Prochaska’s Six-Stage Model | AQA A-Level Psychology Revision

Revision Notes
Aug 7
33 min read

Updated: Aug 14

For 7182 specification, first teach in September 2025

AQA A-Level Psychology | Free Revision Notes

Estimated study time: 60 to 75 minutes

Prochaska’s six-stage model A-Level Psychology revision examines how people move from having no intention to change an addiction to establishing a lasting, addiction-free pattern of behaviour. The model includes pre-contemplation, contemplation, preparation, action, maintenance and termination.

Crucially, change is not presented as a simple straight line. A person may relapse and return to an earlier stage before trying again. You will learn to identify each stage, apply the model to nicotine, gambling and other addictions, and assess whether the model offers a genuinely effective way of supporting behaviour change.

The AQA specification requires the application of Prochaska’s six-stage model of behaviour change.

Learning Objectives 🎯

By the end of this revision page, you should be able to:

Describe the six stages in Prochaska’s model.
Explain why the model is cyclical rather than strictly linear.
Identify evidence of each stage within an unfamiliar addiction scenario.
Apply the model to attempts to reduce nicotine, gambling or other addictive behaviour.
Explain how different support may be appropriate at different stages.
Evaluate the model’s usefulness, evidence base and limitations.

Revision Notes 📚

What Is Prochaska’s Six-Stage Model?

Prochaska’s model describes the stages a person may move through when deliberately attempting to change behaviour.

In addiction, the desired change might be:

Stopping smoking.
Reducing or ending gambling.
Stopping the use of an addictive substance.
Reducing harmful gaming.
Beginning treatment.
Maintaining abstinence.
Recovering after relapse.

The six stages are:

Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination

The model is cyclical because a person may:

Move forwards.
Remain at one stage.
Return to an earlier stage.
Relapse and begin another attempt.

AQA’s June 2024 mark scheme describes it as a six-stage cyclical model for deliberate behaviour change. It allows for relapse at any stage except termination.

The Overall Sequence

The stages can be summarised as:

Not considering change → thinking about change → planning change → actively changing → sustaining change → new behaviour becomes normal

However, the complete model is more accurately represented as:

Pre-contemplation → contemplation → preparation → action → maintenance → termination

with possible movement back to an earlier stage before termination.

Why It Is a Model of Change Rather Than an Addiction Explanation

Prochaska’s model does not primarily explain:

Why nicotine releases dopamine.
Why gambling rewards produce reinforcement.
Why a person possesses genetic vulnerability.
Why peers model addictive behaviour.
Why cognitive biases develop.

Instead, it describes a person’s readiness and progress when attempting change.

It should therefore be distinguished from:

Explanations of addiction.
Specific treatments for addiction.
Biological theories.
Learning theories.

The model may help organise attempts to reduce addiction, but it is not itself a medication, behavioural therapy or cognitive therapy.

Stage 1: Pre-Contemplation

What Is Pre-Contemplation?

During pre-contemplation, the person is not seriously considering changing their addictive behaviour.

AQA describes this stage as:

Not really thinking about changing.
Characterised by inertia.

The person may:

Deny that a problem exists.
Minimise the harm.
Reject advice.
Defend the behaviour.
Feel unable to change.
Avoid thinking about consequences.
Believe the benefits outweigh the costs.
Have no intention of seeking treatment.

Inertia

Inertia means remaining as one is rather than beginning change.

The person continues the addictive behaviour because changing may appear:

Unnecessary.
Difficult.
Frightening.
Impossible.
Less rewarding than continuing.

Pre-Contemplation Does Not Always Mean Ignorance

The person may know that addiction can be harmful while still having no intention of changing.

For example:

“I know smoking can damage health, but I enjoy it and have no intention of stopping.”

The person understands the general risk but remains in pre-contemplation because they are not considering personal change.

Denial and Minimisation

A person might say:

“My gambling is only entertainment.”
“I can stop whenever I choose.”
“Everyone smokes.”
“My gaming is not affecting anyone.”
“People are exaggerating the problem.”
“I have won plenty of money.”

These statements may indicate that the person is:

Denying the problem.
Minimising its seriousness.
Focusing selectively on benefits.
Rejecting the need for change.

Application to Nicotine Addiction

Ellis smokes twenty cigarettes each day. His family asks him to stop, but he says smoking helps him relax and insists that he does not need treatment.

Ellis is likely to be in pre-contemplation because:

He is not considering stopping.
He rejects treatment.
He emphasises perceived benefits.
He does not accept that change is needed.

Application to Gambling Addiction

Hana has lost money needed for bills but says that gambling is not a problem because she sometimes wins.

Hana may be in pre-contemplation because:

She minimises the losses.
She focuses selectively on wins.
She does not accept the need to stop.
No commitment to change is present.

This selective focus may also connect with biased thinking about gambling outcomes [Lesson 7: Cognitive explanations of gambling addiction].

Supporting Someone in Pre-Contemplation

The model itself does not prescribe one compulsory treatment for each stage.

However, it can be used as a framework for selecting suitable support.

At pre-contemplation, useful aims might include helping the person:

Recognise the consequences of addiction.
Examine discrepancies between behaviour and personal goals.
Consider accurate information.
Reflect on costs and benefits.
Become more open to discussing change.

Immediately demanding complete abstinence may be unsuccessful when the person does not yet accept the need to change.

Stage 2: Contemplation

What Is Contemplation?

During contemplation, the person is thinking about changing and is aware that change may be necessary, but has not yet made a firm commitment.

AQA describes this stage as:

Thinking about changing.
Awareness of the need to change.
No commitment yet.

Ambivalence

The person may experience ambivalence, meaning conflicting feelings about change.

They may recognise the harm but still value the addiction’s perceived benefits.

For example:

“I know smoking is affecting my health, but I am worried I will not cope with stress without it.”

or:

“I should stop gambling, but it is the only exciting part of my week.”

Signs of Contemplation

The person may:

Acknowledge that the behaviour is harmful.
Discuss possible change.
Ask questions about treatment.
Think about advantages and disadvantages.
Express concern about consequences.
Imagine life without the addiction.
Remain uncertain about acting.
Delay making a firm decision.

