The process of change: Part 2

As helping professionals, we are in the business of supporting our clients in making changes. In this article, we will look at the second stage of this process: preparation.

This is the second article in our series on the process of change. Part one outlines the Transtheoretical Model and explores contemplation, where a client is deciding whether to make the change or not.

What is preparation?

The preparation stage is when a client has decided to make a change and is now considering how they can go about doing it. It is a transitional stage between thinking and doing.

While theoretical models present discrete stages, in practice, change is far messier. Clients may still express ambivalence even as they begin to plan. Continuing to support them in evaluating their options and deciding to change is still present here. But we are also looking at how they can do it.

This stage is often overlooked, but it’s essential. Without adequate planning, even motivated clients may struggle to follow through or sustain momentum. Our role is to help them bridge the gap between intention and action.

Using DARN-CAT

In the first article, we looked at the acronym DARN: desire, ability, reasons, need. This refers to language we should look out for, known as change talk in Motivational Interviewing, that we can amplify to help the client decide to change.

The reason that we amplify it is that we know that the more a client uses this language, the more likely they are to make a change.

Let us extend this to DARN-CAT: commitment, action, taking steps. This language suggests the client is moving out of the contemplation stage and into the preparation stage. Let's look at some examples:

• "I am going to make more time for relaxation" demonstrates commitment.
• "I will write my resignation letter" demonstrates action.
• "I have emptied all of the alcohol out of my fridge" demonstrates taking steps.

Change planning

As well as continuing to strengthen the case for change, we also want to help our clients put together a practical plan for doing this.

This might involve getting down into the gritty details. What would the change look like? What would be the steps involved in making the change? What challenges might come up and how can we overcome or work around these?

Let's go back to our vignettes from the first article. Charlie is an overachiever with a strong self-critic. For him, preparation might involve developing kinder self-talk and allocating more time to relaxation. What would he say? How would he spend that time?

Nina, looking to make a career change, might need to think about how she would tell her friends and family about the change, what her resignation letter would look like, and what spending she could cut to allow her to live on a smaller income.

Jesse, wanting to stop binge drinking, might need to think about how they could see their friends away from alcohol, how they would respond when invited to the pub, and how they might want to use the time they previously spent hung over to add another source of enjoyment in their life.

Practical tools

Continuing to use Motivational Interviewing skills is important here as clients are likely to still have some ambivalence. Continue to use OARS and DARN-CAT.

Effective change typically involves goal setting, so bringing in frameworks such as SMART (specific, measurable, achievable, relevant, time-bound) is a good idea here. Planning ahead by listing potential barriers and ways to overcome them is useful, too.

Elements of positive psychology and solution-focused approaches are also valuable.

We also want to consider what supports a client has. This is both internal and external. Internally, what strengths does a client have that they can draw on and externally, who in their life could support this change?

We can use scale questions. "On a one to ten scale, how confident are you that you can make this change?" Let's say the client says four, we might ask, "What would get you to a five?"

Conclusion

As a client moves from contemplation to preparation, they have increasingly decided to make the change and are looking for practical support in understanding what taking action would look like. Continuing to help build their motivation and supporting practical planning are the key skills at this stage.