Most residential treatment centers use some type of level system to determine a student’s progress through their program and to manage student behavior. Uinta Academy does not use an artificial level system because it sends the message to students that getting healthy stops once they reach the upper level and leave the program. With level systems, students believe that making progress and getting healthy are just a matter of completing assigned tasks, checking off boxes, or “jumping through hoops” to get to the next level. This focus on external tasks may impede a girl’s ability to focus on the internal processes necessary for making lasting change. Furthermore, focusing on levels makes it difficult for a girl to generalize the treatment experience to other challenges that she will face throughout her life.
Uinta Academy believes that long term change cannot be externally imposed. We use the Stages of Change Model to assess a girl’s progress in treatment. The Stages of Change Model was introduced over 20 years ago by two well-known researchers, Carlo C. DiClemente and James O. Prochaska, and is based on their observations of how people went about modifying problem behaviors. The idea behind SCM is that behavior change does not happen in one step. Rather, people tend to progress through different stages on their way to successful change. Each person decides when a stage is completed and when it is time to move on to the next stage. Also, each person progresses through the stages at his/her own rate.
At Uinta, identifying where a girl is at in the change process allows the therapist to tailor interventions to match the girl’s readiness to change. Just as important is the girl’s understanding of where she is in the stages of change. Insight into cognitive distortions and unhealthy behaviors that are getting in the way of progress will help a girl take ownership of the change process. The Stages of Change are:
is the stage at which there is no intention to change behavior in the foreseeable future. The girl is unaware or underaware of her problem or in denial that there is a problem at all. She may defend her behavior or deflect attention from herself by blaming others. She is unable to see the risks and consequences of current behavior and resists self-analysis and introspection.
is the stage in which the girl is aware a problem exists and is seriously thinking about overcoming it, but she has not yet made a commitment to take action. She is aware of the benefits of making a change, but the costs tend to stand out more. This conflict creates a strong sense of ambivalence about changing. This ambivalence can cause a girl to remain stuck in the contemplation stage for a long time.
is a stage that combines intention and behavioral criteria. The girl is intending to take action and may make small behavioral changes, but has not yet reached the decision to take effective action. She is gathering information about what she needs to do to change her behavior. She may appear to “have one foot in the door” and the other foot out.
is the stage in which the girl believes that she has the ability to change and modifies her behavior, experiences, or environment in order to overcome her problems. She has made the commitment to spend the time and energy to alter her behavior. She is making overt behavioral changes and seeking help and support from others.
is the stage in which the girl works to prevent relapse. This stage is a continuation of change and can be considered to last a lifetime. The girl is constantly reformulating the rules of her life and acquiring new skills to deal with life and avoid relapse.
Along the way to permanent change, most girls experience relapse of unhealthy cognitions and behaviors. The majority of girls do not follow a straight path to a new life but rather cycle through the stages before achieving a stable lifestyle change. Relapse is often accompanied by feelings of discouragement, failure, and frustration. The important thing is to help the girl analyze how the relapse happened and use it as an opportunity to learn how to cope differently. In fact, relapse can be an important opportunity for learning and becoming stronger.