Contemplation Is Not Action

Talking about change does not mean that active change has begun.

A person remains in contemplation when they say:

“I really ought to stop.”
“I am thinking about getting help.”
“I may quit after the holidays.”
“I know this cannot continue.”

but have not yet:

Made a concrete plan.
Contacted support.
Set a starting point.
Changed the addictive behaviour.

Application to Nicotine Addiction

Isla has started worrying about her breathing and says she probably needs to stop smoking. She has not chosen a quit date or contacted anyone for support.

Isla is in contemplation because:

She recognises the need for change.
She is thinking about stopping.
She has not made a definite commitment.
No specific plan has begun.

Application to Gambling Addiction

Marcus accepts that gambling is damaging his relationship. He often thinks about closing his accounts but continues to postpone the decision.

Marcus is in contemplation because:

He recognises the harm.
He is considering a change.
He remains uncertain or hesitant.
He has not yet taken practical action.

Supporting Someone in Contemplation

Support may focus on:

Examining the costs and benefits of change.
Exploring concerns about treatment.
Increasing confidence.
Correcting inaccurate expectations.
Identifying personal reasons for change.
Reducing ambivalence.

For example, a gambler may compare:

The excitement gained from gambling.
The financial, emotional and relationship costs.

A smoker may compare:

Temporary relief.
Physical dependence, withdrawal and long-term harm.

This connects with physical and psychological characteristics of addiction [Lesson 1: Describing addiction].

Stage 3: Preparation

What Is Preparation?

During preparation, the person intends to change and begins making plans.

AQA gives examples such as:

Seeing a drugs counsellor.
Seeing a general practitioner.

The person moves from:

“I should change”

to:

“This is how I am going to change.”

Signs of Preparation

The person may:

Decide to stop or reduce the addiction.
Set a date.
Contact a professional.
Research treatment options.
Tell friends or family.
Remove access to money or substances.
Arrange practical support.
Identify likely triggers.
Choose a treatment.
Create a coping plan.

Planning Is the Key Feature

Preparation involves a definite intention supported by practical planning.

Examples include:

Booking a CBT appointment.
Speaking to a GP about nicotine replacement therapy.
Closing gambling accounts.
Removing cigarettes from the home.
Installing gambling blocks.
Planning alternative evening activities.
Asking friends not to offer the substance.
Identifying high-risk situations.

Application to Nicotine Addiction

Arun has chosen next Monday as his quit date. He has spoken to a GP, obtained nicotine replacement products and asked colleagues not to offer him cigarettes.

Arun is in preparation because:

He has committed to change.
He has selected a date.
He has arranged treatment.
He is preparing the social environment.

His planned medication links with reducing withdrawal and craving through drug therapy [Lesson 8: Drug therapy].

Application to Gambling Addiction

Sophie has decided to stop gambling at the end of the week. She has contacted a counsellor, arranged for her partner to help manage money and downloaded blocking software.

Sophie is in preparation because:

She has made a definite decision.
She is creating a practical plan.
She has sought support.
She has not yet fully implemented the change.

Preparation Versus Action

The distinction is:

Preparation	Action
Planning the change	Carrying out the change
Selecting a quit date	Reaching the quit date and stopping
Booking therapy	Attending and applying therapy
Planning to close accounts	Closing the accounts
Obtaining medication	Beginning the medication plan
Identifying triggers	Using coping strategies when triggers occur

A plan alone is preparation.

Implementing the plan is action.

Supporting Someone in Preparation

Support may focus on making the plan:

Specific.
Realistic.
Achievable.
Appropriate to the addiction.
Supported by others.
Ready for foreseeable risks.

A preparation plan might include:

A clear goal.
A date for beginning.
A chosen treatment.
Strategies for cravings.
Plans for social pressure.
Reduced access to the addictive activity.
A response to an early lapse.

Stage 4: Action

What Is Action?

During the action stage, the person is actively doing something to change the addictive behaviour.

AQA gives the example of:

Throwing all alcohol out of the house.

The person is no longer merely planning.

They have begun implementing the change.

Signs of Action

The person may:

Stop using the substance.
Stop gambling.
Attend treatment.
Take prescribed medication.
Use coping strategies.
Avoid high-risk situations.
Close accounts.
Change routines.
Refuse addictive opportunities.
Seek support when cravings arise.

Action Requires Observable Change

Statements such as:

“I am going to stop next month”

indicate preparation.

Statements such as:

“I stopped yesterday and have begun treatment”

indicate action.

Application to Nicotine Addiction

Grace reached her quit date three days ago. She has stopped smoking, begun using a nicotine patch and avoids the smoking area at work.

Grace is in action because:

The behavioural change has begun.
She is actively using treatment.
She has changed her routine.
She is managing environmental triggers.

Application to Gambling Addiction

Leon closed his gambling accounts last week, gave control of his payment cards to his partner and has begun CBT.

Leon is in action because:

He has implemented his plan.
Access has been reduced.
Treatment is underway.
Gambling behaviour has changed.

Treatments During Action

Possible interventions include:

Drug therapy.
Aversion therapy.
Covert sensitisation.
CBT.
Support from family or professionals.
Environmental restrictions.

The appropriate method depends on:

The type of addiction.
Physical dependence.
Psychological dependence.
Cognitive biases.
Learned cues.
Personal circumstances.

For example:

A nicotine-dependent smoker may use medication to manage withdrawal.
A gambler may use CBT to challenge distorted thinking.
A person experiencing cue-triggered craving may avoid or manage learned cues.

Action Is Not the End of Change

Beginning change does not mean that the addiction has been permanently overcome.

The person may still experience:

Craving.
Withdrawal.
Social pressure.
Conditioned cues.
Irrational beliefs.
Stress.
Temptation.
Lapses.

The next challenge is sustaining the new behaviour.

Stage 5: Maintenance

What Is Maintenance?

During maintenance, the person has sustained the changed behaviour and works to prevent a return to addiction.

AQA describes maintenance as:

Established abstinence for more than six months.
Increased confidence.

The person is no longer in the earliest active phase but must continue protecting the change.

