The Transtheoretical Model (Stages of Change)

The Transtheoretical Model (also called the Stages of Change Model), developed by Prochaska and DiClemente in the tardily 1970s, evolved through studies examining the experiences of smokers who quit on their ain with those requiring further handling to understand why some people were capable of quitting on their ain. It was determined that people quit smoking if they were ready to practice and then. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the private and is a model of intentional change. The TTM operates on the supposition that people exercise not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a cyclical process. The TTM is non a theory but a model; different behavioral theories and constructs can be applied to diverse stages of the model where they may be most effective.

The TTM posits that individuals movement through six stages of alter: precontemplation, contemplation, preparation, action, maintenance, and termination. Termination was non role of the original model and is less frequently used in application of stages of modify for wellness-related behaviors. For each phase of change, unlike intervention strategies are nigh effective at moving the person to the next phase of change and afterwards through the model to maintenance, the platonic phase of behavior.

  1. Precontemplation - In this phase, people practice not intend to take action in the foreseeable future (defined as within the adjacent vi months). People are oftentimes unaware that their beliefs is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behavior and place too much emphasis on the cons of changing behavior.
  2. Contemplation - In this stage, people are intending to start the good for you behavior in the foreseeable time to come (defined as within the next 6 months). People recognize that their beliefs may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behavior takes identify, with equal emphasis placed on both. Even with this recognition, people may still experience ambivalent toward changing their behavior.
  3. Preparation (Conclusion) - In this stage, people are ready to take activeness inside the adjacent thirty days. People starting time to have small steps toward the behavior modify, and they believe irresolute their behavior tin lead to a healthier life.
  4. Activeness - In this stage, people have recently inverse their behavior (defined every bit within the last 6 months) and intend to keep moving forward with that beliefs change. People may showroom this by modifying their problem behavior or acquiring new healthy behaviors.
  5. Maintenance - In this stage, people have sustained their beliefs change for a while (defined as more than than 6 months) and intend to maintain the behavior change going forward. People in this phase work to forestall relapse to earlier stages.
  6. Termination - In this phase, people have no desire to return to their unhealthy behaviors and are certain they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often non considered in health promotion programs.

Stages of Change.png

To progress through the stages of modify, people apply cerebral, affective, and evaluative processes. Ten processes of change have been identified with some processes being more relevant to a specific phase of change than other processes. These processes result in strategies that help people make and maintain change.

  1. Consciousness Raising - Increasing awareness well-nigh the healthy behavior.
  2. Dramatic Relief - Emotional arousal near the wellness behavior, whether positive or negative arousal.
  3. Cocky-Reevaluation - Self reappraisal to realize the salubrious beliefs is part of who they want to be.
  4. Environmental Reevaluation - Social reappraisal to realize how their unhealthy behavior affects others.
  5. Social Liberation - Environmental opportunities that exist to show guild is supportive of the healthy behavior.
  6. Cocky-Liberation - Commitment to alter behavior based on the belief that achievement of the healthy behavior is possible.
  7. Helping Relationships - Finding supportive relationships that encourage the desired change.
  8. Counter-Conditioning - Substituting healthy behaviors and thoughts for unhealthy behaviors and thoughts.
  9. Reinforcement Management - Rewarding the positive beliefs and reducing the rewards that come up from negative beliefs.
  10. Stimulus Control - Re-engineering the environment to take reminders and cues that support and encourage the healthy beliefs and remove those that encourage the unhealthy behavior.

Limitations of the Transtheoretical Model

There are several limitations of TTM, which should exist considered when using this theory in public health. Limitations of the model include the following:

  • The theory ignores the social context in which change occurs, such as SES and income.
  • The lines betwixt the stages tin be arbitrary with no prepare criteria of how to make up one's mind a person'southward stage of change. The questionnaires that have been developed to assign a person to a stage of change are not always standardized or validated.
  • There is no articulate sense for how much time is needed for each stage, or how long a person can remain in a phase.
  • The model assumes that individuals make coherent and logical plans in their determination-making process when this is non always true.

The Transtheoretical Model provides suggested strategies for public health interventions to address people at diverse stages of the decision-making process. This tin result in interventions that are tailored (i.eastward., a message or program component has been specifically created for a target population's level of cognition and motivation) and constructive. The TTM encourages an cess of an individual's current stage of change and accounts for relapse in people'due south decision-making procedure.

return to tiptop | previous folio | adjacent folio