Category: <span>Self-improvement</span>

Stages of Change in Therapy – how understanding of ourselves helps us progress

When clients first come to therapy, they often wonder: “What do I want to gain from this? How can I get help if I don’t even understand what’s bothering me?”.

Maybe they tried therapy before and it “didn’t click” or they lost motivation, or simply couldn’t find time to commit to weekly sessions. What they DO know is they need help, they just need to find out what to do.

These feelings are very common when facing a big step such as going to therapy. The understanding of our motivation is one of the essential parts of getting better – not only knowing what the issue is – also the knowing why I want to change.

What to expect from the process of change?

How fast can I move forward?

What if I fail?

Being prepared will make us more confident and less anxious about the changes and will let us navigate the process in a more mindful way.

The Stages of Change or The Transtheoretical Model of Change is a clinical theory developed in the 1970’s by James Prochaska of the University of Rhode Island and Carlo Di Clemente.

The stages can be best explained as interrelated steps we go through with our thoughts and emotions when we are confronted with a difficult situation that needs changing.

The concept can be applied to anything from quitting drinking to breaking up an unhealthy relationship to healing from grief after losing a loved one. The stages follow an order and each of them has a purpose in creating change. They also occur gradually – from initial resistance and denial, a commitment and progression is created, and relapse is an expected part of the process.

I love to talk to my clients about the Stages of Change, because it provides tremendous help in creating a deeper understanding of the process they are going through and prepares them to set realistic expectations for the next steps. It is like a map of progress that they fill in with their own details to use in moving forward the therapy path.

Important elements to consider in a change process are:

Readiness to change: having the resources and knowledge to make a lasting change successfully (e.g. believing that therapy is helpful or knowing where to find information on AA support meetings).

Barriers to change: if and what is preventing you from changing (e.g. not having time, finances to dedicate to treatment, not having reliable transportation to drive to group meetings.)

Likelihood of relapse: triggers to returning to a former behavior (e.g. living with a person who is using drugs when attempting to stay sober.)

According to the theory, stages follow the order:

Stage 1: Precontemplation (“I don’t need to change.”)

Clients in this stage do not see change as something wanted, needed, or possible and have no intention of changing the behavior. For example, “I have no intention of taking up a sport or going running.”

The client may be lacking awareness, insight or information about the issue, may have tried to address it and failed and feels discouraged. Since the situation is already usually impacting client’s life in a serious manner, we try to help the client consider the need for behavioral change. We want to educate and discuss the risks regarding current behavior.

Stage 2: Contemplation (“I think I want to change.”)

Clients are in procrastination and plan to make the change within next months. They are aware of the pros and cons of making the change. For example, “I know I need to lose weight for my health, but I enjoy fast food.” Important to consider is working with ambivalence – mixed and contradictory feelings, identifying barriers and committing to changes in the present.

Stage 3: Preparation (“Ok, so how do I start?”)

Clients are committed to changing their behavior, they want to work on an action plan, they are organizing resources and support, writing down goals, developing strategies to make the changes happen and implementing first preparatory actions (e.g., getting a gym membership.)

Stage 4: Action (“I’m doing it!”)

The change behavior began, and a new pattern of behavior is forming. Clients have made some progress and modified their lifestyle over the last six months, for example, “I go to the gym on Mondays, Wednesdays, and Fridays every week, and I am following a plan set out by my trainer.” What’s important now is to keep the positive change and motivation going, reward progress behaviors, and monitor for relapse and obstacles.

Stage 5: Maintenance (“I’ve changed.”)

Clients in this stage have been following the new pattern for a certain amount of time and it is now part of their lifestyle. They become confident they can continue their new way of life. It can last between six months and five years (Prochaska & Velicer, 1997). Relapse is now less likely to happen. for example, “I am confident I can make healthy eating choices at home, work, or when I go out.” Now we want our clients to sustain the new behavior for the long term, avoid relapse and develop coping strategies.

Stage 6: Relapse (“I’ve done it again.”)

Clients returned to their old habits or behaviors and regressed to an earlier stage. It is not considered a stage, but a failure to maintain the change, either by the wrong activity (e.g., beginning smoking again) or inactivity (e.g., stopping going to gym.) As disappointing as it feels, relapse is typical for behavioral changes, yet not inevitable. We want clients in this stage to focus on identifying the triggers linked to relapse, to reaffirm them in their commitment and help them process through the stages again.