Signs of Maintenance

The person may:

Have remained abstinent for more than six months.
Use coping strategies consistently.
Recognise warning signs.
Avoid or manage triggers.
Maintain social support.
Feel increasingly confident.
Continue attending follow-up treatment.
Respond constructively to cravings.
Build new routines.

Confidence and Self-Efficacy

As change continues, the person may develop greater self-efficacy, meaning confidence in their ability to manage the behaviour.

Successful experiences such as:

Refusing a cigarette.
Passing a betting shop without entering.
Coping with stress without gambling.
Resisting a gaming invitation.

can strengthen the belief:

“I can manage this situation without returning to the addiction.”

Maintenance Does Not Mean No Risk

A person in maintenance may still encounter:

Major stress.
Addiction-related cues.
Former peers.
A memorable gambling win.
Easy access.
Sudden craving.
Emotional difficulties.

They may therefore need continued:

Relapse prevention.
Coping strategies.
Social support.
Environmental control.
Follow-up treatment.

These strategies link with challenging addictive thoughts and preparing for relapse [Lesson 10: Cognitive behaviour therapy].

Application to Nicotine Addiction

Priya stopped smoking eight months ago. She no longer takes smoking breaks and uses controlled breathing when cravings occur. She feels more confident but avoids situations where friends smoke heavily.

Priya is in maintenance because:

Abstinence has continued beyond six months.
She uses coping strategies.
Her confidence has increased.
She is actively preventing relapse.

Application to Gambling Addiction

Theo has not gambled for nine months. He keeps gambling blocks active, attends a support group and follows a plan for payday and major sporting events.

Theo is in maintenance because:

The new behaviour has been sustained.
Risk situations are anticipated.
Prevention strategies remain active.
Change is established but still being protected.

Maintenance Versus Termination

Maintenance	Termination
Change has lasted for more than six months	The new behaviour has become the normal pattern
Confidence has increased	No temptation to relapse
Relapse remains possible	Relapse is not expected within the model
Coping strategies may still require conscious effort	Addictive behaviour no longer feels like an attractive option
Continued monitoring may be useful	Change is treated as complete

Stage 6: Termination

What Is Termination?

During termination, the new behaviour has become the person’s normal pattern and there is no temptation to return to the addiction.

AQA describes this stage as:

The newly acquired behaviour becoming the norm.
No temptation to relapse.

Characteristics of Termination

The person may:

Identify fully with the new behaviour.
Feel no desire to resume the addiction.
Experience high confidence.
No longer regard abstinence as a daily struggle.
Respond normally to situations that once triggered addiction.
View the old addictive behaviour as inconsistent with their current life.

Application to Nicotine Addiction

Daniel stopped smoking several years ago. He no longer experiences cravings and does not consider smoking even when other people do so around him. Being a non-smoker feels normal.

Within the model, Daniel is in termination because:

The new behaviour is established as normal.
Temptation is absent.
Relapse is no longer expected.

Application to Gambling Addiction

Amira has not gambled for several years. Betting advertisements no longer produce an urge, and she does not see gambling as part of her identity or future.

Within the model, Amira is in termination because:

The behavioural change has become stable.
Gambling is no longer attractive.
She reports no temptation to return.

Termination Is Not Simply Long Maintenance

A person is not automatically in termination because a large amount of time has passed.

The distinguishing feature is:

Absence of temptation and normalisation of the changed behaviour

Someone who has remained abstinent for years but still manages frequent cravings may remain better classified as being in maintenance.

The Cyclical Nature of the Model

Change Is Not a Straight Line

A key feature of Prochaska’s model is that behaviour change is cyclical.

The person does not necessarily move smoothly through:

1 → 2 → 3 → 4 → 5 → 6

They may instead move:

Contemplation → preparation → action → relapse → contemplation → preparation → action

AQA requires some reference to the cyclical nature or relapse for a complete three-mark outline.

Moving Backwards

A person may:

Move from preparation back to contemplation.
Begin action and return to preparation.
Relapse during maintenance.
Return to pre-contemplation by denying that further change is needed.
Repeat several stages before reaching stable change.

Remaining at One Stage

Progress is not automatic.

A person may remain:

In pre-contemplation while rejecting concern.
In contemplation while repeatedly postponing change.
In preparation while constantly revising plans.
In action while struggling to sustain the new behaviour.
In maintenance for a long period.

The model describes stages but does not guarantee progression.

Relapse

What Is Relapse?

A relapse is a return to addictive behaviour after the person has attempted to reduce or stop it.

Examples include:

Returning to daily smoking after abstinence.
Resuming repeated gambling.
Returning to uncontrolled substance use.
Re-establishing a previous addictive gaming pattern.

Relapse Is Integral to the Model

Relapse is not treated simply as evidence that all progress has been lost.

Instead, it is part of the cyclical change process.

The person may:

Identify the trigger.
Examine what happened.
Return to an appropriate stage.
Develop a revised plan.
Attempt action again.
Strengthen future coping.

The June 2024 examiner report states that recognising relapse as an integral part of the model was one of the most efficient ways to gain full marks on the outline question.

Relapse Is Not a Seventh Stage

The model contains six stages.

Relapse is:

A possible event.
A return to an earlier point.
Part of the cyclical process.

It is not a separate seventh stage placed between maintenance and termination.

Relapse During Action

A smoker stops for five days but then returns to regular smoking during a stressful period.

They may move back to:

Contemplation, if they are reconsidering whether to try again.
Preparation, if they immediately create a revised quit plan.
Pre-contemplation, if they deny that another attempt is needed.

The correct classification depends on what they think and do after the relapse.

Relapse During Maintenance

A person who has not gambled for eight months begins gambling regularly after a major life event.

They have moved out of maintenance.

Their next stage depends on their response.

If they say:

“I need to understand what triggered this and make a new plan,”

they may be in preparation.

If they say:

“The gambling is not really a problem anymore,”

they may have returned to pre-contemplation.

Lapse and Relapse

A brief lapse does not always become a full relapse.

For example:

One cigarette may be a lapse.
A return to daily smoking may be a relapse.

