Stages of Change & Reactancein Group WorkJane F. Gilgun, Ph.D., LICSWProfessor, School of Social WorkUniversity of Minnesota, Twin Cities, USA

Topics

• Relevance of Common Factors Model

• Stages of Change

• Reactance & Change

• Reactance & Relationships

• Reactance & Self-Regulation

• Reactance & Executive Function

• Maintenance & Change

Stages of Change Model

• CFM reports that service user motivation/readiness to change is part of good outcomes.

• SCM says that many people go through stages of change

• This model developed on groups for people who quit smoking

• Model may work for other addictions

• Test model for fit with other issues

Stages of Change

• Stage 1: Precontemplation (Not Ready)

• Stage 2: Contemplation (Getting Ready)

• Stage 3: Preparation (Ready) .

• Stage 4: Action

• Stage 5: Maintenance

• (Stage 6: Relapse)

• Cycle repeats itself

Stages of Change

Common Factors Model

• CFM says that relationships between service users and providers are foundational for change.

• As social workers, we must think about extratherapeutic factors

• Think in terms of how environments influence behaviors

• Think in terms of how connected service users are to their environments and the people in them

• Think in terms of how to connect clients to people who are prosocial/have good executive function (judgment)

Common Factors Model

• Extratherapeutic Factors (40%) [events

external to service provision]

• Relationships (30%)

• Optimism, Motivation, Capacities (15%)

• Skills, techniques (15%)

Motivation

& Expectancies

15%

Extratherapeutic

Effects 40%

Relationships

Technique

15%

Definition of Reactance

•Normal response to a threat of loss of valued free behaviors. A motivational state that is directed toward restoring threatened or eliminated free behaviors. (Brehm & Brehm, 1981)

Reactance & Change

• Reactance as a Major Block to Change

• Importance of relationships to Readiness to Change

• Feeling understood a bottom line

• Feeling connected and safe with at least one other

• Maintenance

• Requires attention to “extratherapeutic events”

• Anticipation & safety plans

Reactance, Self-Regulation, & Change• Many ways to handle reactance

• A matter of self-regulation

• Meditation, yoga, going for walks, talking to trusted others, anything that is calming

• Being with positive people

• Remember negative consequences of slips/regressions/reversion to old ways

Reactance & Executive Function• Think of consequences

• Explore thoughts of how to get what you want & not get hurt or hurt others (rationalization: no one will know)

• An executive function issue

• What do you want?

• How do you get it?

• Autonomy foundational to change and its maintenance

References

• Chovanec, M. (2008). Innovations applied to the classroom for involuntary groups: Implications for social work education. Journal of Teaching in Social Work, 28(1/2), 209-225.

• DiClemente, CC; Prochaska, JO; Fairhurst, SK; Velicer, WF; Velasquez, MM; Rossi, JS.The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 1991 Apr;59(2):295–304.

• Gumpert, J. & Black, P. (2006). Ethical issues in group work: What are they? How are they managed? Social Work with Groups, 29(4), 61-74.

• Magen, R. (2009). Group work major models. In A. Gitterman & Salmon, R. (Ed.) Encyclopedia

• of Social Work with Groups (45-58). New York: Routledge.• Stages of Change Diagram from Loyola/Notre Dame Model

webpage. http://guides.lndlibrary.org/content.php?pid=410759&sid=3390249