Academic journal article Child Welfare

Ready or Not: Uses of the Stages of Change Model in Child Welfare

Academic journal article Child Welfare

Ready or Not: Uses of the Stages of Change Model in Child Welfare

Article excerpt

This article reviews the popular stages of change model, its potential applications in child welfare, and relevant research. Empirical evidence indicates that behavioral change does not occur in a series of stages. The article considers the validity of the stage model, its underlying assumptions, and other conceptualizations of readiness for change. Although the stage model may have some heuristic value, the empirical evidence suggests that its practical applications are severely limited.

In cases of child maltreatment, parental motivation and readiness for change are of considerable interest to child welfare workers. Some believe that caregivers who are ready to change abusive or neglectful practices pose less risk of future harm to children and may be more amenable to treatment than are those who are not ready to change. Hence, readiness for change is considered an important component of risk assessment, case planning, decisionmaking, and allocation of treatment and out-of-home placement resources in child welfare (Gelles, 1995,1996, 2000).

Readiness for change is a central component of the stages of change (SOC) model developed by Prochaska and DiClemente (1984, 1986, 1992). The SOC model is part of their larger transtheoretical model, which considers how people change problematic behaviors. The SOC model has gained widespread popularity in the fields of health psychology, mental health, and addictions, in which it is also the subject of considerable debate. Recently introduced to child welfare professionals, the SOC model is beginning to take hold in this field as well.

This article provides a review of the SOC model, its potential applications in child welfare, and empirical research on the model. It raises questions about the validity of the stage model and concerns about practical applications of the model in child welfare. The article also considers the heuristic value of the SOC model and other conceptualizations of readiness for change.

SOC Model

According to the transtheoretical model, behavioral change occurs in a series of discrete stages, whether within or outside of formal treatment, and in relation to virtually any problem behavior (Prochaska & DiClemente, 1984, 1986, 1992). Researchers identified stages in the mid-1980s and have revised the SOC model several times since (Isenhart, 1994; Littell & Girvin, 2002). The current model consists of five stages (Prochaska, Velicer et al., 1994). In the precontemplation stage, people are unaware of a problem or are not thinking seriously about change. People in the contemplation stage are aware a problem exists; they may struggle to understand the problem and begin thinking seriously about change. Those in the preparation stage are not just thinking about change but are getting ready to take some action to resolve the problem. In the action stage, people are making changes in their overt behavior and perhaps in their environment. In the maintenance stage, people may struggle to preserve gains they have made. If maintenance strategies fail, individuals may relapse, returning to a previous stage.

Progress through these stages is thought to be nonlinear and cyclical; people move backward as well as forward through the stage sequence and may cycle through the stages several times before attaining lasting changes in their behavior. Although stage status changes over time, at any given moment a person is assumed to be in a single stage; hence, the stages are thought to be mutually exclusive (Martin, Velicer, & Fava, 1996, p. 69). Individuals "pass through each stage" in an orderly fashion, and stageskipping is not expected (Prochaska, DiClemente, Velicer, & Rossi, 1992, p. 825).

In the transtheoretical model, stages are linked to other constructs, such as a cognitive "decision balance" (weighing the pros and cons of a behavior), self-efficacy, and basic processes used to modify problem behaviors; however, the SOC model is the central organizing construct (Martin et al. …

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