Parents are often curious about the progress their adolescent is making in therapy. Here is an adaptation of the Transtheoretical Model of Behavior Change (developed by researchers James Prochaska and Carlo DiClemente), to help you better understand the phases your adolescent might go through during the therapeutic process.
(1) PRECONTEMPLATION – Ambivalence.
Your adolescent has not identified that a problem truly exists. Although they might feel out of control, they don’t think that the consequences of their behaviors are serious. Ambivalence is a normal and healthy part of the change process. Your adolescent is developing a gauge for their own personal boundaries and limitations. Effective interventions for this stage include motivational interviewing to increase awareness about the problem’s impact on their quality of life.
(2) CONTEMPLATION – Reflection, diagnosing the current situation, and getting motivated about the need to change.
Your adolescent realizes that a problem exists and seeks information about their behaviors or issues. Contemplation might be triggered by an event, pressure from others, or an internal realization that the cons of engaging in the unhealthy behaviors outweigh the pros.
Effective interventions for this stage include psychoeducation (completing assessment tools, reviewing diagnostic criteria, talking to other adolescents with similar issues) and motivational interviewing to identify barriers to change, including their own resistance.
(3) PLANNING – Setting intentions for recovery, experimenting with small changes.
Your adolescent begins preparing for change. Effective interventions for this stage include cognitive behavioral therapy to remove obstacles to change (e.g., identifying and challenging distorted thoughts, developing coping skills to tolerate unsettling emotions, practicing new patterns of behavior).
(4) ACTION – Practicing new patterns of thinking and behaving.
In this stage, your adolescent takes definitive action to change. Increases in anxiety and excitement are common in this stage. Effective interventions for this stage include cognitive behavioral therapy to identify and resolve barriers to change.
(5) MAINTENANCE – Evaluation, tweaking the recovery plan as needed.
In this stage, your adolescent tries to maintain the positive changes they’ve made. Six months is the usual amount of time it takes for an adolescent to feel confident in the changes they have made. Effective interventions for this stage include cognitive behavioral therapy to help track changes.
(6) RELAPSE – a.k.a. The Reminder.
Arguably the most important stage of change, the Relapse Stage is characterized by a return to old patterns of thinking and doing. An adolescent often enters this stage as a result of unanticipated challenges or triggers. Although feeling demoralized is a common part of this stage, the opportunity presented here is to learn from the relapse and to cycle back through the earlier stages with newfound wisdom.
Family and friends can help shorten the length of time an adolescent remains in this stage by allowing the adolescent to experience the natural consequences of the relapse (i.e., avoid enabling). Effective interventions for this stage include motivational interviewing to identify the causes for relapse and to re-explore your adolescent’s readiness for change.