Treatment now is seen as starting with the initial contact, even if the client has no intention of changing behavior. The counsellor can intervene to help the client move towards being aware of the need to change. Motivation becomes a task of the counsellor, not a prerequisite for receiving treatment. The counsellor no longer depends on the client being ready to take action, as in traditional abstinence-based programs, but can engage the clients with effectively tailored interventions. Brief interventions can be employed to help clients progress through one or two stages at a time.
Specific techniques depend on the counsellor's therapeutic orientation.
Individuals may cycle through the stages from three to seven times before successfully achieving maintenance or termination, and the whole process may take on the order of two years to complete. The central feature of the Model is the evidence that a client's thoughts and behaviors in each stage of change are unique to that stage, and this raises exciting potential for making treatment more effective. The counsellor can guide the client to use the most appropriate change strategy for his or her stage of change. The counsellor can also be prepared to see a higher dropout rate amongst precontemplators than among those in the action stage. Despite the valuable insights the Model has yielded for understanding client motivation and optimizing treatment interventions, there are risks in applying it naively in treatment settings.