Safety (Pre-Contemplation)

Most students enter the program in the pre-contemplation stage of change. Students at this stage are not ready for change. In fact, they may not even be aware that they have a problem. Families, teachers, and friends however, are well aware that they have problems. Students at this stage typically feel coerced into change.

They may demonstrate change as long as the pressure is on. Once the pressure is off, however, they will quickly return to old behaviors. Resistance to recognizing or modifying a problem is the hallmark of this stage. Students entering the program are asked to demonstrate appropriate levels of trustworthy behavior.

During this stage, students write letters to their parents but will have no contact with friends. Turnabout’s Parent Connection provides parents with a quick an easy way to write their students as often as they’d like. Some hallmarks of students in the Safety stage of change include:

• The student is not ready for change or even aware of a need for change.
• Students will typically act defensively or offer passive compliance at this stage (“I don’t need to be here”, “My parents are the one with the problem”)
• Students may feel overwhelmed by the prospect of being in a program and what it will really take to change.
• Students will run through their repertoire of coping strategies such as anger, manipulation, withdrawal, etc.
• Students are invited to be safe. They are expected to learn the norms/routines of the program, and learn the group process.
• Students begin to identify: what behaviors have gotten them to this point, thinking errors, strengths and how to get support.

Awareness (Pre-Contemplation and Contemplation)

At this stage, students are starting to admit that a problem exists and are seriously thinking about doing something about it, but have not really made a commitment to change. Students begin weighing pros and cons of change and may not be ready to “pay the price” to be healthy. When faced with dissonance or a challenge, students at this stage often fall back to old behaviors. Some key aspects of students at Awareness include:

• Students begin to become conscious of the problem. They are start to be aware that choices and behavior have consequences.
• Students start making changes but are still motivated by an external locus of control.
• Students at this stage of change are compliant most of the time although they may often test limits and use negative coping strategies to deal with negative feelings, frustration, etc.
• Students are learning how to problem solve and ask for help when needed.
• May become a “support” in our peer support system.
• May present Autobiography to parents at this stage.
• As this is an incubation stage, students are becoming more open to internal change.
• Students prepare to go back to their own home (if in state) and may obtain “in house privileges” at some point during this stage. If out of state, regular phone contact with parents may begin.

Discovery (Preparation)

Students at this stage of change (sometimes called the decisions making stage) have made some changes in their problem behavior and are intending to make significant changes. They are continuing to discover the way their behavior has affected themselves and those around them. They start to realize that there are often deeper issues driving problem behaviors and are beginning to address those issues.  Some hallmarks of students at the Discovery stage of change include:

• Students start to experience the benefits of real change.
• Students practice problem solving daily and accept feedback from their peers and staff.
• Although still externally motivated, students begin to explore the real issues and examine cycles, family systems, and personal issues such as addiction, trauma, mood disorders, etc.
• Students may receive visits from out of state parents. Turnabout’s parent living center is available to parents who make on campus visits.
• Students develop new coping strategies, relationship skills, and start to be aware of the “cost” that making change requires.
• Students at this stage start to care about their peers and the group and see themselves as part of a larger community.
• Students are ready and willing to take responsibility for their behavior and support peers in taking responsibility for themselves.

Responsibility (Action)

Students at this stage of change are actively addressing their thoughts, feelings and behaviors. They have started to take personal responsibility for taking action to modify their lives. This stage of change involves the most visible behavioral changes and requires considerable commitment and energy. Students at this stage are starting to be internally motivated and become strong supports and peer leaders. Some key characteristics of students at the Responsibility stage of change include:

• Students actually do what they say they will.
• They are starting to become internally motivated and do things because they like the way change feels.
• Although there is normal resistance to change, students at this stage are starting to be self motivated to change. They do not do things just to please others avoid discomfort or get out of the program.
• Students show leadership and personal power when interacting with peers, staff, and family.
• Students are goal oriented and are able to identify goals and objectives.
• Students are actively working on issues and shows consistency in dealing appropriately with challenges.
• Students have an established relationship with family members and demonstrates a willingness to continue to address family issues.
• They actively hold others accountable and show leadership through example.
• Students demonstrate a healthy balance of priorities.
• Students are peer leaders and take personal responsibility for the progress of the group.
• If from out of state, students may begin to have home visits. If in state, may begin to go home alone.

Leadership (Action, Maintenance)

Students at this stage of change continue the process of making the changes they have been making long term. They are working on a transition plan and integrating the tools they have gained and the changes they have made into the next phase of life. Some key characteristics of students at the Leadership stage of change include:

• Students are internally motivated.
• Students feel good about what they have accomplished and newly developed coping strategies are becoming habits.
• Have a strong sense of self.
• Actively demonstrate an ability to address conflict, triggers, issues, etc. appropriately and hold themselves accountable with minimal supervision.
• Students at this stage are working on their transition plan and may be working in the community.
• Students work on a comprehensive transition plan and may graduate the program.

Integrity (Maintenance)

At this stage of change, students work to prevent relapse and consolidate the gains they have made in treatment. They are often engaged in transition activities such as working part time, attending college, making frequent home visits, etc. Some hallmarks of students at the Integrity stage of change include:

• New habits have become second nature.
• Have a strong sense of personal commitment to give back to family, peers, and society.
• Students are excited about the next phase of their life.
• Students encourage responsiveness in almost everyone they deal with. They are congruent and “walk their talk”.