Stages of Change Worksheet example
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What is the Stages of Change worksheet?

The stages of change worksheet maps a client’s position across the five stages of the Transtheoretical Model: Precontemplation, Contemplation, Preparation, Action and Maintenance. Each stage carries its own Signs list, so a client identifies where they are from described behavior rather than from a label.

How to use the Stages of Change worksheet

Send this one as homework, since a client reads the Signs lists more honestly without an audience. Ask them to read all five stages before choosing, because the Contemplation Stage and the Preparation Stage look similar until the signs are compared. Your clients can mark the stage they are in now and the one they were in a month ago, which shows direction rather than position. Bring the answer back to session to plan the next step.

Stages of Change Worksheet Download – What’s Included

Three printable pages. Page one is the stage wheel with all five stages named around it. Pages two and three take each stage in turn, giving a one-line description and a Signs list of what that stage looks like from the inside. A Background section explains the model before the stages begin.

Based on the Transtheoretical Model (Prochaska & DiClemente). Prochaska, J. O., & DiClemente, C. C. (1983). J Consult Clin Psychol, 51(3).

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Your Author

Tracy Collins is a licensed clinical psychologist with over six years of direct clinical experience in outpatient and telehealth settings. She specializes in cognitive behavioral therapy, structured treatment planning, and measurable therapy outcomes. Tracy has extensive experience writing SOAP and DAP notes, developing insurance-compliant treatment plans, and aligning documentation with ICD-10 and DSM-5-TR diagnostic criteria. Her clinical approach integrates cognitive behavioral therapy techniques, behavioral activation, exposure-based interventions, and mindfulness-based strategies to create structured and outcome-driven therapy plans. At Mentalyc, Tracy supports therapists by creating educational resources that simplify documentation workflows and improve treatment plan defensibility during audits.

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