Navigating the Phases of Change: June and Johnny Part II

written by Jack Vaughan

 

 

 

***Heads up: If you haven’t already checked out, “People Seldom Listen To Good Advice – Here’s Why” and “Guiding: The Conversational Key to Unlocking Change,” please give those a read before venturing further so that the jargon below makes sense. Or continue at your own peril; I can’t stop you.***   

 

Given the right conditions, people can change for the better. But how exactly do we, as change-advocates, help cultivate this for the change-ambivalent? Well, aside from ignoring the righting reflex and using the guiding style of communication, we need to understand how the stages of change function and learn how to locate our change-based conversation as it relates to each stage. If guiding is necessary throughout each step of the journey, understanding the stages of change is how we derive the present location of our change-based conversation and chart our future destinations. 

 

Perhaps you are familiar with the Transtheoretical Model of Change which established six stages of change. These are precontemplation, contemplation, preparation, action, maintenance, and termination.[1] While these stages can help us better gauge where a change-ambivalent person may be, they don’t tell us how to help them navigate from one stage to the next. This is where Motivational Interviewing comes in. MI has four key processes that change-advocates can use to assist the change-ambivalent throughout every stage of change. These processes are engaging (establishing a helpful connection and working relationship), focusing (developing and maintaining a specific direction in the conversation about change), evoking (eliciting the person’s own motivations for change), and planning (formulating a concrete plan of action and developing commitment to change).[2] The great thing about these four processes is that change-advocates can use them no matter where a change-ambivalent person may be located on the TTM spectrum. To better explore how these four MI processes overlap with the stages of change, let’s pay another visit to June Carter-Cash, Johnny Cash, and Johnny’s penchant for smoking tobacco.  

 

***Disclaimer: Please keep in mind that the following examples are merely for the sake of demonstration and have been intentionally oversimplified. The actual task of using these four MI processes in conjunction with TTM requires tremendous skill, practice, and patience.  

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Precontemplation: Johnny has no intention of changing. He smokes like a chimney and does not recognize his behavior as detrimental in any way. Based on this behavior, June understands that Johnny is in the precontemplation stage. So, she engages him by saying, “Hey Hon, what can you tell me about your current smoking habit?” Then, June focuses their conversation about change by steering it in a specific direction, “How do you feel about this particular habit?” Once this directionality has been established, June works on evoking Johnny’s potential motivations for change, “How do you think you might feel if you smoked less?” Finally, June helps Johnny by planning on continuing the conversation, “I know this is a difficult topic to discuss, but I want you to know that I’m happy to talk it through with you any time.”

 

Contemplation: Johnny is now in a state of ambivalence about change. He contemplates the pros and cons of changing, but the scales are stubbornly balanced. This kind of ambivalence can cause him to slip into lengthy periods of stagnation or worse, backslide into precontemplation. Johnny says, “June, I know smoking isn’t great, and I don’t want our daughters to pick up on my habit, but it helps me cope with the stresses of life on the road.” Given this information, June recognizes that Johnny is in the contemplation stage and engages Johnny by saying, “I hear you, Hon. Touring is definitely stressful." Then, June focuses their conversation, “I hear you saying that “smoking isn’t great.” Can you tell me more about why you feel this way?” As their conversation progresses, June evokes Johnny’s motivations for change by saying, “What would smoking less look like? What steps could you take?” Finally, June works on planning – “I know this is a tough conversation to have, but would you be open to discussing it with me again tomorrow?”

 

Preparation: At this stage, Johnny prepares to take action. The scales are on the cusp of tipping, and the pros outweigh the cons, if ever so slightly. Johnny says, “Alright Hon, I think I’m ready to give up smoking.” June now recognizes that Johnny is in the preparation stage and engages Johnny – “That’s great, Darlin! I’m really happy for you.” Then, June focuses their conversation – “How are you going to go about it?” and evokes Johnny’s motivations further – “What will you specifically do to quit?” Finally, June helps Johnny plan – “What else can we do to help you achieve this goal?”

 

Action: Johnny has successfully taken action toward changing his behavior for the better. However, backsliding is still possible and external support is crucial. Johnny says, “I threw out all of my cigarettes yesterday, even my emergency stash that was buried in the backyard.” June engages Johnny – “I know this isn’t easy, but I’m really proud of you for taking this step.” Then, June focuses their conversation – “What else can you do to stay on this path?” and evokes Johnny’s motivations further – “Imagine how good you are going to feel in a couple of months.”  Finally, June helps Johnny plan – “What other steps can we take to support this change?”

 

Maintenance: Johnny has officially changed his behavior for the better and is at least six months past the action stage. He is well on his way to fostering enduring change, but backsliding is still possible. Johnny says, “It’s been six months since my last cigarette. I still get cravings, but I’m glad I’ve kicked the habit.” June engages Johnny – “I’m sure it’s tough at times, but you have made so much progress.” Then, June focuses their conversation – “What else can we do to help you stay on this path?” and evokes Johnny’s motivations further – “Your daughters and I are so proud of you. Also, you are coughing a lot less.” Finally, June helps Johnny plan for the future – “What do you think you’ll do the next time your tour manager offers you a cigarette?”

 

Termination: At this juncture, Johnny is no longer tempted to succumb to his former bad habit and is confident that this change will be permanent. June can still use her engaging, focusing, evoking, and planning skills when necessary, but she can also rest assured that she has done her best to assist Johnny’s advancement through the stages of change.

 

All things considered, I’m not suggesting that this is the only way for change-advocates to assist the change-ambivalent, but it is a time-tested and science-backed methodology used by thousands of practitioners worldwide. When change-advocates utilize the four key processes of Motivational Interviewing in conjuncture with a working knowledge of the stages of change, they can make a significant impact in the lives of the change-ambivalent.

 

Btw, if you are a visual learner like me, please check out the image below…