Stages of Change in Action

Regina Sewell
Phd, LMHC, PCC, PAT
Hudson Valley Psychodrama Institute and SUNY New Paltz

Change is a process. In order to help clients make the life changes they need to make, we need to be  able to assess where they are at in terms of this process and help them find the tools they need to  make these changes permanent. Talking to clients and/or having them fill out a questionnaire about  their perceptions about change can be helpful, but these approaches only scratch the surface. They  ignore the disconnect between the head and the heart.  

Developed by J.L. Moreno, Psychodrama, Sociodrama and Sociometry are particularly useful methods  for working with change because they bring in the body as well as the mind. In doing so, they cut  through rationalization, denial, justification and various other defenses that people use to avoid  change. Sociometric tools such as spectrograms and locograms provide a way for clients to not just  think about where they are in the change process, but to feel where they are in the process in their  bodies. And because these techniques get clients out of their seats, they provide an easy way to get  group members talking with each other about their relationship to change. Psychodrama, Sociodrama  and Sociometry also provide a wholistic set of tools that help clients resolve their ambivalence about change and develop more healthy tools to cope with life.  

Psychodramatic techniques help people in the precontemplation stage gain awareness of the problem.  Using psychodrama, we can invite clients to step into the shoes of someone they love and experience  how their current or past behavior impacts this person so that they can feel the impact of their  behavior at the body level. This often helps clients find the internal impetus to change. 

Clients in the contemplation stage benefit from psychodramatic techniques that allow them to explore  their ambivalence in action. For example, by giving clients a chance to give voice to the pull to change  and to the pull to not change, the Angel/Devil techniques keeps clients from glossing over the struggle of ambivalence and helps them take the next step to prepare making changes. Coleman’s Angle of  Opportunity allows clients to explore what the future might be like if they continue on the path they  are on and compare it to what the future might be like if they change their behavior. Coleman’s Angle  of Opportunity also helps instill hope by helping them begin to imagine that change is possible.  

Clients in preparation stage have begun “testing the waters” by taking little steps towards changing  their behavior but these steps have not resulted in significant results. The Future Projection technique  is useful in this stage because it gives people a chance to experience what their lives might be like after  they have made the change. By stepping into the future, people are able to identify the steps they  took to successfully make the change. In the process, clients are able to create plan to accomplish  their goals. The act of creating plans makes hope more tangible. 

Clients in action stage are often in need of reinforcement and support in the face of People, Places and  Things that are likely to pull them back into old behaviors. The Social Atom allows clients to map out  their social world and see who is supportive of their change and who in their social world is less  supportive and/or likely to disrupt their efforts to change. They can use this information to decide  which relationships to nurture and which relationships to pull back from.  

Role Training gives clients a chance to practice dealing effectively with challenging situations that  threaten to drag them back to their old behaviors. This is helpful for clients in the maintenance and relapse prevention stage and helps make the changes clients have made sustainable in the long run. 

Psychodramatic techniques are even useful in the unofficial sixth stage – relapse. Timelines give clients  who have fallen off the wagon a chance to explore in action the thoughts, behaviors and experiences  that led them to relapse. This enables clients to learn from their mistakes, have compassion for  themselves and find the drive to change again. 

*Based on: Prochaska, J. O., & Norcross, J. C. (2002). Stages of Change. In J. C. Norcross  (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to  patients (pp. 303–313). Oxford University Press. 

*Original Artwork by Regina Sewell

Regina Sewell, PhD/ MEd, LMHC, PCC, CP is certified by the American Board of Examiners as Certified Practitioner of Psychodrama. She is on the faculty on the Hudson Valley Psychodrama Institute. In her private practice, Regina specializes in co-dependency, addictions, LGBT issues and stress management.