Does Yoga Help With Low Back Pain?

Michael Ferraro
3 min read

Over the course of our lives, almost all of us will experience low back pain. And when we do, many of us will have someone telling us that we should be engaging in physical activity to relieve it.

Yoga is one of the most common forms of exercise to treat low back pain, particularly when it persists. There are many explanations for the proposed therapeutic effects of yoga – increased muscular flexibility and strength, increased physical and mental relaxation, and improved body awareness. People who do yoga to help with low back pain often report that it is helpful; but what does the science tell us?

A recently published gold standard review sought to answer this question. 

The review authors looked at all studies that compared yoga to another treatment, or no treatment at all in people with ‘chronic’ low back pain – that is, low back pain that persists for three months or more. The study aimed to determine whether yoga is beneficial for:

  1. low back pain intensity, 
  2. back-related function (things like the ability to walk or perform house chores), and 
  3. mental and physical quality of life.

A total of 21 studies were included in the review. Studies were conducted in the USA, Canada, Croatia, Germany, Sweden and Turkey and mostly investigated iyengar, hatha, or viniyoga yoga practices. Most of the study participants were women aged between 40 and 50 years.

So what did the authors find? 

Well, compared with doing nothing at all, a three-month course of yoga probably reduces low back pain and improves low back-related function. The catch is that these benefits may be too small to meaningfully change the impact low back pain has on one’s life. 

Ok, so doing yoga is a little better than doing nothing – unremarkable, I know! But is yoga better than doing other types of exercise for low back pain?

The authors concluded that there is probably little to no difference between yoga and other forms of back-specific exercises (think core training and physiotherapy rehabilitation exercises) on function. This is great news for those who don’t want to drop their sweaty Bikram class for an hour of pelvic floor exercises at the physio.

You might be one of the people that has indeed tried yoga for their back pain, but only found that it made it worse. Interestingly, exacerbation of back pain was the most commonly reported harm in these studies. The risk of an exacerbation was higher for yoga than for no yoga, but there was no difference in risk between yoga and other exercise forms. 

So, how do we make sense of this information? 

We know that exercise is beneficial for low back pain. While it seems that yoga only provides minimal benefits for low back pain, there is good reason to do it – for many people across the globe it is the only form of regular exercise they can adhere to. If yoga is not your cup of tea, there is no need to despair! Performing any form of exercise is likely to be beneficial for both your musculoskeletal and general health.

Michael Ferraro is a clinical researcher at the Centre for Pain IMPACT at Neuroscience Research Australia. 

His research is centred around the identification, development and evaluation of treatments for chronic pain, with a specific focus on rare pain conditions. You can follow Michael’s research on Google Scholar or Twitter.

Michael is part of the Good Mood Dudes network of experts available to support your wellbeing program. If you want to soundboard your wellbeing plan or hear how we’d get your program up and running, get in touch with our team for a complimentary strategy call today. 

The Debate on Corporate Sponsorship of Our National Sporting Teams

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: Australian cricket captain Pat Cummins slammed for hypocritical ‘ethical objections’ of major sponsor Alinta Energy

Over the last two weeks, corporate sponsorship of our national sporting teams has been strongly debated across Australia, from the front pages of our leading newspapers and even the WhatsApp chat I have with former cricket teammates.

Australian men’s cricket captain, Pat Cummins has stated he has ethical issues about team sponsor Alinta Energy. Its parent company has been listed as one of Australia’s highest carbon emitters, and despite its well-publicized claims it is investing in renewable energy sources, is rated very low on The Green Electricity Guide which considers the timeframe companies propose to stop using coal, whether a company frequently causes local environmental harm, and is transparent in their marketing.

Those opposed to the views expressed by Pat Cummins have pointed to the fact that he has already received money from Alinta Energy to appear in ads, that he flies first class, and drives an SUV with high carbon emissions. All valid points that are hard to disagree with. 

And while climate change is the single greatest threat to human and planetary health, the current rates of childhood obesity have immediate consequences for our childrens’ future. The promotion of KFC by the Australian cricket team and its captain is of equal concern.

However, I applaud him for raising the issue.

