Primary care physicians receive little formal training on the process of behavior change, yet we are charged with helping patients modify unhealthy behaviors and adhere to prescribed regimens. Understanding the stages of behavior change is an important prerequisite for assisting our patients. The process begins when a patient who is not concerned about a particular behavior (precontemplation) acknowledges that it is unhealthy (contemplation). The patient makes concrete plans to institute a change (preparation) when she feels empowered and self-confident. Implementing a behavior change (action) requires that the patient make a firm commitment and set a specific date. Relapse is actively averted (maintenance) by renewing commitments, developing interpersonal supports, and anticipating what to do in challenging situations. When relapse occurs, it is viewed as inevitable for some and the circumstances leading to relapse are examined carefully to guide future attempts. For each stage of change there are specific steps physicians can take to promote progress to the next stage and ultimately to maintaining a new and healthy behavior. Patients with coexisting psychiatric conditions, including chemical dependency, may benefit more from intensive treatment programs than from office-based counseling. In these cases, our behavioral goal is for the patient to accept the treatment program referral. Counseling and health education are vital components of primary and preventive health care, and they are valued by patients, physicians, and third-party payers.
ASJC Scopus subject areas
- Obstetrics and Gynecology