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Transtheoretical Model. Stages of Change Theory. Change Theory. Changing behavior is difficult Examples?. Change Theory. Typical influences used to promote health: Social (peer pressure, policy changes ) Biological (nicotine replacement)

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transtheoretical model

Transtheoretical Model

Stages of Change Theory

change theory
Change Theory
  • Changing behavior is difficult
  • Examples?
change theory3
Change Theory
  • Typical influences used to promote health:
    • Social (peer pressure, policy changes)
    • Biological (nicotine replacement)
  • In Stages of Change Theory, influence occurs from within
  • Behavior modification occurs in stages, over time
  • These stages describe an individual’s attitude toward the change
  • There are other approaches to describing and explaining behavioral change.
  • The transtheoretical model has supporters and detractors, often specific to behavioral interventions.
  • Because the transtheoretical model is often cited in the media, and because the stage construct is easily applied across health-related behaviors, it is incorporated into HEA150
stage one precontemplation
Stage One: Precontemplation
  • Represents those individuals who have no desire to change behaviors in immediate future
  • Some in this stage are unaware of behavior
  • Some aware of behavior consequences but continue anyway
    • Create reasons why continued behavior makes sense
    • Recognize previous failures at behavior modification
precontemplation the four r s
Precontemplation: The Four R’s
  • Reluctance
    • Not fully conscious of behavior’s impact
    • May not think change will provide positive outcome
  • Rebellion
    • May be due to prolonged fears of change/losing control
    • Adolescence
  • Resignation
    • Lack of energy to change
    • Overwhelmed at perceived effort required to change
  • Rationalization
    • Excuses used to avoid change
stage two contemplation
Stage Two: Contemplation
  • Intent to change behavior within six months
    • Six-month term based upon behavior modification research
  • Individual is aware of the desired behavior
    • Benefits
    • Barriers (finances, time, support)
  • Change planned based on interpretation of benefits and barriers
moving from precontemplation to contemplation
Moving from Precontemplation to Contemplation
  • How?
  • Improve Awareness of behavior
    • Mass media
    • Education
  • Easily attainable goals to ensure success
stage three preparation
Stage Three: Preparation
  • Serious consideration of behavior change within 30 days
  • Previous attempts to change (smoking cessation for a week, e.g.)
  • Here, the individual is most ready for change
movement from contemplation to preparation
Movement from Contemplation to Preparation
  • No rushing
    • Individual should be allowed to take his/her time
  • Encouragement
  • Education
  • Motivational techniques
stage four action
Stage Four: Action
  • A distinct change in behavior occurs
    • Change is consistent
    • Visible
    • Receives the most recognition
  • Requires the greatest commitment
  • Relapse common in this stage
movement from preparation to action
Movement from Preparation to Action
  • General goal(s), objective(s) in place
  • Praising individual for readiness
  • Enlisting support
  • Environment may need to be manipulated
    • Turning off television during prime time to promote studying, e.g.
stage five maintenance
Stage Five: Maintenance
  • Should be at least six months after the behavior change, may last for years
    • The changed behavior will dictate amount of time needed in this stage
      • Major changes will probably require more time
      • Minor changes will probably require less time
  • Individual’s self-efficacy is highest at this stage
movement from action to maintenance
Movement from Action to Maintenance
  • Time required for adaptation to behavior
  • Specific guidelines/routines are followed e.g. reading class notes every MWF 8-10 p.m.
  • Continued support, positive reinforcement
  • Pro’s of behavior change need to outweigh the con’s
stage six termination
Stage Six: Termination
  • Behavior change has been permanently adopted
  • 100% self-efficacy
  • No temptation to relapse
  • Often, a more realistic goal is permanent maintenance
    • Termination difficult to achieve
movement from maintenance to termination
Movement from Maintenance to Termination
  • Relapse preparation
    • Individual anticipates temptation for relapse
    • Individual creates ways to cope with relapse
    • Relapse may extend more than one stage
can you identify the stage
Can You Identify the Stage?
  • Steve wants to meet more people, so he enrolls in a travel class. Class begins next week
  • Natty began an exercise program three months ago and continues to attend
can you identify the stage18
Can You Identify the Stage?
  • Tatiana is told by her family she consumes too much alcohol, but she doesn’t feel there is a problem
  • Mark wants to reduce his negative stress. He investigates possible therapists through his insurance company and has begun to research stress on the internet.
stage model applied to you
Stage Model: Applied to You
  • Changes you acknowledge you need/want
  • Changes you are undergoing
  • Changes you have made
  • Changes you do not yet know about
  • 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 51.3 (1983): 390-395. Print.
  • DiClemente, Carlo C., James O. Prochaska, Scott K. Fairhurst, Wayne F. Velicer, and et al. "The Process Of Smoking Cessation: An Analysis Of Precontemplation, Contemplation, And Preparation Stages Of Change.." Journal of Consulting and Clinical Psychology 59.2 (1991): 295-304. Print.
  • "Stages of Change | Psych Central." Psych Central - Trusted mental health, depression, bipolar, ADHD and psychology information .. N.p., n.d. Web. 10 Sept. 2013.
  • "[Prospective study on the relating f... [Taehan Kanho Hakhoe Chi. 2005] - PubMed - NCBI." National Center for Biotechnology Information. N.p., n.d. Web. 10 Sept. 2013.
  • "TTM Processes of Change." University of Rhode Island | Think Big. We Do.. N.p., n.d. Web. 11 Sept. 2013. <>.