I personally believe that we could use a threshold that if a company produces, manufactures, distributes, or sells a product that leads to health disparities and social and environmental injustices, then the government should prevent sporting teams from having them as a sponsor. Sport/professional sports should solely be about health promotion, especially for our children, and these industries sell products that erode such benefits. 

It is still not widely understood, but non-communicable diseases (NCDs), or chronic diseases are the main causes of deaths globally. Environmental exposures, including tobacco, petrochemicals, pesticides, ultra-processed food, alcohol, and pharmaceutical drugs like opioids, along with climate change-related events, including extreme weather and wildfires, are the main drivers of these chronic diseases harming human health.

The responses I have received to this idea when raised on my WhatsApp chat ranged from “well then, there will be no one to fund the teams, and the players won’t get paid, so good luck” to “you drink beers, fly on planes, eat Maccas and use Panadol, so..”. 

My response to these comments is grounded in the same logic as why we as a society eventually condemned tobacco advertising in sport – because we know the tobacco industry used sports and sportsmen as a vehicle to hide and distract from the harm of their products.

It remains to be seen, but I think there are still a lot of companies that will be able to fill the void left by these industries sponsoring our sporting teams. It happened when tobacco sponsorship was banned so there is good reason to think the same will happen again. 

These harrowing cancer statistics can actually be good news. Wait, what?

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: These harrowing cancer statistics can actually be good news


When I first read this headline, I assumed that this article was going to discuss new government regulations on industry (alcohol in this instance), spurred by more unequivocal evidence on the already established health effects caused by harmful products like alcohol.

Instead, the story focused on what the individual can do to change their behaviour, with education being a key component of that behaviour change.

Seems reasonable, I hear you say.

Let me explain the shortcomings of this approach and why it is the narrative that the industries that produce these harmful products love to see published.

While the story points to the fact that smoking rates in Australia have dropped from 24% in 1995 to 11% in 2021, this was not done through education campaigns alone. It took an aggressive suite of regulatory measures for this to occur. These included an increase in sales taxes, a complete ban on advertising and marketing (sports advertising was one of the first to go), and the introduction of plain packaging, coupled with aggressive graphic health warnings by the Australian government.

Government action must be part of the solution.

I study the commercial determinants of health. This includes the strategies that industries like tobacco, alcohol, packaged food, and fossil fuels use to sell their products, as well as the political and economic systems that they operate within.

As economic globalization has intensified over the last two decades, these determinants of health have not only become the leading cause of disease but have also created health inequities within and across countries. For example, communities of color and low-income communities have experienced disproportionate consequences and impacts on their health due to either higher consumption rates of alcohol, tobacco, and ultra-processed foods or higher rates of exposure to toxic air pollution (due to the combustion of fossil fuels) and chemicals.

These industries use a suite of tactics aimed at preventing government regulation, which includes distorting the science on the human and planetary health effects of their products, undermining the policy process via lobbying, and shaping the narrative on their brands and products through evocative marketing and corporate social responsibility campaigns.

Now I love a beer and a pie at the footy. However, it’s vital that stories covering chronic health statistics should not be presented as a “really good news story” without being accompanied by perspectives addressing the need for government regulation to implement strategies like those mentioned above which have proven successful in tobacco control.

Without strong government action, these statistics will continue to increase, and I cannot see the silver lining in that.


Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

Fast Food & Sports Stars Don’t Mix

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: GP-turned-MP to demand action on junk food advertising


Kids love sports stars.

They buy the shoes and clothes they wear, the cricket bats they use and the sports drinks they drink.

Therefore, a new bill to stop junk food sponsorship of children’s sport and ads shown during prime-time television like 20/20 cricket, when kids are watching with their families, is a welcome move to help reduce the number of overweight and obese Australian children.

We know from the success of smoking cessation rates globally that advertising, especially via mass media, is one of the most pervasive ways that companies can increase sales and consumption of their harmful products. If we cut advertising, we cut consumption and we can cut the resulting rates of disease that are caused by these harmful products.

Although advertisements for unhealthy foods and drinks are banned during broadcasts of television programs made for pre-schoolers, the average 5-8 old is still being exposed to more than 800 junk food television ads a year. Currently, the federal government has allowed the food industry to govern itself through a self-regulatory code, with junk food companies arguing that they are not advertising to children by sponsoring their sports because they only use their brand names and not pictures of their products.