Prochaska’s model emphasises broad movement through stages rather than providing a detailed clinical definition of every lapse.

A practical response is to identify:

What happened.
Whether the old pattern has returned.
The person’s current readiness to change.
Which stage now best describes them.

Applying the Model to an Attempt to Stop Smoking

Consider this extended example.

Pre-Contemplation

Luca smokes heavily and says he has no reason to stop.

He does not accept a need for change.

Contemplation

Luca begins worrying about his health and admits that stopping might be necessary.

He is thinking but has not committed.

Preparation

Luca chooses a quit date, contacts a GP and obtains nicotine replacement therapy.

He has created a practical plan.

Action

Luca reaches the quit date, stops smoking and begins using his treatment and coping strategies.

He is actively changing his behaviour.

Maintenance

Luca remains smoke-free for eight months and manages cravings through planned routines.

Abstinence is established beyond six months.

Relapse

During a stressful period, Luca returns to regular smoking.

He may return to an earlier stage and make another attempt.

Termination

After a later successful attempt, Luca becomes completely comfortable as a non-smoker and experiences no temptation to smoke.

The new behaviour has become normal.

Applying the Model to Gambling Addiction

Pre-Contemplation

Erin believes her gambling is harmless and ignores her financial losses.

Contemplation

She acknowledges the debt and begins wondering whether she should stop.

Preparation

She contacts a therapist, asks for family support and plans to close her gambling accounts.

Action

She closes the accounts, begins treatment and stops placing bets.

Maintenance

She remains abstinent for more than six months and follows a plan for sporting events and payday.

Relapse

After receiving a free betting offer, she begins gambling regularly again.

Return to Change

Erin reviews the relapse with her therapist and creates a stronger plan for promotional messages.

Termination

Gambling eventually has no attraction, and abstinence feels completely normal.

Applying the Model to Behavioural Treatment

The model can be used alongside the treatments covered earlier in the unit.

Drug Therapy

A person in preparation may:

Speak to a doctor.
Select a medication.
Plan a start date.

During action, they may:

Begin treatment.
Manage withdrawal.
Reduce the addictive substance.

During maintenance, they may:

Follow reduction plans.
Continue monitoring.
Prepare for cravings after medication ends.

This links with drug treatment for withdrawal and biological dependence [Lesson 8: Drug therapy].

Aversion Therapy and Covert Sensitisation

During preparation, the person may:

Agree to behavioural treatment.
Identify relevant addiction cues.
Discuss suitable aversive consequences.

During action, they may:

Complete repeated conditioning sessions.
Practise imagined aversion.

During maintenance, they may:

Continue rehearsing the learned response.
Monitor whether aversion is weakening.
Manage relapse risks.

This links with conditioned aversion and avoidance of addictive cues [Lesson 9: Aversion therapy and covert sensitisation].

Cognitive Behaviour Therapy

During preparation, the person may:

Identify treatment goals.
Begin monitoring triggers.
Arrange therapy.

During action, they may:

Challenge irrational thoughts.
Practise coping strategies.
Change routines.

During maintenance, they may:

Use relapse-prevention plans.
Respond constructively to lapses.
Continue practising skills.

This links with cognitive restructuring and behavioural coping strategies [Lesson 10: Cognitive behaviour therapy].

Identifying Stages from Scenario Language

Certain statements often indicate particular stages.

Scenario statement	Likely stage	Reason
“I do not have a problem”	Pre-contemplation	No recognition or intention to change
“I know I should stop, but I am not ready”	Contemplation	Awareness without commitment
“I have booked an appointment and chosen a quit date”	Preparation	Practical planning
“I stopped last week and have begun treatment”	Action	Change is being implemented
“I have remained abstinent for eight months”	Maintenance	Established abstinence beyond six months
“I never feel tempted anymore”	Termination	New behaviour is normal and temptation is absent

Use the Whole Scenario

Do not classify the person from one word alone.

For example:

“I have thought about quitting and have booked an appointment for tomorrow.”

Although the person is thinking about change, the appointment indicates practical planning.

Preparation is therefore the better answer.

How the Model May Guide Support

The model may help a professional avoid giving identical support to every person.

Stage	Main issue	Possible aim of support
Pre-contemplation	No intention to change	Increase awareness and encourage reflection
Contemplation	Ambivalence	Examine advantages, disadvantages and confidence
Preparation	Planning	Create a realistic change plan
Action	Implementing change	Provide treatment and coping support
Maintenance	Sustaining change	Prevent relapse and strengthen confidence
Termination	Change is normal	Maintain the established lifestyle

This is an application of the model rather than a fixed treatment programme prescribed by the AQA source.

Why Stage-Relevant Support May Be Useful

A treatment may fail when it assumes readiness that is not present.

For example:

Giving a complex quitting plan to someone in pre-contemplation may be premature.
Giving information about harm to someone already in action may not address their immediate withdrawal.
Treating someone in maintenance as though they have made no progress may reduce confidence.
Ending all support immediately after action may ignore relapse risk.

The model encourages attention to the person’s current position.

Comparing the Stages

Pre-Contemplation and Contemplation

Pre-contemplation	Contemplation
Not seriously considering change	Thinking about change
May deny or minimise the problem	Recognises some need for change
No intention to act	No firm commitment yet
Inertia	Ambivalence

Contemplation and Preparation

Contemplation	Preparation
Thinking about changing	Planning how to change
No definite commitment	Intention and commitment are clearer
May discuss possibilities	Takes practical preparatory steps
“I should stop”	“I have booked an appointment”

Preparation and Action

Preparation	Action
Creates the plan	Implements the plan
Chooses treatment	Begins treatment
Sets the date	Reaches the date
Reduces access in advance	Actively stops or reduces the behaviour

Action and Maintenance

Action	Maintenance
Recent active change	Change sustained for more than six months
Coping may be new and difficult	Confidence has increased
Relapse risk may be high	Relapse remains possible
Behaviour is actively being altered	New behaviour is being protected

Maintenance and Termination

Maintenance	Termination
Abstinence established for more than six months	Changed behaviour is normal
Temptation may remain	No temptation to relapse
Relapse prevention is still important	The model treats change as complete
Confidence has increased	Complete confidence is implied

Evaluating Prochaska’s Model

Strength: It Recognises That Change Is Cyclical

A major strength is that the model does not assume that one decision immediately produces permanent change.

