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The Tasks of Change We Can Really Believe In

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"Change we can believe in." "The change we need." "Vote for change."

Change is the order of the day. In a near landslide, the American public voted for change.
But now comes the hard part. How does one actually change a country?

About twenty years ago, the psychologist Carlo DiClemente and colleagues devised a model to describe how people go about changing addictive and unhealthy behaviors. DiClemente was interested in breaking down the often amorphous and ill-defined process of change into specific steps. The model, called "The Stages of Change," has since been applied throughout psychiatry and healthcare, and has revolutionized how many caregivers work with patients to bring about more healthy behaviors.

DiClemente said that change involves passing through a series of formal phases which involve critical tasks. The first stage, Precontemplation, is where most people begin any process of personal transformation. That is, they are not considering any kind of transformation at all. Furthermore, they may not be aware that they even have a problem. Addicts who do not think they have a drug or alcohol problem are the classic precontemplators. In the Contemplation stage, one has a creeping awareness that one has a problem, is considering doing something about it, but is ambivalent about actually moving forward. In the Preparation stage comes the critical moment when a person sees that the advantages of change outweigh the consequences of maintaining the old behavior. But it is only in the aptly named Action stage that a person moves beyond thoughts and hopes and makes drastic and repeated behavioral changes in their habits and lifestyle which continues over a three to six month period. The Action stage is the honeymoon period, the challenging but heady early days of change. The Maintenance stage involves the hardest work: the sustaining of change and the prevention of recurrences, lasting from six months up to five years.

The essential insight of the model is to view change as a dynamic and cyclical process that requires completion of critical tasks that make change happen. In the West at least, we are more accustomed to viewing progress and development over time as a strictly linear process. But life is more complicated than that; we are constantly going around in circles and back again. In fact, even the Stages of Change is too sequential. In reality, we dance around all of the above stages in all manner of different sequences.

With the election of Barack Obama, the United States went decisively from the Precontemplation and Contemplation stages (which involved two years of talk about change without anything really ever changing) to the brink of the Preparation stage, by enabling a viable action plan and summoning the early commitment to follow though on the plan. At this very moment, President-elect Obama is setting goals (even if they remain rather ill-defined) and putting together a plan of action.

So far, so good. But here's the rub. As Dr. DiClemente reminded me, the Stages of Change doesn't work for amorphous, abstract notions of change -- "the change we need" -- it works for highly specific, targeted behaviors. Obama has done a brilliant job of defining what we need to "change from," but has been noticeably light on what we are supposed to "change to." But true change doesn't involve just saying no to the past. Nor does it involve mere transformation in attitudes or moods or beliefs, as refreshing as that may be. True change involves the modification of observable behaviors, repeatedly and over time. An addict may feel wonderful or even may refrain from using for a short time, but they only become a non-addict, a new person, when they actually stop using substances over a period of years. For the United States to progress farther along the Stages of Change and move beyond the failures of the last eight years, two Herculean tasks remain. The first job is for the new administration to articulate, with a high degree of specificity, the measurable behaviors that reflect how and in what ways our government will be different in the future. What are we actually changing? What actually will be different? Obama has talked a blue streak about being transparent, and indeed that is an appealing message coming at the tail end of Bush's imperial and obfuscatory reign. But how will this vaunted transparency take shape? What will it look like? Who will do it? When? How? One wonders, especially as detailed items from the Obama agenda suddenly disappeared from the campaign's transition web site (called, appropriately enough, change.gov) a couple of weeks ago. An articulated vision of what change will look like is essential to developing a viable plan of how to get there.

The second task is to gain the commitment of others to enact the proposed changes. The future administration must not only define changes but "tip the decisional balance" in others toward valuing the changes in order to enact them. Without that capacity to persuade others -- to move others through DiClemente's stages -- it may be that the appearance of change is all that we will ever get. All the wonderful proposals will get stuck in committee and the United States will get caught in a state of chronic precontemplation.

No more soaring speeches: the time has arrived to embark upon the unglamorous and perilous work of actually changing our habits.