However, the food industry knows that kids look up to sports stars and they still have a significant opportunity to get our kids hooked on their ultra-processed foods. If Australian men’s cricket captain Pat Cummins can eat KFC and still be one of the best athletes in the world, why wouldn’t an 8-year-old think that he can do the same?

It’s time to get serious and properly protect our children by banning all junk food advertising from sport.


Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

Expert Q&A: Introducing Dr Kate Edwards

1) Could you tell us a little about your career and areas of expertise/interest? 

My research career has been in looking at how exercise affects health through its actions on immune function. My PhD and early work focused on vaccinations and how exercise can boost your immune response and reduce the adverse effects you experience. In recent years I’ve also developed a line of work in oncology, using exercise to improve treatment outcomes during chemo and immunotherapy, and again, reducing the side effects of treatment (exercise really is a wonder drug!).


2) What drew you to this line of work/research in the first place? 

I studied Biochemistry at University but by the end of my degree wanted to get out of ‘the petri dish’. I found that I loved the study and life at uni but wanted to do things that everyone on every corner of the street could relate to. That’s how I found myself doing a PhD in a Sport Science department, they liked me as I brought lab skills to measurements from experiments, and I liked it as I got to work with real-life people. After PhD I had an opportunity to work in research in California for a few years, and about 10 years ago moved here to Sydney to teach and research in my current position. Some could say I’d followed the sun, but it’s not hard to find more than I used to see in England.


3) How do you look after your own physical and mental wellbeing?

A long time ago I played international-level sport, so exercise and sport have been part of my life forever. Sport looks after a lot of my wellbeing because of the social support and interaction that it provides as well as the running around. Whenever moving to a new place (and I’ve done that a lot) the way I made friends was to join a team. Exercise training for a long time was what I did to help me play sport, but now it’s a habit, I feel worse if I’m not moving, which motivates me to move!  


4) Do you have a favourite post-workout cafe?

No, I’m a universal coffee lover, I enjoy an instant coffee and a real one similarly!


5) What is one thing you wish people knew about wellbeing? 

Exercise does as much for mental health as it does for physical health.


6) What is one of the most ridiculous things you’ve read or seen about wellbeing that you know to be untrue?

Current discussions about vaccination safety is a hot-bed of miss-truths and misunderstanding.


7) Do you have any favourite books, podcasts or websites on health or wellbeing that you’d recommend?

Current hot topic is ‘The Long Shot’ discussing the development of the COVID vaccinations, and I often find gems of episodes among the RadioLab series.


8) What is your top tip for living a healthy and happy life? 

Most of the time Grandma was right – meals are best home-made, eat/drink everything in moderation, and walk everyday and you’ll do pretty well.


Staying Healthy at Home

Many Australians are presently working from home. Cutting the travel time to and from work provide opportunities to spend that time doing other things we wouldn’t ordinarily have time for. But working at home can be a disruption to normal routines that we all tend to thrive on. One of the most common sentiments I hear as extended holidays draw to a close is that many actually look forward to having the routine that the work life brings. Lack of regularity is just one of several challenges being house bound presents us. With that in mind, I offer six suggestions to stay healthy and sane whist working from home for this next, unspecified period of time.


  1. Keep a regular sleep/wake schedule: Not having to wake up at a specific time to catch the bus to work and merely having to open the computer to start our day can allure us into creating haphazard sleeping schedules. Humans have evolved to keep regular sleep/wake, light/dark rhythms that rewards us with vitality, productivity and energy when we observe these regular sleep-wake cycles. This period of physical isolation allows us to firmly entrench an 8-hour sleep opportunity and circadian rhythm that we might never have again, as going out to restaurants and other entertainment is off the cards for the foreseeable future. Decide what time you would like to wake each day, work back 8-hours, allowing an extra 30 or so minutes for wind down, shower, intimacy and so on. Remembering to use bright lights in the morning hours and dim light in the period before bed. Then stick to this schedule every day. 


  1. Respect work/life balance: in our parents and grandparent’s day, for the vast majority, there were no mobile phones, computers and internet. Once the work day was done, adults did not go home and keep working until all hours.  Now that we are house bound and have access to emails on our phones, there can be a strong temptation to essentially work 7 days a week, without truly respecting down time. It would be wise to maintain ‘office hours’ and ‘personal hours’, where, during the latter, the phone and computer are off to work and on to family, friends and entertainment. 


  1. Set an exercise schedule: just as we have group exercise classes, personal training and running clubs, keeping a scheduled daily exercise regime (especially in the morning before work hours) is critical to maintaining momentum and not falling off the bandwagon during this time we are at home. Here are several suggestions:
  • Talking a 5 to 10-minute walk after meals aids blood sugar control and the energy slump we often get mid-afternoon. This is a very little time investment but has a huge potentially to make us feel great and energised;
  • Aim to walk in nature several times a week, so we don’t develop cabin fever from doing everything indoors.
  • Exercise every day and alternate hard (see next point) with easy sessions, such as walking and jogging;
  • Use time efficient modes of interval training, such as stair or hill runs, as the ‘hard’ sessions. Aim to accumulate at least 10 minutes of high-intensity work in these sessions. After a 5-minute warm-up, finding a hill or stairs it takes about a minute to reach the top, tackle these 10 times with a slow walk back down. Skipping is another tremendous exercise mode, where you would aim to do a similar workout (10 x 60-seconds of skipping with, say, 30-seconds rest in between);
  • Set up a body weight circuit three times a week. An example of a circuit might be: squats, push-ups, lunges, abdominal planks and skipping. Do each exercise for 60-seconds, moving quickly on to the next exercise. Rest a minute at the end of the circuit, and perform five rounds of the circuit, 


  1. Use house bound time wisely: This unusual time provides us with the perfect opportunity to work on aspects of health and fitness that we do no ordinarily have time for, such as stretching, trigger point work or foam rolling, deep breathing and meditation. It can be as simple as a 5-minute stretch, foam roll or deep breathing while you make your morning coffee or tea. It’s another healthy habit that takes basically no extra time from your day but doing it regularly will make you feel great.


  1. Be mindful of eating ‘as something to do’: Most people working from home have already worked this out – we eat because we are bored, procrastinating or as something to do. So that we all don’t gain unwanted weight over this time, it would be helpful to set an eating schedule that we stick to every day and avoid mindless walks into the kitchen to snack.


  1. Stay connected: It has already been observed that the phase ‘social distancing’ is unhelpful and the term ‘physical distancing’ might be more appropriate. We are very used to seeing people at work, on the bus or after work. This, for the time being, has largely stopped. Rather than just texting people, make the time during ‘personal hours’ try to use FaceTime, Skype and Zoom as a way of connecting with others, especially those really affected by isolation, such as the elderly. Try to call people as well, rather than texting. In this way, those who are more affected by physical distancing will feel a much greater sense of connection, which is far better for everyone’s mental health.


Dr Tony Boutagy is an Exercise Physiologist with a PhD in exercise and sports science from Charles Darwin University. He’s conducted over 50,000 training sessions in his career that has spanned 25 years, and is regarded as one of the premier personal trainers in the country. 

Expert Q&A: Introducing Dr Kieron Rooney

1) Could you tell us a little about your career and areas of expertise/interest? 

My day job entails conducting research and teaching on how what we eat, influences our metabolism. This work includes investigating for example, the influence of lower carbohydrate and higher fat diets in diabetes and obesity as well as on measures of performance in normal healthy individuals. I’ve also completed work on the role of high sugar diets in altering health status and the potential for non-nutritive sweeteners to assist recovery in diets focused on lowering sugar intake. I completed a PhD in Biochemistry in 2003 and since then have been an academic at the University of Sydney.


2) What drew you to this line of work/research in the first place? 

To be honest, it was the only thing I was good at at University. I squandered most of my first year enjoying the freedoms that University Student life brought. However, by second and third year I found myself intrigued by metabolic biochemistry and the way in which our entire system is integrated to utilise the energy of food we eat and how our behaviors may change to seek out specific foods. Through the course of my PhD and then academic life, the relationship between what we eat, how we eat it and our health fascinated me.


3) How do you look after your own physical and mental wellbeing?

