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An escalating problem

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MGH Cox 5
55 Fruit Street, Boston
T, Th, F: 8:30 - 11:00 a.m.
W: 1-3 p.m.

Chelsea Health Center
151 Everett Avenue, Chelsea
T: 1:30- 3:30 p.m.
Th: 3-6 p.m.

A change of habit

The transtheoretical model defines five stages a person goes through to change unhealthy behavior, such as smoking, drug abuse and overeating. According to the psychologists that developed the model, a person must go though each phase without skipping in order to realize its benefits. Yet, one size does not fit all. The length of time and the activities in each phase depends on each individual.


A person has no conscious intention to make a change; there is lack of awareness of a problem.
Example: “Obesity runs in my family. There’s nothing I can do about it.”

There is increased awareness that the behavior is a problem and a person is thinking about changing.
Example: “I know my weight is causing me medical problems, but I’m too busy to worry about it now.”

The individual is making realistic plans to change.
Example: “I made an appointment with a dietitian to help me choose healthier foods.”

The changed behavior is in place, and the person is practicing alternatives to avoid unhealthy behavior.
Example: “Stress is a big cause of my overeating. I practice yoga now to reduce my stress.”

The new behavior has been practiced for at least six months.
Example: “To prevent a relapse, I avoid restaurants that offer buffets.”

Counselors warn that relapses are common and that people recycle through some stages several times.
Instead of viewing a relapse as failure, however, consider it an integral part of the change process.

For more information on the transtheoretical model, visit