Addendum: Assessing Readiness to Change

The "stages of change," developed by Prochaska and DiClemente, provide a framework to conceptualize the process for how people change by categorizing the stages through which people progress when contemplating a behavior change. Because the stages of change are sometimes mentioned with MI, a brief description is provided here. Motivational interviewing can facilitate and/or support change during any of the stages; however, many feel that it is most helpful for those in the precontemplation and contemplation phases, where ambivalence plays the greatest role. The stages of change are generally a cyclical process; however, one could quickly progress from one stage to the next or fall backwards. Furthermore, a person may progress back and forth through the cycle multiple times before the change becomes permanent, and different behaviors are likely to manifest at different positions in the stages of change cycle.

The Six Stages of Change:


The individual is not thinking about changing a behavior.

“What would you think about exercising more?”

“I haven’t really thought about it.”


The individual is considering a change, but has not decided. Some add the time component of contemplating a change during the next six months.

“Have you considered exercising more?”

“Yes…, but…”


The individual has decided to change and is taking some steps toward making the change happen. Some add the time component of contemplating a change during the next month. A key in this stage can be to encourage the patient to commit to making a change by setting a date for the change to begin.


The individual has begun the new activity (or stopped the old one).


The individual has maintained the behavior for a period of time (some say at six months). After six months of maintaining a change an individual will be less likely to regress than during the action phase.

Relapse and Recycle

The individual has ceased the new activity, has returned to an earlier stage, and may or may not desire to resume the change. This is a normal stage in the process of making a change permanent and is to be expected.

Motivational interviewing is a rich, powerful mechanism to encourage behavior change. This has been a very brief introduction. Please consider further reading and taking an introductory training course. A large amount of free information and information about vetted MI courses can be found at

Further reading:

               online toolkit_MI        online toolkit_MI in healthcare

1.    Mid-Atlantic Addiction Technology Transfer Center. Motivational Interviewing: Resources for Researchers, Clinicians, and Trainers. Available at:

Additional Resources: 

Martino S., Ball SA, Gallon SL, et al. Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficien Salem, OR: Northwest Frontier Addiction Technology Transfer Center, Oregon Health and Science University; 2006. Available at:

Miller WR, Rollnick S. Motivational Interviewing: Preparing People

Toolkit Base: