1. Humans can, in fact, change. 2. Human can help others change. 3. Some forms of helping are more effective than others in encouraging and facilitating change.
WHAT IS THE TRANSTHEORETICAL MODEL OF CHANGE
(Prochaska et al, 1992)
Pro change programs are grounded in
the proven effective Transtheoretical
Model of Behavior Change (TTM) sometimes called the Stages of Change. The TTM groups the change process
into distinct stages of readiness and
provides approaches to help move people forward through the stages.
TTM was developed through analysis of successful
self
changers. It has six (6) stages of change:
Stage 1. Pre-contemplation (not ready)
At this stage the person do not intend to start the
healthy behavior and maybe unaware of the need to change. Pre-contemplators understimate the pros of changing, and overestimate the cons. (here they are encouraged to be mindful of their decision making and to be more conscious of the multiple benefits of changing
Stage 2. ready)
Contemplation-
(getting
At this stage, the person is intending
to start the healthy behavior within the next 6 months. However, they are still ambivalent about changing which can cause them to keep putting off their taking action.
Stage 3: Preparation (ready)
At this stage, the person is ready to
start action say, within the next 30 days. He/she takes small steps that he/she believes can help him/her make the healthy behavior a part of his/her life. For ex.,, he/she begin to tell friends and family of his/her desire to change his/her behavior.
During this stage, he/she is
encouraged to seek support from
trusted friends; to tell people about his/her plan to change. The no. 1 concern is when he/she acts, will he/she fail? At this stage the person learns that the better prepared he/she is, the more likely he/she is to keep progressing.
Stage 4: Action At this stage there have been changes in behavior within the last 6 months, and the need to work hard to keep moving ahead. The person need to learn how to strengthen his/her commitments to change and to fight urges to slip back. Strategies taught here include substituting activities related to the unhealthy behavior with positive ones, rewarding themselves for taking steps toward changing & avoiding people/situations that tempt them to behave in unhealthy ways.
Stage 5: Maintenance
At this stage change in behavior have taken place
more than 6 months ago. It is important for people in this stage to be aware of situations that may tempt them to slip back into doing the unhealthy behavior particularly stressful situations. The person at this stage should learn to seek support from and talk with people he/she trusts; spends time with people who behave in healthy ways, and remember to engage in alternative activities to cope with stress instead of relying on unhealthy behavior.
In general, for people to progress, they
need: A. A growing awareness that the advantages (pros) of changing outweighs the disadvantages (cons). TTM calls this decisional balance. B. Confidence that they can make and maintain changes in situations that tempt them to return to the old unhealthy behavior. TTM calls this self-
The Ten Processes include:
1. Conciousness Raising increasing
awareness via info, education, personal feedback about healthy behavior 2. Dramatic Relief- feeling fear, anxiety, or worry due to unhealthy behavior or feeling inspiration & hope when they hear about how people area able to change. 3. Self-Reevaluation realizing that the healthy behavior is an important part of who they are and want to be.
5.. Self-Liberation believing in ones ability to change and
making commitments to act on that belief. 6. Social Liberation realizing that society is more supportive to the healthy behavior. 7. Helping Relationships- finding people who are supportive supportive to their change. 8. Counter Conditioning substituting healthy ways of acting and thinking for unhealthy ways. 9. Reinforcement Management increasing rewards that come from positive behavior & reducing those that come from negative behavior. 10.Stimulus Control using reminders and cues that encourage healthy behavior.
Different strategies are most effective at
different Stages of Change. For ex.; Counter
Conditioning and Stimulus Control can really help people in the Action and Maintainance stages. BUT these processes are not helpful for someone who is not intending to take action. Consciousness raising and dramatic relief work better for someone in pre-contemplation stage. Most studies conducted have involved addictive and other problem behaviors such as smoking cessation, excessive drinking, obesity.
Sample Statements per stage
EX. Obesity: 1. I have not thought of changing my habit of
eating chocolates and cakes. (precontemplation)
2. I am not sure if I want to give up chocolates and cakes. 3. I am thinking about doing something about thisI have thought about it a lot 4. I have actually tried not eating cakes and chocolates during the birthday party of ___ & I am consistently avoiding these for some months already.
