November 19, 2018

Committing to Change

Depression and anxiety create enough disruption in our life to motivate us to seek help. Simply wanting relief from emotional pain, however motivating, is not enough. You need to make a conscious decision to commit to change. The commitment to change is a significant component of any effective treatment, including CBT.

Changing the way we feel, think, and behave is very difficult. But in order to overcome depression or anxiety we should be willing to change. How do people change? The Transtheoretical Model of Change suggests that people change all the time, with or without professional help. The model includes the following five stages of change:

Stage Description
1. Pre-contemplation The person has no intention of changing and often is not even aware of a problem.
2. Contemplation The person is aware of having problems and is seriously considering changing, but lacks the commitment to take action. Some people stay in this stage for a long time and often think about pros and cons of change.
3. Preparation The person intends to take action and has already begun making small changes, but these changes are not effective or strong enough to create the needed change in the problem area.
4. Action The person has made the commitment to change and is investing time and energy to overcome the problem by changing behavior, experiences, or environment.
5. Maintenance The person works not only to maintain the gains acquired but to prevent a relapse.

These stages of change reflect shifts in a person’s attitudes, intentions, and behaviors. The processes of change in the Transtheoretical Model help explain how these shifts happen. Several examples of these processes are described below:

Change Process Description
Consciousness Raising Becoming increasingly more aware and informed about one’s problem and its causes and consequences. Interventions such as observations, confrontations, interpretations, feedback, and education are effective in raising a person’s awareness, which in turn moves the person to contemplate changing.
Dramatic Relief Using emotions such as fear, guilt, hope, and inspiration to move a person to contemplate change and to sense the relief that will come with the change. Some effective interventions are role playing, grieving, and personal testimonies.
Environmental Reevaluation Assessing how a person’s problem negatively affects his or her social environment. The assessment is done both affectively and cognitively through interventions such as empathy training, value clarification, and family interventions.
Self-Liberation Believing in change and having commitment to act on that belief. Any strategies that can motivate a person to act are effective. Examples include providing the person with more choices and ways to change.