:
Pros of current behavior:

Cons of current behavior:

________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
Pros of changing:

Cons of changing:

________________________________________ ________________________________________
________________________________________ ________________________________________
________________________________________ ________________________________________
(over)

WELLNESS WORKSHEET 3 continued

_____ Create a new self-image: Describe yourself and your life after you change your target behavior:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_____ Enlist the help of friends and family members to support your efforts and help you identify the causes
and consequences of your target behavior. List the people youve spoken with, and briefly describe
what they told you about your target behavior:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Preparation
_____ Make change a priority in your life; plan to commit the necessary time and effort to change.
_____ Create a specific plan for change, and complete a contract (see Wellness Worksheet 5).
_____ Tell the people in your life about the change youll be making, and enlist their help. List the people
youve spoken with and how they will help in your program for change:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Action
See Chapter 1 in your text for a detailed discussion of strategies for the action stage of change.
_____ Use a journal to monitor your behavior.
_____ Substitute healthier responses for your problem behavior. Complete Wellness Worksheet 4 to help you
identify ways to break the chain of events that leads to your target behavior.
_____ Manage your stress level, and dont let yourself get overwhelmed. (See Chapter 2 in your text for a
detailed discussion of stress-management techniques.) List three strategies youll use to help manage
stress during your behavior change program:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

(over)
Insel/Roth, Connect Core Concepts in Health, Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 1
Insel/Roth, Connect Core Concepts in Health, Brief Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 1

WELLNESS WORKSHEET 3 continued

_____ Practice positive, realistic self-talk (see Chapter 3 in your text).
_____ Make changes in your environment that will discourage your target behavior and encourage healthier
choices. Identify cues that trigger your target behavior and develop strategies for avoiding them or
making different choices (complete Wellness Worksheet 4).
_____ Give yourself the rewards you named in your contract (Wellness Worksheet 5) as well as plenty of
self-praise.
_____ Involve the people around you. Find a buddy to work with you on change and/or find a role model
who has already made the change you are working toward and who can provide both inspiration and
practical advice.
Buddy:__________________________________________________________________________
Role model:______________________________________________________________________
_____ Keep a positive attitude about yourself and the change you are attempting. Dont get discouraged
the action stage typically lasts for at least several months.

Maintenance
Continue with all the positive strategies you used in the action stage.
_____ Continue to monitor your behavior with a journal.
_____ Continue to manage your environment.
_____ Continue to practice realistic self-talk.
_____ Guard against slips, but dont let a slip set you back. Be prepared for complications.
_____ Help someone else make the change that you have just made. (Person to help:
_______________________________________________________________________________.)

Termination
If you complete the previous five stages and are no longer tempted to lapse back to your target behavior, you
are in the termination stage. You have a new self-image, positive feelings of self-efficacy, and a healthier
lifestyle.
For more on the stages of change model and many additional practical strategies, see the text Changing for
Good by James Prochaska, John Norcross, and Carlo DiClemente (Avon Books).

SOURCE: Prochaska, J. O., J. C. Norcross, and C. C. DiClemente. 1994. Changing for Good: A Revolutionary Six-Stage
Program for Overcoming Bad Habits and Moving Your Life Positively Forward. New York: Avon Books.