People may:

Try to stop.
Experience difficulty.
Relapse.
Reconsider their approach.
Prepare again.
Make another attempt.

This is more realistic than describing change as one uninterrupted journey.

Why This Is Useful

Recognising relapse may:

Reduce all-or-nothing thinking.
Help identify weaknesses in the previous plan.
Encourage another attempt.
Prevent a setback being treated as total failure.
Support long-term engagement.

The cyclical nature was central to AQA’s 2024 mark scheme and examiner guidance.

Strength: It Distinguishes Readiness to Change

The model recognises that two people displaying the same addictive behaviour may have very different attitudes towards change.

For example:

One smoker denies that stopping is necessary.
Another is selecting a quit date.
Another has remained abstinent for seven months.

Treating all three as though they are at the same point would ignore important psychological differences.

The stages give professionals a language for describing:

Intention.
Planning.
Active change.
Sustained change.
Relapse risk.

Strength: It Has Practical Applications

The model can be used to organise support around the person’s current stage.

For example:

Awareness work may suit pre-contemplation.
Decision-making may suit contemplation.
Treatment planning may suit preparation.
Medication or CBT may suit action.
Relapse prevention may suit maintenance.

This can make intervention more individualised.

However, this is an application of the model rather than proof that stage-matched treatment is always effective.

Strength: It Separates Intention from Behaviour

The model distinguishes:

Thinking about change.
Planning change.
Performing change.
Maintaining change.

This is valuable because intentions do not always become actions.

A person may repeatedly say:

“I will stop next month”

without entering preparation or action.

The model prevents thoughts about change from being mistaken for actual behaviour change.

Strength: It Emphasises Maintenance

Some accounts of addiction treatment focus mainly on the moment the person stops.

Prochaska’s model recognises that:

Initial action is not enough.
Change must be sustained.
Confidence develops over time.
Relapse remains possible.
Long-term behaviour matters.

This is especially relevant to addiction because temporary abstinence does not necessarily represent lasting recovery.

Strength: It Can Be Applied to Different Addictions

The same broad stages can describe attempts to reduce:

Nicotine addiction.
Gambling addiction.
Alcohol or drug addiction.
Gaming addiction.
Other persistent addictive behaviours.

The practical details differ, but the movement from no intention to sustained change can still be identified.

This gives the model broad applicability.

Limitation: It Is Descriptive Rather Than a Treatment

The model describes where a person may be within a change process.

It does not itself explain exactly how to produce change.

For example, identifying someone as being in action does not show whether they require:

Drug therapy.
CBT.
Aversion therapy.
Social support.
Financial controls.
A combination of treatments.

AQA’s specimen mark scheme identifies a direct limitation of Prochaska’s model: it is more descriptive and lacks empirical support for its effectiveness as a method of reducing addiction.

Describing Does Not Necessarily Cause Change

A stage label may help organise information without directly improving behaviour.

For example:

“The person is in contemplation.”

This classification does not by itself:

Increase motivation.
Reduce withdrawal.
Challenge cognitive bias.
Remove gambling access.
Teach coping skills.

The model must be combined with an actual intervention.

Limitation: Limited Direct Evidence of Effectiveness

AQA’s specimen mark scheme states that Prochaska’s model lacks empirical support for effectiveness when treated as a method of reducing addiction.

This is important because a useful-sounding model is not automatically an effective treatment.

Evidence would need to show that using the stages produces better outcomes than:

Treatment without the model.
Standard support.
Another way of assessing readiness.

The supplied AQA materials do not provide named studies or outcome statistics demonstrating that the six-stage model itself reduces addiction.

These details should not be invented.

Limitation: Stage Classification May Be Subjective

Professionals may disagree about which stage best describes someone.

For example:

A smoker says they intend to quit and has purchased nicotine gum but has not selected a date.

One professional may classify them as:

Late contemplation.

Another may classify them as:

Preparation.

The boundary depends on how much planning counts as genuine preparation.

Why Subjectivity Matters

If stage identification is unreliable:

Different professionals may select different support.
Movement between stages may be measured inconsistently.
Research findings may be difficult to compare.
Apparent progress may depend on interpretation.

Clear behavioural criteria are needed wherever possible.

Limitation: Stage Boundaries May Oversimplify Change

Human motivation may change gradually rather than in six clearly separated steps.

A person might:

Be highly motivated in the morning.
Become uncertain by the evening.
Prepare to stop one part of the behaviour.
Remain unwilling to change another part.
Take action without feeling mentally prepared.

The stage model places a continuous and complicated process into categories.

This can improve clarity but may lose detail.

Limitation: People May Occupy Different Stages Simultaneously

A person may be in different stages for different behaviours.

For example:

In action for stopping casino gambling.
In pre-contemplation about online sports betting.
In maintenance for smoking.
In contemplation about alcohol use.

Even within one addiction, a person may:

Stop one type of gambling.
Continue another.
Accept financial harm.
Deny social harm.

One global stage label may fail to represent this complexity.

Limitation: The Six-Month Boundary Is Simplified

AQA identifies more than six months of established abstinence as part of maintenance.

This creates a clear exam distinction.

However, six months is a time boundary rather than proof that the same psychological change has occurred for every person.

Two people abstinent for seven months may differ greatly:

One may experience almost no craving.
The other may experience intense temptation every day.

Both may be classified as being in maintenance, but their relapse risk and support needs differ.

Limitation: Termination May Be Difficult to Verify

Termination requires:

The new behaviour to be normal.
No temptation to relapse.

These internal states may be difficult to measure objectively.

A person may:

Underreport temptation.
Want to appear successful.
Experience temptation only in rare situations.
Encounter a future stressor that has not yet occurred.

Researchers cannot easily prove that relapse is now impossible.

Termination May Be an Idealised Endpoint

For some people, long-term management may be more realistic than complete absence of temptation.

A person may maintain change successfully while continuing to:

Avoid particular cues.
Use support.
Monitor stress.
Practise coping strategies.

