Summit Achievement finds the Stages of Change Model as a beneficial way to look at the change process for troubled teens and young adults. The Stages of Change Model, technically referred to as the Transtheoretical Model of Change, was first developed in 1977 by Dr. James Prochoska at the University of Rhode Island. The premise is that any change process for a troubled teen or young adult (or anyone for that matter) goes through six different stages. The six stages are Precontemplation, Contemplation, Determination, Action, Maintenance, Termination. When we work with teenagers and their families, we often refer to the Stages of Change Model. All of our faculty, guides and clinicians are trained in this model. We encourage people to read more about this useful way to look at change and feel that this book is one of the great tools that explain the model. We will explore the model in this blog post as well as how we facilitate the process at Summit Achievement through our unique model of wilderness therapy and residential treatment program for teens and young adults.
Using the Stages of Change Model
To start, we will use an example of a troubled teenager who struggles with anxiety going through the stages. You could change the word “anxiety” to depression, social challenges, attention deficit disorder, or executive functioning if it is more fitting for your child. The first stage is Precontemplation- which is when the struggling teen is not even aware there is a problem. The problem is seen as being caused by school, other students, society, and so forth and so it is not possible to fix. Teenagers in the Precontemplation stage refuse any treatment, nor do they see it as a problem nor something that they need to address. The parent can see, as well as many others, the teen’s anxiety and the subsequent behavior but is unable to effectively get their teen to see that there is a problem. Because they cannot see the problem, they will not address it. Many years ago, this stage was called “Denial.” It is impossible to admit there is a problem if you don’t see one. At this stage, a parent is often frustrated as they see that their teenager is struggling but cannot get their child to see it no matter what they do.
The second stage is Contemplation- which is when the troubled teen admits, at times, that there is a problem but vacillate between seeing it as a problem to minimizing it as a problem. The teen may say they will go to mental health treatment and then say it is “not really a problem” or reject the recommendations of the mental health practitioner. The parent is often glad to see their teen sees the problem but frustrated as the troubled teen is not doing anything about the challenge, even with plenty of options for help. Consider the nicotine user who says they are going to stop, but not until next week, month or New Years or etc. They say it is a problem, but they also don’t act like it is one, so it continues. One can be in the Contemplation stage a long time, so long that one becomes comfortable with the discomfort.
The third stage is Determination (also referred to as Preparation) when a troubled teen starts addressing the issue, such as reading more about anxiety and going to counseling sessions. Perhaps they will even begin telling friends they are dealing with stress. They are more likely to ask for help and be open with their parents about the need for help. They see the problem and want help and will actively engage with mental health professionals. Sometimes troubled teens regress to the Contemplation stage as they realize that making a change is a challenge.
The next stage is Action, which is when a troubled teen is active in treatment, such as following treatment recommendations by their mental health provider and doing associated treatment goal work. For the anxious, troubled teen, this may mean doing activities that they refused to do in the past because of their anxiety, such as going to school five days a week or meeting new people. This stage has the teen regularly practicing new behaviors that help to address triggers that could cause a relapse into anxiety or whatever challenges are occurring.
The fifth stage is Maintenance when a behavior change has sustained for six months or more. During this stage, the troubled teenager may have, from time to time, anxiety but they use the tools that they learned in adolescent treatment settings to not relapse back into a place of not participating in basic adolescent tasks such as going to school, doing homework and participating in family activities.
The final stage is Termination, which is when the issue is no longer part of the teen’s life, whether it is anxiety, depression, substance use, etc. This issue is something that young people and their parents look back upon and say, “remember when you…” and reflect on how much has changed since that time. We have numerous stories to tell regarding this stage.
The majority of students who enroll at Summit Achievement are either in the Precontemplation or Contemplation stage as they are still grappling with how to make a change or even that there is a problem, to begin with. For a deeper understanding of this, read the book.
How do we facilitate the change process at Summit?
Summit Achievement combines the best in evidence-based treatment practices delivered by licensed mental health practitioners in our residential and wilderness therapy program setting to help create change for young people and their families. Evidenced-based treatment practices are defined by the American Psychological Association as “the integration of the best available research with clinical expertise in the context of client characteristics.” At Summit Achievement, our clinicians utilize several modalities of Evidenced Based Treatment Practices, including Cognitive Behavioral Therapy (CBT), Family Systems Therapy, and Motivational Interviewing. We use these modalities as they have been proven to be effective treatment strategies to help create change. Our clinicians are regularly updating their training on these treatment modalities. We also integrate treatment practices throughout the therapeutic milieu (on our campus) and the wilderness therapy expeditions to help accelerate the Process of Change for our students. We provide individual, group, and family therapy for troubled teens and their parents starting the week of enrollment.
Developing growth through the uncomfortable
When young people enter the Summit Achievement treatment program, they are often in the Precontemplation or Contemplation stage. Our team works tirelessly to connect with troubled teens so we can help steer them through the therapeutic process. It is easier to support a troubled teen through the therapy process at a residential and wilderness setting than it is for parents because we do not have the longtime patterns of behavior to unbundle or emotional connection. We care deeply about our students while being clear as to what is healthy and unhealthy behavior, and we address issues at the time they occur. To read more about how we facilitate the change process at Summit Achievement, please read this webpage.