I wax and wane. Periods of control and periods of laziness. I like to convince myself it is all by design. But to be honest sometimes I have all the energy in the world to commit to health and sometimes sleeping in, having an extra drink and getting take away feels like the right thing to do. When I am committed, there are 3 – 4, 7km runs a fortnight interspersed with some weights on alternate days and more often than not there are 10-11 home cooked dinners in that fortnight with leftovers for lunches. I typically avoid sugar sweetened beverages, and opt for extra veges over “passenger carbs” like bread and pasta 


4) Do you have a favourite post-workout cafe?

Not really, since most of my runs and weights workouts are at home. But if you are in the Balmain / Birchgrove area The Gladstone Corner store does a great long black.


5) What is one thing you wish people knew about wellbeing? 

It takes a conscious effort to find it, grow it and keep it. And a subconscious effort to lose it.


6) What is one of the most ridiculous things you’ve read or seen about wellbeing that you know to be untrue?

That you have to cut the fat off your meat to make it healthy.


7) Do you have any favourite books, podcasts or websites on health or wellbeing that you’d recommend?

I really enjoyed “the art and science of low carb living” and “The case against sugar” otherwise I am somewhat of an online itinerant.


8) What is your top tip for living a healthy and happy life? 

Every sugary drink is doing you harm


The Truth About Supplements


Supplements are often the first question I get asked about.

The magic bullet that will improve your overall health and wellbeing in one or two (or sometimes 6) tablets a day! There are few, but critically important populations that do need supplements. For example, any woman of reproductive age is recommended to take a multivitamin every day to get sufficient folic acid. Folic acid supplementation reduces the chance of having a baby with neural tube defects. These defects occur very early during gestation, often before a woman knows she is pregnant. 

The main challenge in determining if they work or not is the one size fits all approach. There is A LOT of research done on supplementation. It is a multibillion-dollar industry that benefits from making health claims demonstrating the efficacy and or effectiveness of their products. 

If you think about all of the different supplements out there and all of the different health outcomes they purport to benefit, you are going to find some that have evidence to support their use. For example, if you look at the Cochrane Library Database* that houses the GOLD standard in reviews of the evidence for clinical studies and type in “probiotic” you will see that there are 56 reviews on them spanning topics such as “probiotics for treating eczema” to “probiotics for non‐alcoholic fatty liver disease and/or steatohepatitis”… And you will see there are over 7381 individual trials on them! 

So do they work? Maybe. It depends on what you are trying to measure. 

One of the biggest issues (and sometimes dangers) with recommending supplements is that there is an assumption that a particular naturally occurring vitamin or mineral in food, if taken in isolation and in high doses will lead to better health as we believe we understand the mechanisms by which it works.

Let’s take vitamin A or E as an example. These are antioxidants that combat free radicals. We assume vitamin A or E will reduce the damage to cells caused by free radicals, including damage to our DNA, which may play a role in the development of cancer. Seems logical these vitamins could help reduce cancer. Better load up on antioxidants supplements. 

Well they did just that back in the 1990s and early 2000s with a series of studies that were designed to improve cancer outcomes in high risk groups. 

One study conducted in the 1990’s wanted to test if the health effects of vitamins found in fruits and vegetables, retinol and beta carotene, (think vitamin A), which had been seen to be in higher concentrations in people with lower rates of lung cancer, would be the same when taken as a supplement. 

Over 18,000 men and women at a high risk of developing lung cancer were either assigned a beta-carotene and retinyl  palmitate (vitamin A) supplement taken daily or a placebo. The study was stopped ahead of schedule because participants who were randomly assigned to receive the beta-carotene and Vitamin A were found to have a 28% increase in incidence of lung cancer and a 17% increase in incidence of death compared to the placebo group. 

A second study in 2001 was conducted to determine the long-term effect of vitamin E and selenium on reducing the risk of prostate cancer in approximately 34,000 relatively healthy men >55 years. It was assumed these antioxidants would reduce the risk of cancers in high enough doses. 

Oral selenium and vitamin E was planned to be taken for a follow-up of a minimum of 7 and maximum of 12 years at very high doses. It was found that the risk of prostate cancers in men that were supplemented with vitamin E was 17% greater compared to a placebo (no supplement). In the selenium group there was also an increased risk but it wasn’t statistically significant.

So what does all of this mean?

