Muslim Stages of Change (Stage 2: Awareness)
(this is the second of a series of 6 posts)
We began the series with a discussion on the first stage of the Muslim stages of change, Inertia. (read about it here). Over time, the Muslim client progresses from the stage of Inertia to an awareness of the problem and a need to change.
Prochaska and DiClemente (1983) called the second stage of change Contemplation. At this stage, the individual recognises that there is a problem and is contemplating if a change is needed, but has not yet committed to making the change. This implies gaining insight into the behaviour that is causing negative consequences to the self, and perhaps to the significant members of the individual's system.
While Prochaska & DiClemente's Transtheoretical Model includes ambivalence as part of the contemplation, I believe, for Muslim clients, achieving an awareness of the problem is significant enough to be considered a stage in which social work practitioners have to explore thoroughly to move them toward an acknowledgment of the need to change.
For Muslims, gaining insight into the problem is not simply a matter of deep introspection. It is also widely believed to be divine intercession by God through His Mercy. When there is awareness of the problem, the client is said to have received hidayah.
Hidayah (Arabic: هداية, Hidaayah IPA: [hɪdaːja]) is an Arabic word, not simply meaning 'guidance' as it is often translated, but 'to guide gently' (Better Arabic, 2018). Interestingly, the Arabic word 'gift' (hadiyyah) also comes from the same root letters for hidayah. Hence, Muslims generally perceive the individuals' awareness of the problem and the need to change as God's gift to gently guide them towards the straight path, the right way, or the best outcome for their situation in this world, and the hereafter.
In layman's terms, divine guidance is the 'lightbulb moment' that gives individuals the spiritual significance of the problem. Any event that gives significance to the client is hidayah if the client is able to find a spiritual significance to it - a dream, a mishap, an illness, the death of someone significant, a chance encounter, or even a sudden realisation after a period of contemplation.
The social worker is not the one who gives hidayah, but may engage the client in conversations to process the event/problem's spiritual significance with the hope of the client's openness to receiving hidayah.
Because hidayah comes from God alone, the social worker may experience frustrations when the client does not see the problem and the need to change despite efforts to bring it to awareness. Social workers may also encounter family members to be accepting of the client's denial of the problem, or refusal to change at the point of the client's entry into the formal helping system; mistaking it as apathy or fatalism.
The Second Stage - Awareness
With hidayah, the client progresses from the stage of Inertia to Awareness. Like Prochaska & DiClemente's Contemplation stage, the client in the Awareness stage now recognises that the problem exists but needs to reflect further if a change needs to happen. The contemplation and introspection process (called muhasabah) is significant enough for Muslim clients that social workers will need to give sufficient time for them to do this outside of the interview session. DiClemente and Velasquez (2002) acknowledged that people may stay in contemplation for a long time because change can be difficult. Contemplators of change are not necessarily ready to make a commitment to change.
For Muslims, contemplations are best partnered with the spiritual significance of what is being considered. While information gathering helps in providing content for consideration, giving them space and time for introspection raises the consciousness of the need to 'do something' about the problem/situation.
Case Example 2
Mdm N sought counselling for her depression. Several years prior, Mdm N in a moment of haste, had quit her good-paying job but changed her mind the following day. However, her immediate supervisor refused to allow her to retract her resignation letter stating that it had already been accepted by the Human Resources Department. She spent the session lamenting her rash decision and blaming her husband for pushing her to quit.
I encouraged her to take some time for introspection (muhasabah), reflecting on what part she had played in the decision to quit. Mdm N returned to share her realisation that she too was responsible for the decision because of a secret wish to negotiate better remuneration with her previous employer. Intervention then focused on getting Mdm N to decide if she wanted to remain in the current state since she had already acknowledged responsibility for this incident.
Assessment for the stage of Awareness focuses on finding out if the client begins to acknowledge the problem and the impact of the problem on his or her circumstances.
The client might say "I know what I am doing right now is not helping my situation, but I think I am fine with it for now." People who are aware of the problem but not ready to make the change will need to move towards ambivalence, pushing them towards making a decision about their circumstances. For Muslims, the state of ambivalence, or was-was (doubts), is uncomfortable and religiously enjoined to be addressed, for doubts and temptations are believed to be the whispers of the devil.
Say, (O Prophet), "I seek refuge in the Lord of humankind the Master of humankind,the God of humankind, from the evil of the lurking whisperer, who whispers into the hearts of humankind - from among jinn and humankind."
Quran: Chapter 114: verses1-6
To move the client to the next stage, Ambivalence, social workers could encourage their Muslim clients to engage in muhasabah, a process best carried out alone, with a review of their findings in the next follow-up session.
The social worker equips the client with relevant information, reviewing the advantages and disadvantages of change, the pros and cons of staying in the current state, or the consequences of action and inaction.
The client reflects on the significance of the hidayah that God has given. How does the understanding of the problem contribute to the current situation? Would the client feel comfortable continuing with the current state of being or could this be an indication that change is needed? What is the spiritual significance of denying this hidayah?
For social workers, following up on the muhasabah aims to create uneasiness leading to Ambivalence.
I shall discuss the process of muhasabah and the third Muslim stage of change, Ambivalence, in my next post.
References & Readings
Better Arabic (Setember 25,2018). Hidayah, Hadiyah. https://betterarabiconline.wordpress.com/2018/09/25/hidayah-hadiyah/
DiClemente, C. & Velasquez, M. M.,(2002) Motivational interviewing and stages of change. In Miller, W. R. & Rollnick, S., (Eds) (2002). Motivational interviewing (2nd Edition) (pp. 201-216), The Guilford Press.
Mustafa Khatab (2016). The clear Quran. Message for Humanity.
Prochaska, J.O., DiClemente, C.C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change.J Consult Clin Psychol Jun;51(3):390–5. Archived 2011-06-06 at the Wayback Machine