Motivation to Change in Therapy: Understanding How Change Actually Happens

One of the biggest misconceptions about therapy is that people show up ready to change.

In reality, most people walk in somewhere between “I don’t think this is a problem” and “I know something needs to change, but I don’t know how.” That space in between is where therapy often begins.

Motivation to change isn’t something you either have or don’t have—it’s something that develops over time. And different psychological models help us understand how that process unfolds.

In this post, we’ll explore several of those models—not just from therapy, but from psychology and public health—to show how change works from different angles. To keep it grounded, we’ll follow one example throughout: someone who feels like they may be drinking too much.

Motivation as a Process, Not a Trait

Motivation is fluid. It shifts with awareness, life circumstances, confidence, environment, and support. Research consistently shows that where someone is in their readiness to change strongly impacts therapy outcomes.

That’s why therapists don’t just focus on what needs to change—but also where you are in relation to that change.

The Stages of Change Model (Transtheoretical Model)

The Stages of Change Model, developed in the context of smoking cessation research, is one of the most widely used frameworks in therapy. It recognizes that change happens in phases—not all at once.

Using our example: drinking

1. Precontemplation – “I don’t have a problem.”
“I drink like everyone else. It helps me unwind.”
At this stage, there’s little awareness or desire to change. If they’re in therapy, it may be due to outside pressure.

What helps here: Increasing awareness, not pushing change.

2. Contemplation – “Maybe this is a problem…”
“I know I probably drink too much, but I’m not ready to stop.”
Ambivalence is the core experience. The pros and cons feel equally strong.

What helps here: Exploring both sides without judgment.

3. Preparation – “I think I’m ready to do something.”
“I’ve been researching ways to cut back.”
They begin planning and experimenting with small steps.

What helps here: Building a realistic, personalized plan.

4. Action – “I’m actively making changes.”
“I haven’t had a drink in two months.”
Behavior is changing, but effort is high and relapse risk is real.

What helps here: Support, reinforcement, and coping strategies.

5. Maintenance – “I’m working to keep this going.”
“I still get urges, but I know how to handle them.”
The focus shifts to sustaining change and preventing relapse.

What helps here: Strengthening identity and long-term habits.

What this model highlights:
Change is a gradual, nonlinear process—and relapse is part of it, not failure.

Social Cognitive Theory: How Your World Shapes Your Behavior

While the Stages of Change model focuses on when change happens, Social Cognitive Theory (SCT)—developed by Albert Bandura—focuses on how change is shaped by the interaction between you and your environment.

Originally developed within psychology and later widely applied in education and public health, SCT emphasizes that people are not passive. You are constantly influencing—and being influenced by—your surroundings.

At the core of this model is reciprocal determinism, the idea that three factors are always interacting:

• Personal factors (beliefs, thoughts, confidence)

• Behavior (what you actually do)

• Environment (social context, access, norms)

Using our example: drinking

Let’s break it down:

Personal factors

• “Drinking helps me relax.”

• “I don’t think I could stop even if I tried.”

• Level of self-efficacy (confidence in ability to change)

Behavior

• Drinking nightly after work

• Using alcohol to cope with stress

Environment

• Friends who drink heavily

• Work culture that normalizes drinking

• Easy access to alcohol at home

How the cycle reinforces itself

• Low confidence → continued drinking

• Continued drinking → reinforces belief that change is hard

• Environment normalizes behavior → reduces urgency to change

How change can begin in SCT

Change can start in any part of the system:

• Observational learning: Seeing a friend cut back successfully

• Self-efficacy shift: “If they can do it, maybe I can too”

• Environmental change: Avoiding high-risk settings

• Skill building: Learning new coping strategies

Each shift influences the others.

Key mechanisms in this model

• Self-efficacy: Confidence drives effort and persistence

• Observational learning: We learn by watching others

• Reinforcement: Rewards (internal or external) strengthen behavior

• Expectations: What we believe will happen if we change

What this model highlights:
Change isn’t just about willpower—it’s about the interaction between your beliefs, your habits, and your environment.