Stage 7: Termination (“I permanently changed.”)

The behavior is extinguished now and there is no need or craving to return to old behaviors. Client is now integrated with the change because the unhealthy habit is no longer a part of their way of coping. The new, healthier behavior is part of the person’s identity and lifestyle and has persisted for a long time, for example, “I have been keeping up with physical exercise for some years now, and even after recovering from a long-term injury, I continue to do so.

Another view is that termination is never reached and a risk of relapse into unhealthy ways is always present.  In this perspective, the client always remains in the maintenance stage. In some cases, individuals who do not participate in therapy are usually in a contemplation or preparation stage of change, sometimes even in an action stage.

From there we work together on creating new habits and learning to accept the change as a wonderful part of life!

If any of this information feels right to you, please feel free to contact our office for more information.


-Zuzanna Gromulska, MS, LPC-Associate Supervised by Guillermo A. Castañeda, LPC-S


Prochaska, J. O., & Velicer, W. F. The transtheoretical model of health behavior change (1997). American Journal of Health Promotion12(1).

La Magia del Amor Interior


En esta escritura, los invito a buscar en sí mismos la magia, y no magia en la que se puede sacar un conejo de un sombrero o una moneda de las orejas del participante, si no una magia espiritual, magia de amor y los milagros.


¿Qué significa lo que digo? ¿Qué significa la magia espiritual, la magia de amor?


Primero propongo a que se pongan a pensaren todas las cosas que han declarado estar mal en su vida. El sentimiento de estar atrapado en un trabajo miserable, un matrimonio que no parece mejorar, en una situación solitaria, o una carrera en la que se estudió con fuerzas, pero no realizo los sueños.


Todos estos sentimientos son muy comunes entre la sociedad. Van a ver veces donde no sentimos que en nadas nos va bien, esto no significa que es el fin del esfuerzo. Esto solo quiere decir que estamos presenciando un cambio mágico. Desafortunadamente, no sabemos como apreciar esta magia, y pues, se nos va de las manos para no volver y después aprendemos arrepentirnos del momento perdido.


Así con esto, los invito aprender como cambiar nuestro sistema de vida para poder valorar esta magia espiritual en donde podemos apreciar los milagros del día tras día e incrementar nuestro estado de ánimo. Así para lograr amarnos a sí mismos.


El primer paso para esta magia espiritual y los milagros es aceptar que el sufrimiento es igual de importante que el amor.


El sufrir no es para siempre y después de este sufrimiento viene el amor y la paz. Sin el sufrimiento y el dolor interno, no sabríamos entender la verdadera belleza de nuestra humanidad. Es muy humano sentir coraje, tristezas, miedo, y felicidad. Cuando peleamos contra los sentimientos, imponemos reglas de amor.


¿Y qué quiere decir esto?


Que queremos decidir como amar cuando el amor no tiene reglas. Las reglas en el amor disminuyen la intensidad de su poder, la belleza humana, y la magia espiritual.


El autor Paulo Coelho explica que, -Sufrimos porque no conseguimos imponer nuestras reglas-


El amor interior y la magia espiritual consisten en poder amar sus sentimientos incomodos, sus sufrimientos, sus fallas, así como amamos nuestras alegrías y logros.


Amarnos sin condiciones, sin reglas.


Todos los días que aceptamos amar sin reglas, es una oportunidad para llenarnos de milagros y de la magia espiritual.


Los invito a poder sentir estos milagros diarios de manera humana donde valoramos lo bueno junto con lo malo, ver la vida de manera hermosa, y saber que todo es pasajero.


Agradecer y contemplar los días, el sol, la luna, la naturaleza, los sentidos, la familia, y el universo. Todas estas son los milagros que se nos han dado y cuando amamos, se vuelven mas intensos y mas bellos y dejamos de sufrir en un estado constante.


 -Los milagros pasan cuando dejamos de tratar en controlar nuestro alrededor- Paulo Coelho.



Elda Stepp, LPC, LMHC, CART

La Tiranía de Las Emociones


Como seres humanos somos seres sujetos a emociones, de hecho, nuestro cerebro se divide en tres, la primera fase de este es su parte primitiva, que se le llama cerebro reptiliano, debido a que lo compartimos con los reptiles, esta parte del cerebro funciona preparándonos para el ataque o la huida, esta es carente de emociones, entenderemos entonces que el cuento de Peter Pan es sólo una fantasía, porque los reptiles, en ese caso, el cocodrilo no podría odiar al Capitán Garfio. Entonces, esta región del cerebro es totalmente carente de emociones.


