Managing Change: Sustaining the Effort

Congratulations on reaching this final stage in the process of making a behavior change. Your preparation and commitment to following your plan of action have paid off. Here are some helpful strategies for maintaining change.

Stages of change

Recent theories of change have focused on the process of change as just that: a process. Change is not a single event; it does not occur overnight, but rather, change occurs through defined stages.

The maintenance stage of the process of making behavior change is typically considered to be the downhill leg of the change process. This is a bit of a misnomer, particularly for those dealing with chronic problems such as addictions or overeating. The word “maintenance” implies a passive approach to sustaining change. While it is true that a small percentage of individuals who have successfully come through the action stage report that they no longer have a desire to, or face temptation to, engage in their problem behavior, the vast majority of people report a significant risk for relapse.

From action to maintenance

While there is no clear line of demarcation separating the two stages, experts suggest that maintenance occurs when the behavioral change has been successfully integrated and accommodated into one’s lifestyle.

For example, going on a low-carbohydrate diet in order to lose 20 pounds is very difficult at first, requiring a lot of cognitive energy to learn which carbs are good and which carbs are bad, etc. Once one learns the ropes, finds a tasty low-carb diet and incorporates it into one’s lifestyle, it doesn’t require so much thought. In other words, the person can “just do it.”

For recovering alcoholics, a sign that they have entered the maintenance stage is when attending Alcoholics Anonymous meetings becomes enjoyable—a regular and welcome part of their weekly routine.

Preventing relapse

There is no cure for most problem behaviors. Consequently, the potential for relapse is very real and must not be underestimated.

Think of relapse as a process and not an event. In other words, relapse includes identifiable thoughts and feelings that, if avoided, inexorably lead to engaging in the problem behavior again. Self-deception is the common thread in most instances of relapse.

Consider a recently recovering compulsive gambler, Jim, who has not wagered in four months. At Gamblers Anonymous he has learned that he should avoid people and places associated with gambling. However, Jim is feeling very confident in his recovery, so much so that when he is invited to a low-stakes poker game for a friend’s bachelor party, he tells himself that he can handle it. Within minutes of arriving at the party Jim is overwhelmed by a desire to gamble. He tells himself that he will gamble “just to be social” and sets his loss limit at $10. By the end of the night, he has lost more than $250. The story illustrates that relapse occurs the moment one breaks even a little rule or tells oneself a little lie.  

Signs and symptoms of relapse

• increased feelings and perception of stress and feeling overwhelmed
• pretending things are OK when they are not
• self-pity
• isolating from supportive people
• feelings of anger or entitlement
• skipping treatment sessions or support meetings
• feeling overly confident
• poor sleep
• overworking

Strategies for maintaining change

Maintaining behavioral change is about more than avoiding relapse. It also involves taking a proactive approach. Here are some helpful strategies for maintaining change:

• Review goals, accomplishments and any setbacks each week.
• Be honest with yourself about your progress and setbacks.
• Keep a private journal of your thoughts and feelings about your life as you journey through the change process.
• Look for ways to improve your plan—ask others.
• Stay in touch with your support team.
• Periodically assess the level of support and accountability you need, and adjust accordingly.
• Disclose newly discovered relapse triggers or risky situations immediately.
• Ask for specific feedback on how your team perceives your progress and attitude. Does anything concern them?
• Learn more about your problem behavior. Consider attending a workshop or conference.

Acceptance

Acceptance is perhaps the purest outcome of the maintenance stage. This is the spiritual aspect of the change process, and the one that is hardest to define and measure. Acceptance is that place you come to when you realize that you really had to make a change and, that you will be all right. The “Serenity Prayer” sums up the change process eloquently and succinctly:

“… Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

If you are struggling with maintaining a change, revisit the previous stages in your process by reviewing these articles:

“Managing Change: Preparing to Change”

“Managing Change: Making It Happen”

If at any time you want or need help changing a problem behavior, don’t hesitate to contact your employee assistance program or a mental health professional.

By Drew Edwards, EdD, MS
© 2005 Achieve Solutions