Transtheoretical Model

1. Transtheoretical Model Stages of Change Theory

2. Change Theory • Changing behavior is difficult • Examples?

3. 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

4. Caveats • 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

5. 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

6. 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

7. 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

8. Moving from Precontemplation to Contemplation • How? • Improve Awareness of behavior • Mass media • Education • Easily attainable goals to ensure success

9. 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

10. Movement from Contemplation to Preparation • No rushing • Individual should be allowed to take his/her time • Encouragement • Education • Motivational techniques

11. 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

12. 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.

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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.

19. 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

20. References • 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. http://psychcentral.com/lib/stages-of-change/000265?all=1 • "[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. http://www.ncbi.nlm.nih.gov/pubmed/15778554 • "TTM Processes of Change." University of Rhode Island | Think Big. We Do.. N.p., n.d. Web. 11 Sept. 2013. <http://www.uri.edu/research/cprc/TTM/ProcessesOfChange.htm>.