La segunda estructura del cerebro es lo que denominamos el cerebro límbico o emocional, que participa en la función de la memoria, el control de las emociones, las motivaciones, diversos aspectos de la conducta, el aprendizaje, de hecho en la supervivencia.  Su anatomía incluye el fondo de saco, el hipocampo, la circunvolución cingulada, la amígdala, la circunvolución del hipocampo y partes del tálamo.


La tercera estructura es lo que denominamos el neocórtex, que representa lo que llamamos popularmente la materia gris, que es una concentración enorme de neuronas y en donde se procesa principalmente la inteligencia, teniendo una acción muy especial el lóbulo frontal.


Es importante aclarar que la división que he hecho de las diversas estructuras del cerebro es sólo teórica, porque en la práctica existe una interrelación muy estrecha entre ellas, por lo que una sin las otras no podría funcionar.


Pero vamos a concentrarnos en las emociones, nosotros seres humanos procesamos emociones como amor, miedo, ansiedad, tristeza, euforia, alegría, rabia, enojo y otras más, esto es por supuesto muy humano, completamente normal, pero ¿Qué ocurre cuando estas emociones se desbordan y se vuelven incontrolables? Entonces es cuando nos sentimos perdidos, nos desconectamos del mundo.


¿Cuántas veces hemos tenido la sensación de perder el control a consecuencia de cualquiera de las emociones mencionadas? Parece sencillo, de hecho, muchas personas a nuestro alrededor rápidamente nos aconsejan: Ya, tranquilo, domínate, no pasa nada, no exageres, Etc.


¿Pero de verdad es tan sencillo recuperar otra vez el control? Si respondemos sinceramente esta pregunta la respuesta, por supuesto, es no.


¿Qué es lo que nos lleva a perder el control?


Lo primero es la producción de una serie de mediadores químicos que produce nuestro cerebro, lo que genera un disparo emocional fuera de control, se producen mensajes a través de diversos caminos neuronales, sin dirección. Nuestra frecuencia cerebral predominante se ve alterada. Es el momento en que debemos pensar en solicitar ayuda profesional, que nos pueda devolver la calma, la cual debe ser proporcionada por una persona calificada, preparada para poder entender y ayudar en el manejo de las emociones.


En este proceso juega un papel muy importante nuestra mente inconsciente, que es donde se almacena la información de toda nuestra vida, la que almacena toda la información recibida incluso desde el periodo fetal, con la característica de que nuestra mente inconsciente no juzga, no califica, no comprende el humor, simplemente almacena información y esta información nos genera emociones que no alcanzamos a comprender y que obviamente impactan nuestra vida, lo cual explica el título de este escrito.


¿Qué pasa cuando sólo sentimos, pero no comprendemos el por qué?


Se generan emociones como la ansiedad, la tristeza, el miedo, etc. Y recurrimos a diversas instancias, como platicar con un amigo, con un médico, con un ministro religioso, cuando el profesional calificado sería un consejero, un psicólogo o un hipnólogo, quien nos ayudará a entender el origen de dichas emociones y a través de su guía poder controlar sus manifestaciones.


Si gusta más información sobre la hipnosis, no dude en llamar nuestra oficina (915) 209- 1234.



Guillermo Castañeda, Hipnotista Profesional

The Tummy & Brain Connection

What is the one thing that is most annoying when it comes to thinking your stomach?

        Is it doctors saying that you are overweight? Or family members commenting on your weight which in turn makes you feel terrible about yourself? Or is it not feeling good about how you look? How does this make you feel? How does this change your appetite? What about your health overall?

It’s common to struggle throughout the years to a point in which we don’t even want to hear the word “stomach” ‘tummy’ or even look at it. Maybe this has been the case for you or perhaps not.  However, our stomach is an important part of us.

Well, what would you think if I told you that your stomach is attached to your brain and affects your mood? For some of us, it may concerning to hear that since it may impact the way we treat it.

Read more

2 Important Types of Empathy

You matter.

What is empathy?

We have heard this word go around the internet and even in conversation when considering the emotions of others and those that surround us; but what is it really?

According to Lanzoni (2018), it is the ability to understand and experience the pain, happiness, excitement, sorrow, and so on of others. It is the ability to see the world through their eyes and comprehend their decisions along with the reactions to the world around them. Pretty powerful stuff, right?

