Contemplation Stage — MRCPsych Paper B MCQ

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EasyPsychotherapyContemplation StageMRCPsych Paper B

In the transtheoretical model of change described by Prochaska and DiClemente, a patient recognises that their behaviour is problematic and is considering change, but remains ambivalent and has not committed to taking action. Which stage of change does this describe?

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Correct answer: D — Contemplation

The correct answer is D, contemplation. In this stage, the person recognises the problem and is considering change but remains ambivalent and has not committed to action. Exploring decisional balance and resolving ambivalence are therefore clinically relevant. In pre-contemplation, the person is not seriously considering change and may not recognise the behaviour as problematic. Preparation entails an intention or commitment to act soon, often with initial planning or small steps. Action means that the behaviour has already been modified, while maintenance concerns sustaining an established change and preventing relapse. Motivational interviewing may help a person in contemplation explore ambivalence, although it is not restricted exclusively to this stage.

Reference: Greenhalgh T, Kostopoulou O, Harries C. Making decisions about benefits and harms of medicines: supplementary Box A, ‘Stages of change (transtheoretical) model’. BMJ. 2004;329:47–50. https://www.nice.org.uk/guidance/cg115/chapter/Recommendations