Both of these studies highlight that caution should be used when recommending or using high doses of vitamins or micronutrients. Naturally occurring dietary constituents (i.e. vitamins and minerals) are part of normal physiology, and either deficiency or excessive doses are harmful. 

It doesn’t mean you shouldn’t adhere to advice given to you by your doctor or dietician if treating a medical condition, but it does show that the assumed benefit of a vitamin or mineral is not always correct when taken in isolation. 

This lack of benefit/potential harm from single antioxidants was later confirmed in 2012 with one of those GOLD standard Cochrane reviews I was talking about before that looked at Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

This review included 78 clinical trials with 296,707 participants randomised to antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. They found, wait for it, an increased risk of mortality was associated with beta-carotene and possibly vitamin E and vitamin A, but was not associated with the use of vitamin C or selenium, with absolutely no benefit of antioxidant supplements in the general population or in patients with various diseases.

Ok, but you are really here for me to tell you whether fish oil is good for you or not. Right? Well. 

A recent large Cochrane Review assessed the effects of increased intake of fish and plant-based omega-3 fats on all-cause mortality, cardiovascular events and blood lipids levels, mainly via capsules, as many people believe that taking omega-3 supplements reduces risk of heart disease, stroke and death. 

The review included 86 clinical trials and over 120,000 participants that compared greater omega-3 intake versus lower omega-3 intake for at least a year. The review found that increasing EPA and DHA (omega-3 fats found in fish) had little or no effect on all cause mortality, cardiovascular death, stroke, or heart irregularities.

So, what’s the take away from all this?

Some supplementation is necessary for some people

There will be new studies that may change what we know on some of the topics I have shared with you here, and if they do, and the reviews are high quality, without industry funding then the thinking around supplementation may change. But if you’re healthy, and not a female trying to fall pregnant or sexually active and of reproductive age, eat a minimally processed, plant-based diet and you are going to be in good health!


* Cochrane Library Database – If you ever want a summary of the evidence on a topic that uses randomized controlled trials to test an intervention, then this is the place to look – and they now give great plain language summaries.


​Dr Nick Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

The Stages of Change

People know that smoking is bad for their health, but still choose to smoke. People know they ‘should’ go for that run, but still choose to sleep in. People know that the McDonalds drive through is not the healthiest option for dinner, but still use it on a Friday night after work. People are informed and educated around healthy behavioural choices, however still make unhealthy choices. Even when an individual has a serious health scare, they still may not want to change or know how to change the behaviours that have led them to their condition. 

The Transtheoretical Model (Stages of Change) can explain why. 

Social psychological research into dietary change and levels of physical activity are often the forgotten piece in understanding how to promote healthy behavioural change, long term. 

Health Behaviour Models

The contribution of social psychology is now becoming more and more influential in affecting long term dietary and exercise change. The most important contribution has been the advancement and application of various health behaviour models to initiate and promote change.

Some of the most popular models of health behaviour include: the health belief model; social cognitive theory; protection motivation theory; the theory of planned behaviour; and finally, and importantly, the transtheoretical model of change.

The Transtheoretical Model of Change (Stages of Change Model)

Developed by Prochaska and DiClemente, the model’s central concept is that all individuals pass through similar stages of change regardless of the problematic behaviour that they are trying to change.

These stages are:

  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance

With relapse common in the attempt to maintain any new behaviour.

Think of a current behaviour in your life that is potentially unhealthy. It doesn’t need to be anything too sinister; perhaps your partner has been telling you to drink less wine during the week, or you’re staying up past midnight binging on Netflix, or you’ve only exercised once in the past month. Look at each stage outlined below and see if you can identify which stage you are currently in, where you have been, and most importantly, where you would like to be!

Pre-contemplation: This is where a person has little to no awareness that their current behaviour is unhealthy or problematic. People in the pre-contemplation stage have no intention to change their behaviour in the foreseeable future. This is your husband or wife who you have desperately wanted to exercise for the past ten years, and despite your every attempt to change his or her behaviour, they haven’t even walked past the gym!! They’re thinking… “What problem?! It’s not a problem!”

Contemplation: This is where a person is thinking about making a change, but they haven’t yet taken any kind of action. This may have been you before joining the gym. People in contemplation see the advantages and disadvantages of their problematic behaviour… “I know that half a bottle of red wine each night isn’t great for my waist line, but it really helps me to relax once the kids have gone to bed.” Sound familiar?! 

