Stages of Change: Maintenance
The person has made a sustained change wherein a new pattern of behavior has replaced the old. Behavior is firmly established and threat of relapse becomes less intense.
Things to consider
Maintenance is often viewed as an afterthought where very little activity occurs. However, maintenance is not a static stage.
Relapse is possible and occurs for a variety of reasons. Most relapses are not automatic but occur after an initial slip has occurred.
Client’s will often turn to a therapist during what Saul Shiffman calls a relapse crisis (i.e., they’ve slipped or are about to).
During these times the client’s self-efficacy is weakened and fear is high.
Clients seek reassurance from
therapists while trying to make sense of the crisis.
Review of the spiral model of the Stages of Change can be very helpful for clients at these times.
Therapists do not usually see clients that are well-established in maintenance.
If they do, a review of the action plan and a strategy for periodic review of the plan are useful. More often therapists will see clients when a relapse crisis is present.
Tasks for these times are:
• Exploration of the factors precipitating and maintaining the crisis
• Provision of information
• Feedback about plans
When crises are occurring, slow
the process down. Explore what succeeded,
as well as what is precipitating their current concerns or
crisis. Offer models of success while normalizing
relapse in situations where change is not easily accomplished.
If the client is returning to discuss their success, reinforce their active efforts in making change possible and their commitment to change.
Client exits the Stage of Change spiral. For a relapsing client, they re-enter the contemplation or preparation stage.
Adapted from DiClemente, 1991; Prochaska and Norcross, 1994