The model would classify this as maintenance rather than termination, even when the person has achieved a stable and meaningful recovery.

Limitation: The Model Does Not Explain the Causes of Addiction

The stages do not explain why the addiction developed through:

Genetic vulnerability.
Dopamine activity.
Reinforcement.
Cue reactivity.
Cognitive bias.
Family modelling.
Peer influence.
Personality.

Two people may both be in contemplation but require very different treatment because the processes maintaining their addictions differ.

The model describes readiness but does not replace an explanation of addiction.

Limitation: It Does Not Identify the Best Treatment

Knowing that someone is in action does not determine whether the most appropriate intervention is:

Biological.
Behavioural.
Cognitive.
Social.

For example:

A nicotine-dependent smoker may need help with physical withdrawal.
A gambler may need cognitive restructuring.
A person influenced by peers may need assertiveness and social support.
Someone responding to conditioned cues may need cue-management strategies.

The model should therefore be combined with assessment of the addiction’s causes and maintaining factors.

Limitation: Relapse Paths Are Highly Variable

The model allows relapse, which is a strength.

However, it does not specify one fixed destination after relapse.

A person may return to:

Pre-contemplation.
Contemplation.
Preparation.
Action.

The stage depends on:

Their attitude.
Motivation.
response to the setback.
Immediate plans.

This flexibility reflects real behaviour, but it can make precise predictions difficult.

Limitation: Readiness May Be Affected by External Conditions

A person’s movement through the stages may depend on:

Availability of treatment.
Cost.
Waiting lists.
Family support.
Employment.
Housing.
Peer pressure.
Physical health.
Access to gambling or substances.

For example, a person may be psychologically prepared for action but unable to access appropriate treatment.

The model could classify them as being in preparation without capturing the external barrier preventing progress.

Limitation: Self-Report May Be Inaccurate

Stage classification may rely on statements such as:

“I intend to stop.”
“I am not tempted.”
“I feel confident.”
“I have remained abstinent.”

These reports may be affected by:

Social desirability.
Memory errors.
Fear of judgement.
Desire to please a therapist.
Lack of insight.
Different interpretations of commitment.

Behavioural information should therefore be considered alongside self-report where possible.

Comparison with CBT

Prochaska’s model	CBT
Describes readiness and progress	Actively changes thoughts and behaviour
Includes six stages	Includes cognitive restructuring and coping skills
Recognises relapse	Provides strategies for preventing relapse
Can help organise treatment	Is itself a treatment
Does not specify one intervention	Specifies psychological techniques
May classify a person as being in contemplation	May help move the person towards action
More descriptive	More directly therapeutic

The model can help identify when CBT may be appropriate, but CBT supplies the active mechanisms of change.

Comparison with Drug Therapy

Prochaska’s model	Drug therapy
Describes behavioural change	Alters biological processes
Does not reduce withdrawal directly	Can reduce withdrawal and craving
Applies across several addictions	Usually targets a particular biological system
Helps identify readiness	Requires adherence during preparation and action
Recognises maintenance and relapse	May support early abstinence
No pharmacological side effects	May cause side effects

The two approaches answer different questions:

Prochaska: Where is the person in the change process?
Drug therapy: How can physical dependence be treated?

Comparison with Behavioural Interventions

Prochaska’s model	Behavioural interventions
Stage-based description	Conditioning-based treatment
Identifies readiness	Creates an aversive association
Does not directly change cue responses	Attempts to produce avoidance
Includes relapse as movement through the cycle	Conditioned aversion may weaken and cause relapse
Can apply broadly	Requires a specific treatment procedure

Practical Value Across Treatment

Prochaska’s model may be most useful as an organising framework.

A professional might ask:

Does the person recognise the addiction?
Are they considering change?
Have they committed to a plan?
Are they implementing treatment?
Have they sustained the change?
Is temptation still present?
Has relapse occurred?
Which support is currently needed?

The model can therefore help structure conversations and planning, even if it does not provide the active treatment.

Overall Evaluation

Prochaska’s model describes six stages of deliberate behaviour change: pre-contemplation, contemplation, preparation, action, maintenance and termination. It recognises that people differ in their readiness to change and that sustained recovery involves more than making an initial decision.

A major strength is its cyclical nature. Relapse is treated as an integral possibility rather than automatic proof that change has failed. The model can also help professionals identify whether a person needs greater awareness, decision-making support, practical planning, active treatment or relapse prevention.

However, the model is primarily descriptive. Classifying a person as being in a stage does not directly reduce craving, alter neurochemistry, challenge cognitive bias or teach coping skills. AQA has identified its descriptive nature and limited empirical support for effectiveness as a method of reducing addiction.

Stage boundaries may also be subjective, and motivation may be more continuous and changeable than six categories suggest. The six-month maintenance boundary does not mean that everyone has reached the same level of recovery, while termination and the complete absence of temptation may be difficult to verify.

The most balanced conclusion is that Prochaska’s model is useful for understanding readiness, relapse and long-term progress. It is strongest as a framework used alongside an evidence-based biological, behavioural or cognitive treatment rather than as a complete treatment by itself.

