On Your Mark... Get Set... Change!

On Your Mark... Get Set... Change!

Author: Dr. Julie T. Kinn is a clinical psychologist and the Deputy Director of the Mobile Health Program at the National Center for Telehealth & Technology (T2).

In my last post Beg, bribe, or badger: How do I convince my spouse to get help?, I wrote about how difficult it is to force people to seek treatment for addictions or other mental health issues like depression and anxiety. This week I’m focusing on the overall ways people change for the better.


Not everyone makes life changes in the same way. For example, a lot of folks like to quit unhealthy behaviors “cold turkey” whereas others slowly taper down. However, there does appear to be a consistent way in which we wonderful humans think about and get ready to change. The way many mental health professionals think about behavior change is through the lens of the Transtheoretical Model of Behavior Change. According to this model, there are five stages we go through when we change our behavior:

  • Precontemplation: Not yet considering a change
  • Contemplation: Thinking about whether or not to try changing
  • Preparation: Getting ready to make a change
  • Action: Changing the behavior, and sticking to it for about six months
  • Maintenance: The changed behavior has become part of the individual’s life, but he or she still needs to prevent relapse

According to this viewpoint, people generally don’t skip stages, so you can’t rush your loved one through this process. That said, this model can help you understand the best type of support you can provide, and when to provide it.


Here’s an example to help paint what these stages look like. Let’s say your best friend’s drinking has reached a problematic level. In this hypothetical situation, she has confided to you that she sometimes misses work due to her drinking, and you have noticed that she is no longer dependable when you want to get together. Let’s go back through the stages of change listed above to identify the best kind of support for her.

  • Precontemplation: Your friend may not yet realize her drinking is a problem, or she may not think she has the power to change her behavior. Try clearly stating that you’re concerned about her drinking and let her know that you are standing by to help when she is ready. In the meantime, focus on taking care of yourself. The precontemplation stage is a particularly difficult time for loved ones.
  • Contemplation: Your friend is aware that her drinking is a problem, but is not yet certain that she is willing (or able) to change her behavior. As she weighs the pros and cons of changing how much she drinks, be available for support and to be her sounding board.
  • Preparation: Your friend is starting to think about how to cut down on her drinking and could use help identifying potential roadblocks. For example, if her family traditionally celebrates July 4th with lots of alcohol, she might want help coming up with a strategy in advance to avoid drinking.
  • Action: All right! She has started to reduce her drinking. For the next few months, sticking to the action stage will be difficult for her, especially around times when she previously drank a lot (holidays, stressful workdays, etc.). You can help your best friend by praising her success and helping her to see the positive results she is experiencing.
  • Maintenance: In addition to continuing your support of your friend’s behavior change, be prepared to help her if she slips a bit. If she drinks more than is healthy, try helping her reframe it as a small event instead of a major failure. This way, it will be easier for her to get right back up on the horse (or wagon – pick your favorite metaphor).


Now that you know what the stages of change look like, you can apply them in other situations. Consider healthy changes you have made in life – did your experience follow this pattern? And to learn more about behavioral health options open to the military community, consider calling the DCoE Outreach Center at 866-966-1020. There is even a live chat option.

afterdeployment.t2.health.mil Community Terms and Conditions

  • If you have feelings of suicide, hopelessness or depression - please call the National Suicide Prevention Hotline at 1-800-273-8255.

  • afterdeployment.t2.health.mil reserves the right to edit and/or remove any user-generated content that violates these Terms and Conditions. The contents of the afterdeployment.t2.health.mil site, such as text, graphics, images, information, and other material contained on the afterdeployment.t2.health.mil site ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the afterdeployment.t2.health.mil site. If you choose to participate in the afterdeployment.t2.health.mil forums and/or blog ("Community") you agree to these Terms and Conditions.

  • Community posts and comments are reviewed by the Moderators for appropriateness before they are published to the Community. Posts and comments are reviewed between the hours of 0800 and 1700 hours Pacific Time, Monday through Friday and will go live immediately after review unless they are deemed inappropriate based on these Terms and Conditions at which time they will be deleted without notification.

    You will not be contacted at any point by any member of the afterdeployment.t2.health.mil staff, nor any related agency or organization. If you are in need of assistance or medical attention, please contact the DCoE Outreach Center or National Suicide Prevention Hotline listed in the top right corner of your screen.
  • You agree not to hold afterdeployment.t2.health.mil liable for anything stated within the Community. Messages and/or comments posted at this site are the sole opinion and responsibility of the poster. afterdeployment.t2.health.mil makes no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained within the Community.

  • afterdeployment.t2.health.mil and its Moderators reserve the right to remove, edit or delete without notice any and all content placed in the Community.

  • Moderator and/or afterdeployment.t2.health.mil action may be final. Actions may be reversed by afterdeployment.t2.health.mil or a Moderator after review of the matter.

  • Using the forum to solicit discussions contrary to the Terms and Conditions may be considered unacceptable.

  • It is your responsibility to be familiar with and remain updated to current Community Forum Terms and Conditions. All users of the Community must comply with these Terms and Conditions. Infractions of any Term or Condition may result in revocation of forum privileges.

  • General content that is inflammatory, vulgar, sexually explicit, rude or otherwise inappropriate will not be tolerated and will be removed.

  • Always be respectful of the Community, afterdeployment.t2.health.mil employees, and Moderators. Be civil, clean, and decent in all posts. Open discussions of varying points of view are encouraged but only if they remain constructive and not inflammatory. Personal attacks are neither allowed nor tolerated. Anyone using/ posting inappropriate content, language, personal attacks, engaging in hate speeches and rants, or being disruptive to the Community's positive environment may be barred from all further discussions and/ or the afterdeployment.t2.health.mil Community.

  • The Community is not a venue for personal or private vendettas or causes, including political debates.

  • Links to adult content, pages with links to adult content, or messages describing anything inconsistent with these Terms and Conditions will be removed.

  • Do not post copyrighted material or articles written by others without their permission.

  • Do not post altered-text as an attempt to defeat forum word-filters or otherwise circumvent the rules.

  • Nicknames, signatures, and avatars are not allowed on the site.

  • Keep forum thread discussions on topic, and within the subject of the forum. Please do not "hijack" or "bump" the thread to gain additional exposure to a post or yourself. Please do not
    cross-post within other forums and threads.

  • Content and Spam that is posted for the sole-purpose of unrelated promotion will be removed and may result in a permanent loss of forum privileges.

  • Anyone posting another member's personal or website details will be banned. Please do not post sensitive or confidential information to the Community about yourself or other members. Examples include account information, private communications with moderators, etc.