However, empathy is much more than this definition.

So, a little history, the concept of empathy—or being able to comprehend and experience other’s pains—goes way back to the Greeks, more specifically, Aristotle. He believed that the human journey to happiness and humanity, consisted of being able to connect emotionally with others’ despair/happiness (Lanzoni).

            As time has progressed, science evolved, and the implementation of psychology and psychotherapy, so has the concept of empathy. Empathy has actually split into two different concepts of comprehension.

There is emotional empathy and cognitive empathy.

Read more

What if Questions Were the Answer?


Dear Reader,


As a counselor and a teacher, I know the value and importance of asking the right type of questions.  In essence, being intentional has value.  The questions we ask ourselves, often, guide our focus, critical thinking and problem solving.


I have learned that during difficult times, we have an inclination to shift to survival mode, which is typically appropriate and adaptive depending on circumstances and even past experiences.  This survival lens may influence our perspective and mindset.


It is important to keep in mind that if we have experienced any form of trauma, then there are additional layers that need to be considered besides shifting our mindset.  In fact, some of those layers include feeling safe, type of support system, and resources, among many more.


My intention is to invite a possible way of reframing some of our internal dialogue in spite of adversity.  The purpose of this is to help us change our perspective and view things in a way that may be more helpful than unhelpful.


Five Signs That Tell You It’s Time to See a Therapist

As a mental health professional who has been in the field for a while, it’s been interesting to observe why and how people end up in my office seeking guidance. The following is a list of indicators that may be signaling to you it could be time for you to seek support from a mental health professional.

  1. Your loved ones are noticing that you are different. Sometimes, we are not able to look at ourselves objectively…that is we can’t clearly see how we behave sometimes. It is like when you look into a mirror and only see certain flaws or spots in your face or body but can’t quite see the whole picture.  Those around us, specifically our loved ones, hold a special perspective of ourselves and can see different aspects of ourselves that we are not able to.  If loved ones, people who see us every day, or people who interact with us often notice unusual or “not typical” behaviors and point it out, they might be signals that mean we need some extra help from a therapist. They may tell you that they are concerned about things like substance abuse, irritability, mood changes, isolation, or your daily routines.
  2. You feel a sense of emotional discomfort that has lasted longer than 2 weeks. You’ve made it this far into life with all you’ve got, but sometimes, life can become daunting or unmanageable.  If you feel any sense of apathy, sadness, nervousness, worry, or uncertainty that has been unmanageable or if you’re noticing behavior changes like not wanting to engage in relationships, snapping back at others, feeling like you don’t want to do anything, not finding pleasure in old hobbies, or changes in your appetite, it might be time to take a closer look at yourself.  When these “signals” come up for longer than two weeks it might be time to get Read more

7 Types of Anxiety: Not all Anxiety is the Same

Anxiety is a totally normal response in daily life, it is a conditioned response that distinguishes us from inanimate objects. For example, when we feel hungry we have a feeling of anxiety, which preserves life.  The same is the case when an animal threatens us.  We tend to flee or defend ourselves, but when anxiety is shown disproportionately to the stimulus that caused it , or when it comes up for no apparent reason is when we are faced with a pathological situation.  Typically, this is when we seek and need help.

Usually the first answer is to go to anxiolytics, methods to reduce anxiety.  However, it is very important to find out the real triggers of anxiety so that we can feel and manage own our emotions again. That’s when we require the assistance of a professional. Anxiety of this kind deteriorates the quality of life; the world becomes a threat.

These manifestations can last a long time and/or present themselves intensely, leading to panic attacks and anxiety.  Many times, this can lead to an in individual to visit the emergency room in a hospital, where, of course, they do not discover physical problems.

Symptoms that usually occur include, but are not limited to:

  • Feeling nervous, agitated or strained
  • Feeling imminent danger, panic or catastrophe
  • Increased heart rate
  • Accelerated breathing (hyperventilation)
  • Sweating
  • Tremors
  • Feeling weak or tired
  • Problems concentrating or thinking about anything other than the current concern
  • Having trouble falling asleep
  • Having gastrointestinal problems
  • Having difficulty controlling concerns
  • Having the need to avoid situations that create anxiety

Read more

Stages of Change in Therapy – how understanding of ourselves helps us progress

When clients first come to therapy, they often wonder: “What do I want to gain from this? How can I get help if I don’t …

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La Hipnosis en las Fobias

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