Transtheoretical Model

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Transtheoretical Model

• Stages of Change Theory

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Change Theory

• Changing behavior is difficult
• Examples?

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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 individuals attitude
  toward the change

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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
• Rationalizing makes sense
• Previous failures at behavior modification

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Precontemplation The Four Rs

• Reluctance
• Not fully conscious of behaviors impact
• Rebellion
• May be due to prolonged fears
• Adolescence
• Resignation
• Lack of energy to change
• Rationalization
• Excuses

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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

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Moving from Precontemplation to Stage 2

• How?
• Improve Awareness of behavior
• Mass media
• Education
• Easily attainable goals to ensure success

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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

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Movement from Contemplation to Stage 3

• No rushing
• Individual should be allowed to take his/her time
• Encouragement
• Education
• Motivational techniques

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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

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Movement from Preparation to Stage 4

• 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.

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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
• Individuals self-efficacy is highest at this
  stage

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Movement from Action to Stage 5

• 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
• Pros of behavior change need to outweigh the
  cons

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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

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Movement from Maintenance to Stage 6

• Relapse preparation
• Individual anticipates temptation for relapse
• Individual creates ways to cope with relapse
• Relapse may extend more than one stage

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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

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Can You Identify the Stage?

• Tatiana is told by her family she consumes too
  much alcohol, but she doesnt 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.

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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