The COM-B Model: What Needs to Be in Place for Change

The COM-B Model, developed in 2011 by Susan Michie and colleagues, comes from behavioral science and public health. It was designed to help create practical, real-world interventions—from clinical care to large-scale health initiatives.

Instead of focusing on stages or interactions, COM-B asks a simple but powerful question:

What conditions need to be in place for a behavior to happen?

It identifies three essential components:

• Capability (Can you do it?)

• Opportunity (Does your environment allow it?)

• Motivation (Do you want to do it?)

All three must be present for change to occur.

Using our example: drinking

1. Capability – “Do I have the ability to change?”

This includes:

• Psychological capability (knowledge, coping skills)

• Physical capability (energy, health)

Examples:

• “I don’t know how to relax without drinking.”

• “I’ve never learned other ways to deal with stress.”

What helps:

• Therapy skills (coping, emotion regulation)

• Education about triggers and patterns

2. Opportunity – “Does my environment support change?”

This includes:

• Physical opportunity (access, availability)

• Social opportunity (relationships, norms)

Examples:

• Friends who drink regularly

• Alcohol always available at home

• Social events centered around drinking

What helps:

• Changing routines or environments

• Building supportive relationships

• Reducing exposure to triggers

3. Motivation – “Do I actually want to change?”

This includes two types:

• Reflective motivation: conscious decisions

  • “This is affecting my health and relationships.”

• Automatic motivation: habits, cravings, emotional responses

  • Drinking out of stress, boredom, or routine

What helps:

• Clarifying values and goals

• Addressing habits and emotional triggers

Why COM-B is useful

It explains why motivation alone often isn’t enough.

Someone might want to stop drinking—but:

• They don’t know how (capability)

• Their environment makes it difficult (opportunity)

What this model highlights:
If change isn’t happening, it’s not just about motivation—something in the system is missing.

Motivational Interviewing: Helping Motivation Grow

While the previous models explain change, Motivational Interviewing (MI) is a clinical approach designed to work directly with motivation in therapy.

Originally developed in addiction treatment and now widely used across healthcare, MI is especially helpful when someone feels stuck or ambivalent.

Instead of telling someone what to do, MI helps them explore their own reasons for change.

Using our example: drinking

Rather than:
“You need to stop drinking.”

MI sounds like:

• “What do you enjoy about drinking?”

• “What concerns you about it?”

• “Where does that leave you?”

This approach helps people hear themselves say things like:

• “I don’t like how this is affecting my sleep.”

• “I want to feel more in control.”

This is called change talk—and it’s one of the strongest predictors of actual behavior change.

Core principles of MI

• Ambivalence is normal
  You can want change and not want it at the same time.

• The client is the expert
  The therapist guides, but doesn’t direct.

• Change is more likely when it’s self-driven
  Internal motivation is more sustainable than external pressure.

• The therapist adapts to your stage
  More exploration early on, more planning later.

What this approach highlights:
People don’t need to be pushed into change—they need space to discover why it matters to them.

Putting It All Together

Each model gives us a different lens:

• Stages of Change: Where am I in the process?

• Social Cognitive Theory: How do my beliefs, behavior, and environment interact?

• COM-B Model: What conditions are missing or supporting change?

• Motivational Interviewing: How can I strengthen my own motivation?

Together, they create a more complete picture of how change actually works.

Final Thoughts

If you’ve ever felt “unmotivated” in therapy, it doesn’t mean something is wrong with you.

It may mean:

• You’re still working through ambivalence

• Your environment isn’t set up to support change

• You don’t yet feel confident in your ability to do it

Change is rarely immediate. It’s layered, nonlinear, and deeply human.

You don’t need to be fully ready.
You don’t need to have it all figured out.

You just need a place to start—and support that meets you there.