The Transtheoretical Model (Stages of Change)

The Transtheoretical Model (also called the Stages of Change Model), adult by Prochaska and DiClemente in the belatedly 1970s, evolved through studies examining the experiences of smokers who quit on their own with those requiring further treatment to empathize why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the conclusion-making of the individual and is a model of intentional modify. The TTM operates on the supposition that people do not change behaviors quickly and decisively. Rather, modify in behavior, especially habitual behavior, occurs continuously through a cyclical process. The TTM is not a theory but a model; dissimilar behavioral theories and constructs can be applied to various stages of the model where they may be most effective.

The TTM posits that individuals move through half dozen stages of modify: precontemplation, contemplation, preparation, action, maintenance, and termination. Termination was not role of the original model and is less often used in application of stages of alter for health-related behaviors. For each phase of alter, different intervention strategies are well-nigh constructive at moving the person to the adjacent stage of alter and subsequently through the model to maintenance, the platonic phase of behavior.

  1. Precontemplation - In this phase, people practice not intend to have action in the foreseeable future (defined as within the next 6 months). People are frequently unaware that their behavior is problematic or produces negative consequences. People in this phase ofttimes underestimate the pros of irresolute behavior and identify too much emphasis on the cons of changing beliefs.
  2. Contemplation - In this stage, people are intending to first the healthy behavior in the foreseeable time to come (defined as within the next half dozen months). People recognize that their beliefs may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the beliefs takes identify, with equal accent placed on both. Fifty-fifty with this recognition, people may still feel ambivalent toward changing their behavior.
  3. Preparation (Determination) - In this stage, people are gear up to accept action inside the next 30 days. People start to take pocket-size steps toward the behavior alter, and they believe changing their behavior tin can lead to a healthier life.
  4. Activeness - In this stage, people have recently changed their behavior (defined as within the last six months) and intend to keep moving forrard with that behavior change. People may exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
  5. Maintenance - In this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the beliefs change going forward. People in this phase work to foreclose relapse to earlier stages.
  6. Termination - In this 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.

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To progress through the stages of change, people utilise cognitive, affective, and evaluative processes. Ten processes of change have been identified with some processes existence more relevant to a specific stage of change than other processes. These processes result in strategies that help people brand and maintain modify.

  1. Consciousness Raising - Increasing sensation well-nigh the healthy behavior.
  2. Dramatic Relief - Emotional arousal most the health behavior, whether positive or negative arousal.
  3. Self-Reevaluation - Self reappraisal to realize the healthy behavior 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 society is supportive of the healthy behavior.
  6. Self-Liberation - Commitment to change behavior based on the conventionalities that achievement of the salubrious behavior is possible.
  7. Helping Relationships - Finding supportive relationships that encourage the desired alter.
  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 from negative behavior.
  10. Stimulus Control - Re-engineering the surround to have reminders and cues that support and encourage the healthy behavior and remove those that encourage the unhealthy beliefs.

Limitations of the Transtheoretical Model

There are several limitations of TTM, which should be 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 between the stages can be capricious with no set criteria of how to determine a person's stage of alter. The questionnaires that have been developed to assign a person to a stage of modify are not always standardized or validated.
  • There is no articulate sense for how much fourth dimension is needed for each phase, or how long a person can remain in a phase.
  • The model assumes that individuals make coherent and logical plans in their decision-making process when this is not always truthful.

The Transtheoretical Model provides suggested strategies for public health interventions to address people at various stages of the controlling process. This can result in interventions that are tailored (i.e., a bulletin or program component has been specifically created for a target population's level of noesis and motivation) and effective. The TTM encourages an assessment of an individual's electric current phase of modify and accounts for relapse in people'south decision-making process.

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