Clients may or may not be ready for change. Several theories describe the process of change, and the Stage of Change Theory is one such model. Many professionals are familiar with cases where the client is in a situation of domestic violence, or Intimate Partner Violence (IPV), and is not ready to leave the abusive situation or make changes necessary to avoid repeating the abusive relationship. Stage of Change theory suggests such people may be in a “precontemplative” stage where they have not acknowledged the problem, or other stage where change remains difficult to achieve. Other theories, such as attachment theory, help us understand that the abusive relationship may be subjectively perceived as less dangerous than the risk of change. The research study below identifies certain change stages, and found that reliable and satisfying social support networks can be important to promote initial and long term change.
There are a number of change process models. The Transtheoretical Model (TTM) is a model developed initially in the field of drug addiction. It includes a Stages of Change model which identifies five stages:
- Precontemplation, where the person is not ready for change and lacks necessary awareness of the problem;
- Contemplation, involves a recognition of a problem and an initial assessment, and getting ready to change;
- Preparation, the person is ready to change and can start taking small steps in a direction for change;
- Action, making active steps to change behaviors;
- Maintenance, is an interim period of at least six months of change, but the change has not yet become ingrained;
- Termination, the problem behavior has been solidly managed and is less likely to return.
The study below looked at why survivors of IPV sometimes find it difficult to end the abusive relationship by applying the Stages of Change model and considering the impact of social support, and other factors which might promote changed behavior. The study found five distinct clusters of change that are a little different from the Stages of Change model: 1) preparticipation, 2) decision making, 3) engagement, 4) ambivalent, and 5) action.
In terms of relational neuroscience and the ICCM, we might say that a positive social support network can help provide healthy relationships such that the risk of leaving a negative relationship can be tolerated. In terms of attachment theory, we might say that protection from perceived danger and needed comfort can be provided by a different type of relationship -a positive social network. The ICCM’s 4-Step Change Model is designed to apply more specifically to clients in a legal setting. It does not include some of the steps identified in this post, and includes other more germane steps.
Study:
The Association Between Social Support and Stages of Change in Survivors of Intimate Partner Violence
Heather Zapor, Caitlin Wolford-Clevenger, Dawn M. Johnson, Journal of Interpersonal Violence, Published online before print December 2, 2015 http://jiv.sagepub.com/content/early/2015/12/02/0886260515614282?papetoc
Abstract: For survivors of intimate partner violence (IPV), it is often difficult to take steps to establish safety and obtain a violence free life. Researchers have applied stage of change theory to aid in understanding the experience of survivors, as well as, the factors that can help women who desire to make changes in or break free from a violent relationship. Social support is one factor that can be helpful to IPV survivors who are attempting to make changes in their relationship. The purpose of the current study was to examine the differences in social support experienced by women who are at varying points in the process of change. Shelter residents (N = 191) participated in this cross-sectional non-experimental study. Analyses demonstrated five distinct clusters or profiles of change among study participants and were labeled by the authors as follows: preparticipation, decision making, engagement, ambivalent, and action. All forms of social support (i.e., structural, functional, and satisfaction) were generally higher for individuals more engaged in the process of change. More specifically, differences were noted between the action and decision-making clusters and the engagement and decision-making clusters. These findings suggest that it is vital that clinicians working with survivors of IPV not only assess but also tailor interventions to meet survivors where they are in the process of change. Further, interventions that foster survivors’ abilities to develop reliable and satisfying social support networks will be beneficial for survivors of IPV.
Study – The change process is enhanced with effective social support