Table 2.

Stage of Change Model and Application to Headache Management

Stage	Definition	Nicholson’s suggestion17
Pre-contemplation	Patients not interested and do not acknowledge the need to make any changes to their behaviors.	Provide headache psychoeducation and increase patients’ awareness of the need and benefits to manage their headaches, such as keeping a diary and learning about their triggers.
Contemplation	Patients acknowledge that there is a problem, but are ambivalent about it.	Provide strategies to empower patients to manage their headaches (e.g., general medication management and learning to utilize their diary to manage their headaches).
Preparation	Patients have a desire to change and make a commitment to do so.
Action	Patients take steps to proactively change.	Focus on problem-solving for specific challenges, such as acquiring ways to manage stressful situations or exploring which medications to take and when.
Maintenance	Patients maintain behavior changes.