MECC Part 2

Last activity on December 5, 2024


Cycle of Change

The Cycle of Change aims to describe how people change, with or without therapy, and maintains that responsibility for this change lies with the individual. People often go round the cycle more than once before making a final exit. Some believe that it is common for people to go round the cycle from 3 to 7 times. People are thought to move from one stage to the next around the cycle, either clockwise (good), or anticlockwise (bad).

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There are 6 stages in the Cycle of Change:

1. Precontemplation: In this stage, people do not intend to take action in the foreseeable future (usually defined as within the next 6 months). People in this stage do not think that they have a problem. They could typically be referred via the legal system or be attending due to pressure from family or friends.

2. Contemplation: People in this stage may be planning to change within the next 6 months, or at least recognise there may be a problem, but are unsure what, if anything, to do about it.

3. Preparation (Decision): In this stage, people have decided to change but not sure how to go about it. This is a decision-making stage when change is planned within the next 30 days.

4. Action: In this stage, people have decided how to change, now they are trying to do it. This is the first 6 months of change.

Illustration showing the cycle of change

5. Maintenance: In this stage, people have sustained their behaviour change for a while usually defined as more than 6 months and intend to maintain the behaviour change going forward. People in this stage work to prevent relapse to earlier stages.

​6. Lapse/Relapse: Returned to previous behaviour despite efforts to change. Lapses can occur at any stage and are a temporary return to substance use. Relapse is a full return to using behaviour. Both are normal in the cycle of change.

Key benefits in referring to the cycle of change are:

Knowing where someone is on the cycle of change makes your conversation more relevant and shows you are interested.

Making an assumption of their position of the cycle of change may well close down the conversation.

Knowing their experiences will also help when looking to what they would like to do when they come to the change step.

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