Working with Victims of Crime: A Manual Applying Research to Clinical Practice

5.0 The Basics - Stages of Change

• In trying to change, people cycle through different stages: precontemplation (no plan to change because they don't believe they have a problem), contemplation (aware of the problem and are seriously considering change), preparation (intend to do something soon), action (actively trying to make change) and maintenance (keeping the gains) (Prochaska et al. 1992).
• People may be mostly in one stage, but can be in all stages at the same time (Prochaska et al. 1992). For example, a victim may recognize she has a problem resulting from victimization and may seek out therapy to deal with depression or anxiety (action). However, she may refuse to talk about the crime itself, saying that it has nothing to do with the depression (precontemplation). She might then drop out of therapy but still recognize that she needs help (contemplation).
• People who feel they don't have a problem (precontemplators) report more distress with treatment, less progress and are more likely to quit treatment early (Smith et al. 1995).
• Most change happens when a person moves from precontemplation into the other three stages (Rosen 2000).
• Workers can decrease their own frustration and improve the effectiveness for victims by assessing where people are in these stages and selecting appropriate interventions.
• Precontemplators should be given "consciousness raising" activities (reading, self-help books, attending information sessions, etc.). These efforts help the victim learn about possible reactions and the benefits of getting help (Prochaska et al. 1994).
• Other activities that can help motivate victims include looking at the effects on themselves and others, experiencing and expressing emotions, and paying attention to changing social norms regarding victimization and getting help (Rosen 2000).
• Workers can help victims prepare for leaving active treatment by: teaching them healthy living skills, educating them about early warning signs of backsliding, and helping them develop self-monitoring skills and other daily activities that are focused on gaining and maintaining control over their life. Allowing time for practising and mastering these skills is time well spent in treatment.
• Victims can also benefit by workers developing ways to help educate the victim's natural supports (family, friends, etc.)