Stages of Change

Oftentimes, when people hear stories about domestic violence, they quickly ask the question, “why didn’t she just leave?” At Genesis, we know that leaving is much easier said than done, as there are several factors that go into the decision to end a relationship. Change is a difficult process and not something that can be done overnight. One way we think about change is through the lens of the The Transtheoretical Model of behavior change, which was originally developed by Prochaska and DiClemente (Prochaska and DiClemente, 1984, 1986) within a clinical context to describe the process of behavior change for addictive behaviors. This model is also known as the stages of change. There are five stages of change that an individual goes through when making life changes. These stages are not linear and it is common for individuals to vacillate between stages as they move through the process of change. At Genesis, we use this model to conceptualize where clients are on this continuum so that we can be sure to meet them where they are in the treatment process.

The Five Stages of Change are:

1. Precontemplation: she is not aware that there is a problem and does not know to be interested in change. 
2. Contemplation: she is beginning to recognize that there may be a problem and she weighs the pros and cons of changing. In this stage, it can be hard to identify ways of changing or even imagine how she could make the change.
3. Preparation: she recognizes there is a problem and has decided to make a change. In this stage, she is making plans, seeking help from experts and professionals on how to change, and coming up with concrete steps for an action plan.
4. Action: she implements her plan for change and is actively working on changing. She continues to seek help from supportive people and professionals and adjusts her plan as needed.
5. Maintenance: she continues to maintain the change and progress she has made, recognizing that change is a journey and not a destination and that relapse is possible. She adapts and implements an action plan as needed.

If a survivor of domestic violence is in the Precontemplation Stage, she may have beliefs such as: “His behavior is normal, this is just how men are,” or “My partner just has an anger management and/or a drug or alcohol problem,” or “Conflict in a marriage is normal and I just have to deal with it.” We recognize that these beliefs are common and it may take some time before she recognizes the issue of domestic violence. Perhaps she witnessed domestic violence between her parents or in her family growing up, and she is not aware of the characteristics of healthy vs. abusive relationships. Perhaps her abusive partner has manipulated and gaslighted her into believing that she is the problem in the relationship. 

There are a number of factors that make it difficult for a woman to leave an abusive relationship. In the Contemplation Stage, survivors of domestic violence are faced with all these obstacles and must carefully weigh options. 

• Economic needs and Lack of resources: Maybe she would not have access to basic resources if she were to leave the relationship. The only way she can provide for her children, the only way she has a roof over her head, the only way she has access to childcare, the only way she has health insurance for herself and her family is by staying in this relationship. 
• Isolation: She believes she has no other support or no one else to support her if she left. Maybe he has convinced her that no one will believe her and she doesn’t feel like she can reach out for help. 
• Immigration status: Perhaps she is afraid that if she left, she would be deported. Maybe he has threatened her that she would not be able to stay with her family if she left the relationship. 
• Beliefs about family and/or marriage: Cultural and religious beliefs, such as “I have to keep the family together at all costs,” “Kids need to grow up with two parents,” “Divorce is a sin,” or “What happens in the family, stays in the family” can leave a woman feeling trapped in a relationship.  
• Trauma symptoms: The presence of post-traumatic stress symptoms after experiencing abuse can make it difficult to concentrate, sleep or make decisions, and lead a woman to blame herself for the abuse.
• Love and Hope: She may genuinely love her partner. The beginning of abusive relationships do not start off as abusive. The beginning is really good, and she falls in love with this person. The honeymoon phase in the cycle of violence can also be confusing and she is sucked in by his apologies, promises and romantic gestures. 
• Lack of support: Maybe she has tried to leave and was not able to get help so she had to go back. So many times, women reach out to police, medical professionals or church leaders and they are told that there is nothing to be done, or that they should just deal with it. Perhaps she has called for shelter and there are no beds available.
• Fear: The most dangerous time for a woman in an abusive relationship is when she is leaving. Perhaps it is safer for her to stay. Maybe he has threatened her that if she leaves, he will kill her or kill her children, so she stays in order to protect herself and her family.  

As you can see, there is a lot to consider in the Contemplation Stage. For some women, they may ultimately decide it is best for their families or their safety to stay in the relationship. They can seek support from Genesis to make sure they have a safety plan and are able to cope with their situations.

At Genesis, we see clients in all stages. We can provide education for women in the Precontemplation stage and help her become more aware of the difference between a healthy and an unhealthy relationship. We can help women in the Contemplation and Preparation Stages make safety plans, connect them with legal resources, or house them in our Emergency Shelter. Clients in the Action Stage may be engaged in weekly group counseling and engaging with our advocates to implement their plan. 

If you know someone in an abusive situation, remember to believe her and to be patient with her.  It can be hard to watch a loved one in a hard situation; however it is important that she knows she has a support system even as she moves through these stages. Let her know you are concerned for her safety and that you are there to support her. She may be confused about what to do. Finally, let her know that at Genesis, clients can meet with counselors and advocates to explore what is best for her. No matter what stage she is in, Genesis is here to support her. 

If you know someone who is contemplating change in their relationship, we can help. If you or someone you know may be experiencing domestic violence, call our 24-hour hotline at 214.946.HELP (4357).

Written by Victoria O Connor, women’s and children’s therapist at Genesis Women’s Shelter & Support.