The process of change: Part 4

Welcome to the final article in our series on the process of change. In this series, we have been exploring how to apply the Transtheoretical Model to help our clients, or ourselves, make positive life changes.

In the first three parts, we examined the process of deciding to change, planning to change and taking action. In this article, we will explore how we maintain this change over the long term and integrate it into daily life.

What is the maintenance stage?

We might define the first two steps of the Transtheoretical Model as the thinking stage and the latter two as the doing stage. In action, we begin to implement the things we want to change. This stage comes with challenges, but motivation is typically high at this point.

As time goes on, however, the novelty can wear off and our motivation can begin to slide, opening the chance for relapse. Fully developing a habit can take months, or in some cases even longer, so this is a critical stage to long-term success.

A key difference is that in the action stage, the change is being done deliberately. This requires effort. In the maintenance stage, we want to gradually change this from being deliberate to being automatic.

For example, let's say we're trying to make healthier dietary choices. In the action stage, we might deliberately reach for the fruit rather than the chocolate bar. But this is hard. At some point, we want to reach for the fruit without thinking about it. Otherwise, when we're tired or feeling low, we are likely to reach for the chocolate bar again.

Preparing for challenges

The maintenance phase has its own set of challenges, and we can help our clients to prepare for this.

Motivation declines over time as we lose the excitement or passion that drove the initial change. We may need to re-examine the initial motivation to remember why we chose to make the change.

At this stage, we may encounter identity mismatch where we still think of ourselves in the old way and have not fully assumed our new identity.

We may encounter ups and downs in life. We often make changes when we are in a good place, but then run into rough patches over time, and these can derail us.

We may also encounter specific challenges, such as people or places that cue old habits. For example, we decide to stop drinking, but then an old friend invites us to the pub. Or we commit to eating healthier, but then it is the holidays and party food is everywhere.

Supporting clients in maintenance

Let's once again re-examine our vignettes. Charlie, the overachiever with a strong self-critic, is now relaxing more. But over time, he will encounter new demands on his time. For example, his next set of exams. He might need support in maintaining these boundaries and continuing to separate achievement from his self-worth.

Nina has made her career change. While she finds the new career more fulfilling, she finds learning new skills frustrating, as she has lost the sense of mastery she had in her old career. Some days she might think of going back to her old job and earning some easy money. She might need support reconnecting with her values, leveraging support and continuing to form her new identity.

Jesse has reduced their binge drinking. This has made more time for their relationship, but also meant disconnecting from old friends. Jesse might benefit from support in developing this new identity away from alcohol and finding new social outlets. They may also need support in planning for challenging situations, for example, being invited to a wedding where most people will be drinking.

Practical tools

A foundation of this stage is normalising setbacks and relapses. Clients may be tempted to think that relapse "opens the floodgates". But progress is often up and down, and rarely perfect. Expecting and normalising this can help clients stay on the right track overall. When it does happen, we should greet these events with compassion and avoid shaming.

We can take this further by planning for potential setbacks and putting strategies in place ahead of time. What are the high-risk situations? What resources or coping skills could help?

Habit-formation strategies can help clients do behaviour on autopilot. For example, using cues or routines. Let's say we wanted to relax more. Instead of having our laptop on the desk when we get home, we might have a fun book to read. If we want to go to the gym first thing in the morning, we might prepare our bag the night before.

Finally, we want to develop our new identity. This might involve encouraging the client to reflect on who they are becoming and what they like (and dislike) about it.

Conclusion

In the maintenance phase, we begin to fully adopt our new identity; changes stop being something new that we are doing and start being the way we do things.

This does not happen overnight and may involve ups and downs. Clients benefit from planning for setbacks, habit-formation strategies and support in developing their new identity.