Definitions
In this stage, "I" would say this
True/False
What is missing in my goal?
Why did I relapse?
100

Fall back to old patterns of behavior

Relapse


100

"I can't or won't change this behavior"

Contemplation

100

If I do everything right, I will never relapse.

False

100

I want to feel better.

Missing: specific definition of "feel better"

100

I will go to the gym 5 hours a day 7 days a week, but I stopped after 4 days. 

Too much time commitment, not enough recovery time for the body, etc. 

200

Sustained Change. New behavior replaces old

Maintenance

200

"I am currently changing this behavior"

Action

200

I may have to change how I maintain a new behavior.

True

200

I am going to take deep breaths.

Missing: Measurable- how many? for how long?

200

I am going to be fully independent and I do not need anyone for my mental health, but I am back at the hosptial

Lack of professional supports

300

No intention on changing behavior

Pre-contemplation

300

"I continue to change this behavior"

Maintenance

300
I can be unaware a problem even exists to change.

True

300

I will get go to Disney World, Disneyland, and Rome all in the same day.

Missing: Realistic 
300

I want to feel better, but I don't.

I am missing a plan and ways to reach my goal

400

Active change on behavior or goal

Action

400

"I tried to change the behavior"

Relapse

400

Relapse is a normal part of change.

True.

400

I will eventually buy a car.

Missing: Time Line? When will you do it? How will you do it?
400

I engaged in an unhealthy coping skill

No one can think of every single situation and what coping skills will work in that moment. When we have a situation like this, we need to learn and grow stronger so that each relapse is shorter and less devastating

500

Aware problem exists, but no commitment to do anything

Contemplation

500

"What behavior?"

Pre-Contemplation

500

After I relapse, I should do my action step the same way every single time.

False

500

I will discharge from the hospital today.

Missing: In my control; How much control do I have over the situation

500

For 10 years I was sober, and then I moved to a different state.

Life stressors can bring back old patterns and habits.