Termination—Helping Patients Internalize the New Identity

What Is the Termination Stage?

Termination is not just the end of behavior change. It represents full integration of the new identity and behavior. The risk of relapse is minimal, and the behavior is automatic, habitual, and aligned with the person's core self (Prochaska & DiClemente, 1983).

Why Most Never Reach Termination

• Lack of identity transformation

• No system of reinforcement

• Change was situational, not internal

• Emotional attachments to old behavior remain unresolved

Tool: The I.N.T.E.G.R.A.T.E. Checklist

• Identity: 'Who am I now?'

• Normalization: It's not special anymore—just part of life

• Training: Ongoing self-practice and learning

• Emotions: Addressing lingering grief, loss, or guilt

• Goal alignment: Behavior supports deeper life goals

• Reflection: Seeing how far they've come

• Acknowledgment: Reinforcing a new story

• Trust-building: Reaffirming belief in one’s change

• Environmental support: New norms and communities

Quick Prescriber Scripts

• 'This isn’t something you’re doing anymore—this is who you are.'

• 'What helps you trust that this change is lasting?'

• 'Is there anyone you need to forgive to keep moving forward?'

Tool: Identity Shift Prompts

• I used to believe _____. Now I believe _____.

• The old me would have _____. The new me chooses _____.

• My story is no longer about _____. It's now about _____.

References

• Oyserman, Daphna. “Identity-Based Motivation: Implications for Action-Readiness, Procedural-Readiness, and Consumer Behavior.” Journal of Consumer Psychology, vol. 19, no. 3, 2009, pp. 250–260.

• Prochaska, James O., and Carlo C. DiClemente. “Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change.” Journal of Consulting and Clinical Psychology, vol. 51, no. 3, 1983, pp. 390–395.

• West, Robert. “Time for a Change: Putting the Transtheoretical (Stages of Change) Model to Rest.” Addiction, vol. 100, no. 8, 2005, pp. 1036–1039.