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Regardless of what specific behavior you would like to change, there are several steps you must take in order to shift the habit. I find being aware of the pre-contemplation stage, where you muse about whether the behavior is a problem or not, and the contemplation stage, where you weigh the costs and benefits of changing, will help you achieve the goal with greater success. Furthermore, recalling these first two stages is the key to dealing with, and recovering from, relapse.  Start with these questions:

Questions for Patients in the Precontemplation and Contemplation Stages*


Precontemplation stage
Goal: The patient will begin thinking about change.
“What would have to happen for you to know that this is a problem?”
“What warning signs would let you know that this is a problem?”
“Have you tried to change in the past?”
Contemplation stage
Goal: The patient will examine benefits and barriers to change.
“Why do you want to change at this time?”
“What were the reasons for not changing?”
“What would keep you from changing at this time?”
“What are the barriers today that keep you from change?”
“What might help you with that aspect?”
“What things (people, programs, and behaviors) have helped in the past?”
“What would help you at this time?”
“What do you think you need to learn about changing?”

*–The change can be applied to any desirable behavior (e.g., smoking or drinking cessation, losing weight, exercise).
Information from Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York: Guilford, 1991:191-202.

There is more on the American Family Physician website. Also if you want to quit smoking the California Smokers’ Helpline (800-No-Butts)  is useful and I have a number of patients who have had wonderful success with hypnotherapy (and have a great one I would recommend).

Stages of Change Model


Stage in transtheoretical model of change


Patient stage


PrecontemplationNot thinking about change
May be resigned
Feeling of no control
Denial: does not believe it applies to self
Believes consequences are not serious
ContemplationWeighing benefits and costs of behavior, proposed change
PreparationExperimenting with small changes
ActionTaking a definitive action to change
MaintenanceMaintaining new behavior over time
RelapseExperiencing normal part of process of change
Usually feels demoralized

Information from Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Am Psychol 1992;47:1102-4, and Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York: Guilford, 1991:191-202.