Key Words 🔑

Key word	Student-friendly definition	How it may be used in an exam
Behaviour change	Movement from an established behaviour to a different pattern	Introduce the model
Stage model	A model dividing change into identifiable phases	Describe Prochaska’s approach
Pre-contemplation	Not seriously considering changing the addictive behaviour	Apply denial or inertia
Inertia	Remaining as one is rather than beginning change	Explain pre-contemplation
Contemplation	Thinking about change without firm commitment	Apply awareness and uncertainty
Ambivalence	Having conflicting feelings about changing	Explain contemplation
Preparation	Making practical plans and intending to change	Apply appointments or quit dates
Action	Actively implementing behaviour change	Apply beginning treatment or abstinence
Maintenance	Sustaining abstinence for more than six months with increased confidence	Apply long-term change
Termination	The new behaviour is normal and there is no temptation to relapse	Identify the final stage
Cyclical model	A model allowing movement backwards as well as forwards	Explain the model’s structure
Linear model	A model involving movement in one straight sequence	Contrast with Prochaska
Relapse	Return to an addictive pattern after attempting change	Explain backward movement
Lapse	A brief return that may not become a full relapse	Distinguish a setback from sustained return
Abstinence	Complete avoidance of the addictive substance or behaviour	Apply action or maintenance
Commitment	A firm decision to perform a planned change	Distinguish contemplation from preparation
Quit date	A planned date for stopping an addictive behaviour	Apply preparation
Treatment plan	A structured account of how change will be attempted	Apply preparation
Coping strategy	A planned way of managing cravings or triggers	Apply action and maintenance
Trigger	An event associated with craving or addictive behaviour	Explain relapse risk
Self-efficacy	Confidence in one’s ability to manage behaviour	Explain increased confidence in maintenance
Relapse prevention	Preparation for future situations that might restart addiction	Apply maintenance
Readiness to change	The extent to which a person is psychologically prepared to alter behaviour	Explain practical use of the stages
Stage classification	Judging which stage best describes a person	Apply the model to a scenario
Descriptive model	A model that organises or describes behaviour rather than directly changing it	Evaluate Prochaska
Empirical support	Evidence obtained through systematic observation or research	Evaluate effectiveness
Subjectivity	Dependence on personal judgement or interpretation	Evaluate stage classification
Appropriateness	Suitability of support for a particular person or stage	Explain stage-based application
Termination criterion	Absence of temptation and normalisation of the changed behaviour	Evaluate the final stage

Hints from the Examiner Reports 💡

Give the Six Stages in the Correct Order

The required sequence is:

Pre-contemplation.
Contemplation.
Preparation.
Action.
Maintenance.
Termination.

Changing the order may make the model appear muddled.

Include the Cyclical Nature

Examiner hint: A list of six stages alone may not secure full marks on an outline question.

AQA’s June 2024 mark scheme required some reference to:

The cyclical nature of the model.
Relapse being incorporated.

A concise full outline might state:

Prochaska proposed a cyclical six-stage model consisting of pre-contemplation, contemplation, preparation, action, maintenance and termination. Relapse may return the person to an earlier stage before termination.

Be Economical in a Three-Mark Question

The June 2024 examiner report stated that the most economical route to three marks was:

Refer to the cyclical nature.
List the six stages.
State that relapse is integral.

Some students wrote lengthy descriptions of every stage and may have wasted examination time.

Match detail to the marks available.

Distinguish Contemplation from Preparation

Use the difference between:

Thinking: contemplation.
Planning: preparation.

Example:

“I know I should stop” is contemplation.

“I have booked an appointment” is preparation.

Distinguish Preparation from Action

Preparation involves making the plan.

Action involves carrying it out.

Do not classify a person as being in action merely because they have chosen a quit date.

Use the Six-Month Detail Carefully

AQA describes maintenance as established abstinence for more than six months with increased confidence.

A person abstinent for three weeks is more appropriately placed in action.

Do Not Forget Termination

Termination involves:

The new behaviour becoming normal.
No temptation to relapse.

It is not simply another name for maintenance.

Relapse Is Not a Seventh Stage

There are six stages.

Relapse causes movement back through the cycle.

Do not add it to the end of the list as Stage 7.

Apply Thoughts and Actions

When applying the model, use:

What the person says.
What the person intends.
What the person has planned.
What the person is currently doing.
How long change has lasted.
Whether temptation remains.

Avoid Classifying from Time Alone

Time can help distinguish action from maintenance, but it does not automatically establish termination.

Termination requires the changed behaviour to feel normal and temptation to be absent.

Explain Rather Than Merely Label

Weak application:

Aisha is in preparation.

Improved application:

Aisha is in preparation because she has committed to stopping, chosen a quit date and contacted a counsellor, but has not yet begun abstinence.

Evaluate the Model Rather Than the Treatment

The model is not identical to:

CBT.
Drug therapy.
Aversion therapy.
Covert sensitisation.

A relevant limitation is that it describes stages but does not itself provide the mechanism that reduces addiction.

Do Not Invent Evidence

The supplied AQA materials identify the model as descriptive and lacking empirical support for effectiveness, but they do not provide named studies or numerical findings evaluating it.

Do not invent:

Success rates.
Participant numbers.
Follow-up periods.
Named research findings.

Use supported evaluation such as its descriptive nature and limited empirical support for effectiveness.

Mistake 15

Mistake: Saying the model is useless because it is descriptive.

Why this is too absolute:

Description may still help assess readiness and organise support.

How to improve:

Balance practical usefulness against the absence of an active treatment mechanism.

Exam-Style Questions ✍️

Question 1

Name the first and final stages in Prochaska’s model of behaviour change. [2 marks]

Question 2

Explain one difference between contemplation and preparation. [3 marks]

Question 3

Outline Prochaska’s six-stage model of behaviour change. [3 marks]

Question 4

Tariq knows that smoking is affecting his health. He often says that he ought to stop but has not chosen a date or sought support.

Identify Tariq’s stage and explain your answer. [3 marks]

Question 5

For each statement below, identify the most appropriate stage.

“My gambling is not a problem, and I have no intention of stopping.”
“I know gambling is harming my relationship, but I am not ready to stop.”
“I have booked an appointment and will close my accounts on Friday.”
“I closed my accounts yesterday and have begun CBT.”
“I have not gambled for eight months and still use a relapse plan.”
“Gambling no longer tempts me and avoiding it feels completely normal.”

[6 marks]

Question 6

Explain how relapse is incorporated into Prochaska’s model. [4 marks]

Question 7

A support service recorded the stages of 120 clients when they first entered the service and six months later.

Stage	Number at entry	Number six months later
Pre-contemplation	30	14
Contemplation	32	20
Preparation	28	22
Action	22	40
Maintenance	8	24
Termination	0	0

Calculate the percentage of clients who were in either action or maintenance six months later. Explain one conclusion and one limitation of the data. [6 marks]

Question 8

Maya stopped smoking seven months ago. She still experiences cravings when friends smoke but uses breathing techniques and leaves the situation.

