Stages of change

Stages of change are the five phases of adopting a behavior in the transtheoretical model: precontemplation, contemplation, preparation, action and maintenance.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 981.} The early stages are defined by intention and the later ones by action; maintenance starts once a person has been regularly active for six months.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 981.} Self-efficacy is lowest in the earliest stages and highest in the latest.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 981.}

Identifying a client’s stage helps the trainer choose interventions to move them toward the next one.^{2Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 148.}

In practice

• In precontemplation, explain the benefits of activity and talk through perceived barriers.^{3Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 985.}
• In contemplation, explore solutions to barriers, build self-efficacy and stress that small steps count.^{3Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 985.}
• In preparation, write an activity plan with the client, formalize it with a goal sheet or contract, and teach self-monitoring.^{3Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 985.}
• Maintenance doesn’t guarantee lasting exercise adherence: clients can slip back into sedentary habits, so keep affirming them and checking in on their plans.^{4International Personal Trainer Academy, Certified Personal Trainer Textbook, p. 130.}

Where sources differ

ACSM defines the early stages by intention: no plan to be regularly active in the next 6 months, a plan to start within 6 months, and a plan to start within 30 days.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 981.} The NSCA defines them partly by behavior: preparation describes someone already doing at least 30 minutes of moderate activity on at least one day a week, but not on most days.^{2Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 148.}