The stages of change paradigm operates under the assumption that

• A. People will always change no matter what the health professional does
• B. The majority of people are ready for change
• C. People change predominantly based on the significant others in their life
• D. The majority of individuals are not yet ready to change

Answer: (D)

At the heart of the stages of change framework is readiness to change. It holds that people exist on a continuum of motivation and commitment, moving through stages such as not considering change, weighing it, preparing to act, taking steps, and maintaining a new behavior. Because most individuals are not in the action or maintenance stages at any given time, the model assumes that the majority are not yet ready to change. This is why interventions should be matched to where someone sits in that progression, focusing on awareness and motivation in earlier stages and on planning and skills in later ones. The other ideas—that change is guaranteed with the right clinician, that most people are already ready, or that change is driven mainly by others—don’t fit the model, which centers on individual readiness and staged progression.