Identify Maya’s stage and explain why she has not reached termination. [4 marks]

Question 9

Explain one strength and one limitation of Prochaska’s model as applied to addiction. [6 marks]

Question 10

Discuss the usefulness of Prochaska’s six-stage model when attempting to reduce addiction. [16 marks]

Answers and Mark Scheme

Question 1

Award one mark for each correct stage:

Pre-contemplation
Termination

Maximum: 2 marks

Question 2

Award one mark for each linked point, up to three marks:

During contemplation, the person recognises the need for change or thinks about changing.
They have not yet made a firm commitment.
During preparation, the person intends to change and makes practical plans.
Examples include choosing a date or contacting a professional.
The key distinction is thinking compared with planning.

Question 3

Award marks in line with the AQA approach:

3 marks: A clear, coherent outline including the six stages and some reference to the cyclical nature or relapse.

2 marks: A clear outline with some detail but limited reference to the cycle or relapse.

1 mark: A limited or muddled outline.

Indicative answer:

Prochaska proposed a cyclical model containing pre-contemplation, contemplation, preparation, action, maintenance and termination. People may relapse and return to an earlier stage before reaching termination.

Question 4

Award one mark for:

Contemplation

Award up to two marks for explanation:

Tariq recognises that smoking is harmful.
He is thinking about stopping.
He has no clear commitment.
He has not made a practical plan.
He has not entered action.

Question 5

Award one mark for each correct answer:

Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination

Maximum: 6 marks

Question 6

Award one mark for each linked point, up to four marks:

The model is cyclical rather than strictly linear.
A person may return to addictive behaviour before termination.
Relapse may return them to an earlier stage.
The stage reached depends on their response, motivation and new plans.
They may move through preparation and action again.
Relapse is integral to the model.
Relapse is not a seventh stage.
Relapse is not expected after termination within the model.

Question 7

Six months later:

Action = 40
Maintenance = 24
Total in action or maintenance = 64

Award up to two marks for the calculation:

12064×100=53.3%

Approximately 53.3% of clients were in action or maintenance.

Award up to two marks for a conclusion:

More than half were actively changing or maintaining change.
The number in action increased from 22 to 40.
The number in maintenance increased from 8 to 24.
The number in pre-contemplation decreased.
The pattern is consistent with movement towards change.

Award up to two marks for a limitation:

The table does not show whether the same individuals moved forwards.
Some clients may have relapsed and moved backwards.
The stages may have been assigned subjectively.
Self-report could be affected by social desirability.
There is no comparison group.
The data do not show that use of Prochaska’s model caused the change.
Six months is not enough for clients newly entering action to meet the maintenance criterion.
No clients reached termination, but temptation was not directly measured.

Question 8

Award one mark for:

Maintenance

Award up to three marks for explanation:

Maya has sustained abstinence for more than six months.
She uses coping strategies.
She continues to experience cravings.
Termination requires no temptation to relapse.
Her need to manage smoking cues shows that the new behaviour is not yet entirely effortless or temptation-free.

Question 9

Award up to three marks for one developed strength and three marks for one developed limitation.

Possible strength:

The model recognises that change is cyclical and that relapse may occur. This is useful in addiction because a return to smoking or gambling does not have to be treated as complete failure. The person can identify what caused the relapse, return to an appropriate stage and make another attempt.

Possible limitation:

The model is descriptive rather than an active treatment. Identifying someone as being in contemplation does not reduce withdrawal, challenge cognitive bias or teach coping behaviour. AQA also identifies limited empirical support for the model’s effectiveness as a method of reducing addiction.

Other creditworthy points include:

Attention to readiness.
Stage-relevant planning.
Recognition of maintenance.
Broad application.
Subjective classification.
Oversimplified categories.
Difficulty verifying termination.
Failure to explain addiction’s causes.
Six-month boundary.
External barriers to change.

Question 10

A high-level answer should include accurate knowledge and developed evaluation.

Indicative AO1 Content

Prochaska’s model as a model of deliberate behaviour change.
Six stages.
Pre-contemplation.
Inertia or lack of intention.
Contemplation.
Awareness without commitment.
Preparation.
Planning and seeking support.
Action.
Implementing the change.
Maintenance.
Abstinence for more than six months.
Increased confidence.
Termination.
New behaviour becoming normal.
No temptation to relapse.
Cyclical rather than linear structure.
Relapse at any point before termination.
Returning to an earlier stage.
Application to nicotine, gambling or another addiction.
Possible stage-relevant support.

Indicative AO3 Content

Recognition that lasting change is difficult.
Realistic inclusion of relapse.
Relapse not being treated as total failure.
Attention to readiness and motivation.
Distinction between intention, planning and action.
Importance of maintenance.
Practical use when organising support.
Possible matching of support to the person’s stage.
Broad application across addictions.
Descriptive rather than therapeutic nature.
Failure to specify how behaviour changes.
Limited empirical support for effectiveness.
Subjectivity of stage classification.
Unclear boundaries between stages.
Motivation being continuous rather than categorical.
People occupying different stages for different behaviours.
Six-month maintenance criterion being simplified.
Difficulty verifying absence of temptation.
Termination possibly being idealised.
Failure to explain the causes of addiction.
Failure to select the most appropriate active treatment.
External barriers affecting progress.
Self-report and social desirability.
Comparison with CBT.
Comparison with drug therapy.
Need to combine the model with an evidence-based intervention.

Thirteen to sixteen marks: Knowledge is accurate and generally detailed. All six stages are clearly distinguished, the cyclical nature and relapse are explained, and application to addiction is effective. Discussion is thorough and balanced, considering practical usefulness, descriptive limitations, evidence, classification and comparison with active treatments.

Nine to twelve marks: Knowledge is mostly accurate and discussion is generally effective. The six stages and relapse are covered, although some stage distinctions or evaluative arguments may lack depth.

Five to eight marks: Some relevant knowledge is present, but the response is mainly descriptive. Stages may be listed without clear explanation, or evaluation may be generic and undeveloped.

One to four marks: Knowledge is very limited or confused. Stages may be placed in the wrong order, relapse may be described as a seventh stage or the model may be confused with a specific addiction treatment.