Preparation: This is the third stage where a person shows intent to act and has gone about planning for changing their behaviour. This may have been you when you hired a personal trainer and started arranging for a regular time to be available in your week for exercise. 

Action: Once a person is engaging in their new healthy behaviour, they are in action. For example, doing your first exercise session!! This is also known as the “doing” stage.

Maintenance: Once a person has continued with their new behaviour for 6 months or more, they are in the final stage of change.  

Relapse: A relapse or a ‘lapse’ is a normal part of changing an unhealthy behaviour. A relapse is defined as going back to the problematic behaviour (or worse), whereas as a ‘lapse’ is like a little slip up. The important thing is to learn from any lapses or relapses by identifying the trigger, and then putting strategies in place for preventing another one from occurring in the future. 

As you pass through each identified stage of change, so too does your level of self-efficacy. In other words, once you progress to maintenance (especially if you have been following a detailed program) you will find it easier to identify and overcome any common barriers in the future. Therefore, when you relapse or lapse (which is very normal), you can re-implement your new learnt and healthful behaviours. The goal is to move towards maintenance, while increasing your levels of self-efficacy. 

It is important to note however, that ‘at-risk’ populations are often not prepared for the action stage and will not be served by traditional educational programs. Therefore, helping people set more realistic goals and assisting them in moving towards action with a trained professional is a very important step in this process. Professionals who have the right skills can guide you in changing your thinking and attitudes.

If you have issues with self-worth, or anxiety around changing your behaviour, or perhaps a belief that prevents you from acting, this is completely normal! Seeing a psychologist may be a crucial step for you in changing your problematic behaviour. Psychologists are well trained in dealing with ambivalence. It is very common for people to be ‘stuck’ in the contemplation stage. If this sounds like you, a psychologist can guide you in working through the pros and cons of changing your behaviour and collaborate with you to start preparing for change. 

Take Home Message

Changing life long behaviours and creating new healthy habits can be incredibly difficult. The first and most crucial step to the process is about identifying the behaviours in your life that are problematic. If you believe that you don’t have the ability to change, it is recommended that you seek professional help from a psychologist to guide you in commencing the process of change. Everybody can change a problematic behaviour; you may just have to change your attitude towards the behaviour first!


Simone Chartres is an endorsed Clinical Psychologist with the Australian Health Practitioner Regulation Agency (AHPRA). She has over 10 years of clinical experience working with young people and adults with complex presentations in the public and private sector. Simone has extensive clinical experience in the assessment, diagnosis and treatment of anxiety disorders, mood disorders, substance use disorders and eating disorders.

Expert Q&A: Introducing Jemma McGeachie

1) Could you tell us a little about your career and areas of expertise/interest? 

I am a Women’s health and Musculoskeletal physiotherapist who has worked for nearly two decades helping people achieve their goals.

My passion is helping women through pregnancy and beyond and also the journey of back pain and how exercise rehabilitation can be the change.


2) What drew you to this line of work/research in the first place? 

I was fortunate to work with specialist physiotherapists early in my career both in Sydney and in London, who were truly inspirational.

After the birth of my 3 boys I was extremely passionate about helping women in this space, returning them to work pain free and helping them to reach their exercise goals.


3) How do you look after your own physical and mental wellbeing?

Habits and routine are so necessary for me. I love pilates which makes it easy to attend and I also enjoy running with my friends. My boys keep me active too!


4) Do you have a favourite post-workout cafe?

Somewhere in the sun with  good coffee and a good friend.


5) What is one thing you wish people knew about wellbeing? 

It can mean something different to everyone! And that’s okay!


6) What is one of the most ridiculous things you’ve read or seen about wellbeing that you know to be untrue?

High intensity workouts can damage your joints and weaken your pelvic floor. This is simply untrue!


7) Do you have any favourite books, podcasts or websites on health or wellbeing that you’d recommend?

I love what Noom is doing with their app. Lots of great tips and tricks based on evidence based psychology on how to achieve health and fitness goals.


8) What is your top tip for living a healthy and happy life? 

Prioritise yourself first and really work out what makes you feel good. Reward yourself often and smile more. Your brain will believe you are happy if you do!