What is the transtheoretical model of behavior change?

Introduction

Changing negative behaviors has been an important interest of psychologists for many years. Psychotherapists have used many strategies with patients to rehabilitate juvenile delinquency, depression, and addictions. In the 1980s, the transtheoretical model was developed by James O. Prochaska in collaboration with Carlo DiClemente and James Norcross. This model was developed not only to guide psychotherapists to positively change behaviors in their patients but also to explain how individuals can change behaviors themselves.

The main premise of the transtheoretical model is that people go through several stages before change occurs. For this reason, the model is also known as the stages of change. An important feature of the model is that regression is as real as progression. Just because individuals move toward a positive behavioral change does not mean that they will not at some point move back in a negative direction. Another characteristic of the model is that strategies used to help people move toward positive behaviors are different at the various stages. Therefore, the objective is to methodically move the person in the positive direction, not jump straight to the positive behavior that the person may not be prepared to sustain.

Stages of Change

In the original model, Prochaska and his colleagues identified six stages through which a person must move to fully implement the positive behavioral change: precontemplation, contemplation, preparation, action, maintenance, and termination. After many years of research, the termination stage was dropped because it was determined that changing forever is not guaranteed for those who reach a desired behavioral change. There is always the risk of returning to a negative behavior.

The first stage is precontemplation. Individuals in this stage are not considering a change in a specific behavior. In many cases, these individuals are not aware that their behavior is problematic, nor do they believe there is anything they can do about it. Individuals in the contemplation stage have realized that they have a problem behavior, and they are thinking that they need to make a change in that behavior. While they have identified a specific behavior as a problem, they do not have a plan for change. In the preparation stage, people have identified a problem behavior and have developed a plan to make a positive change. The plan may or may not be a good plan. These people have progressed from thinking about starting a change to planning for it.

In the action stage, individuals have implemented the plan and have begun to make the behavioral change. However, the behavior has been changed for less than six months. Once the change has been sustained for more than six months, individuals progress to the maintenance stage. Although people in the maintenance stage have been successful for six months, they are always at risk of reverting back to the negative behavior.

Applications of the Model

When using the stages of change model, different strategies are used for individuals at different stages. Precontemplators need assistance to make changes. They should not be pushed into action. The focus must be on getting these individuals to realize that a behavioral change is needed and is possible to achieve. When this is accomplished, these individuals become contemplators. The strategy used with contemplators is to prepare them to plan the change by getting them excited about it and getting them to reevaluate themselves. This will help them move into the preparation stage. The key to this stage is commitment. Commitment can be developed by developing a plan of action, setting a date for the change, and letting others know about the planned change. Then these individuals are ready for action. The behavioral change is attempted but not guaranteed. Attention is still needed to substitute good behaviors for those being changed, by controlling the environment that affects the changed behavior and rewarding the individuals for the new behavior. After the behavioral change has been maintained for six months, individuals move to the maintenance stage. The threat of going back to the negative behavior is still real, and interventions are required. Maintaining a positive environment, positive thinking, and using the help of others make maintaining the change more permanent.

Bibliography

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