Transtheoretical Model of Behavior Change | Stages and Processes of Change
What is the Transtheoretical Model of Behavior Change?
The Transtheoretical Model of Behavior Change (sometimes referred to as the TTM) is a psychological model that describes how individuals progress toward change. The model was first described by Prochaska and DiClemente in the late 1970s. It evolved through studies examining the experiences of smokers who quit on their own with those requiring further treatment to understand why some people were capable of quitting on their own.
Precontemplation Stage of Change
In the pre-contemplation stage, people are not thinking seriously about changing and are not interested in any kind of help. There is a time in our lives when we are not even aware that there is a need to change. In some instances, this can be because they don’t know that their actions are bad or other ways of doing things exist.
Precontemplation Stage of Change Example
People in this stage tend to defend their current bad habit(s) and do not feel it is a problem. They may be defensive in the face of other people’s efforts to pressure them to quit, for example, defending the habit of smoking.
Contemplation Stage of Change
In the contemplation stage, people are more aware of the personal consequences of their bad habits, and they spend time thinking about their problems. Although they can consider the possibility of changing, they tend to be ambivalent about it.
But at this stage in development, people start to visualize how they could change their circumstances, learning from people who behave in the ways they may wish to. It’s important not only to help reduce the negative impacts of any changes but also to try your best to encourage new skills and healthy habits for the future!
Contemplation Stage of Change Example
For example, deciding to give up unhealthy behavior in favor of a healthier one. Like deciding to quit alcohol or smoking.
Preparation Stage of Behaviour Change
Preparation is a stage that combines intention and behavioral criteria. Individuals in this stage intend to take action in the next month and have unsuccessfully taken action in the past year.
In the preparation stage, people are ready to make changes in their lives. They might be buying equipment or signing up for a class to help them start their goal of change.
Preparation Stage of Behaviour Change Example
The pre-change behaviors they engage in could include telling others about their intentions and booking activities to incentivize themselves into making changes sooner rather than later.
Action Stage of Behaviour Change
Action is the stage in which individuals modify their behavior, experiences, or environment in order to overcome their problems. The action involves the most overt behavioral changes and requires considerable commitment of time and energy.
Action Stage of Behaviour Change Example
The best way to do that is by supporting them in a range of ways, including substitution, goal setting, commitment, changing social groups, and support. Setting a goal is an example of action.
Maintenance Stage of Behaviour Change
Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during the action. For addictive behaviors, this stage extends from six months to an indeterminate period past the initial action.
Maintenance Stage of Change Example
At the maintenance stage, individuals have found a way to stay on track with their new habits. They are still subject to relapse, but they are stable in most situations. This is because they’ve successfully adopted their new skills and do not need as much support as those who are in the action phase.
Termination Stage of Behaviour Change
In the Termination stage, people have no desire to return to their unhealthy behaviors and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs.
Termination Stage of Behaviour Change Example
When an individual has successfully changed their behavior, there is a sense of accomplishment and freedom. They no longer feel the need to engage in behaviors that they once identified with as a part of themselves. Once people have reached the termination stage of change, they know that old habits are gone for good.
Transtheoretical Model Processes of Change
Consciousness Raising
Consciousness Raising means increasing awareness of the causes, consequences, and cures for particular problem behavior. Interventions that increase awareness can include feedback, education, confrontation, interpretation, bibliotherapy, and media campaigns.
Consciousness Raising Example
I recall information people had given me on how to stop smoking
Dramatic Relief
Dramatic Relief can be a powerful tool for emotional manipulation, but it also has its drawbacks. The relief that people feel when they experience this method is short-lived and if they are not able to take action, the negative emotions will return as soon as their attention is diverted away from the crisis. Psychodrama, role-playing, grieving, personal testimonies, and media campaigns are all examples of techniques that can move people emotionally.
Dramatic Relief Example
I react emotionally to warnings about smoking cigarettes
Environmental Reevaluation
An environmental Reevaluation is a tool for assessing how the environment can be influenced by personal habits. It combines both cognitive and emotional assessments, such as empathy training, documentaries, and family interventions. By undergoing an assessment of one’s environmental impact, one may realize that one action have the power to influence others in either positive or negative ways.
Environmental Reevaluation Example
I consider the view that smoking can be harmful to the environment
Social Liberation
Social Liberation is the process of liberation from social constraints or restrictions. This can be achieved by providing new opportunities for people, as well as advocating for change in policies and procedures that were previously set. For example, we can help to increase social prospects for those who are marginalized by advocating to make changes such as increasing access to health care.
Social Liberation Example
I find society changing in ways that make it easier for the nonsmoker
Self-Reevaluation
Self-reevaluation is a combination of cognitive and emotional assessments about one’s self-image. One way to do this is by combining both your unhealthy habits, such as being a couch potato or an active person. Value clarification, healthy role models, and imagery are all techniques that can move people evaluatively.
Self-Reevaluation Example
My dependency on cigarettes makes me feel disappointed in myself
Stimulus Control
Stimulus Control is an important tool in the fight against old habits because it can remove cues for unhealthy habits and add prompts for healthier alternatives. Avoidance, environmental re-engineering, and self-help groups are all ways to provide stimuli that support change and reduce risks for relapse. Planning parking lots with a two-minute walk to the office or putting art displays in stairwells are examples of reengineering that can encourage more exercise.
Stimulus Control Example
I remove things from my home that remind me of smoking
Helping Relationship
The most important aspect of any relationship is the mutual respect and care that is shared between two people. The healthy behavior change can only be achieved with this in mind. Some ways to make sure there are no barriers to getting help when you need it are by building relationships, having a therapeutic alliance, and using rapport as well as support from family members or friends who understand what you’re going through.
Helping Relationship Example
I have someone who listens when I need to talk about my smoking
Counter Conditioning
To counter condition unhealthy behavior, it is necessary to learn healthier alternatives that can be used in place of the problem. For example, relaxation could help relieve stress; assertion could help you say no to peer pressure; nicotine replacement could replace cigarettes and fat-free foods can be a safer substitute.
Counter Conditioning Examples
I find that doing other things with my hands is a good substitute for smoking
Reinforcement Management
Reinforcement Management provides consequences for taking steps in a particular direction, and while punishments are a type of reinforcement, self-changers rely on rewards much more. Reinforcements are emphasized since a philosophy of the stage model is to work in harmony with how people change naturally.
Reinforcement Management Example
I reward myself when I don’t smoke
Self-Liberation
Self-liberation is not something that you can just do once and be done with it. It requires a commitment to oneself, and to one’s goals.
It’s also about doing the work necessary in order to improve your life. One simple way to start this process is by setting resolutions for yourself at the beginning of each new year. Doing so makes you accountable for your own success or lack thereof, which will help keep you motivated as well as make sure that no matter what happens in life, there are still actions being taken on your behalf towards achieving those goals.
Self-Liberation Example
I make commitments not to smoke
Criticisms of the Transtheoretical Model
The transtheoretical model has the following limitations/weaknessness ;
- The Transtheoretical Model ignores the social context in which change occurs, for example, income.
- In the Transtheoretical Model, there is no clear sense for how much time is needed for each stage, or how long a person can remain in a stage.
- The model assumes that individuals make coherent and logical plans in their decision-making process when this is not always true.
Transtheoretical Model Stages of Change