How to use the stages of change
-
Upload
ventana-hidalgo -
Category
Documents
-
view
51 -
download
6
description
Transcript of How to use the stages of change
Tara Walton
HOW TO USE THE STAGES OF CHANGE
The Transtheoretical Model
Review the 4 constructs of the TTM
Review the 5 stages of behavior change
Learn how to apply TTM to change a
behavior
Review strengths and limitations of TTM
OBJECTIVES
A model used to explain individual behavior change
Consists of 4 main constructs:
STAGES OF CHANGE/TRANSTHEORETICAL MODEL
(TTM)
Stages of Change
Processes of Change
Decisional Balance
Self-efficacy
Pre contemplation• “ignorance is
bliss”
Contemplation• “fence sitting”
Preparation• “testing the
waters”
Action• “go for it”
Maintenance• “steady as she
goes”
Relapse• “Fall from
grace”
1. THE STAGES OF CHANGE
Termination
2. THE PROCESSES OF CHANGE
The covert and overt activities that people use to progress through stages (Prochaska et al., 2002)
These strategies can be: CognitiveAffective Behavioural
Application to specific stages can facilitate movement
Processes can help guide development of stage-specific interventions
3. DECISIONAL BALANCE
Relative weighing of the costs and benefits of changing the behaviour
motivation/readiness to change varies with each stage, relative to the balance of pro’s versus con’s of changing
4. SELF-EFFICACY
The situation-specific confidence that you have in your ability to change the behaviour
APPLYING THE STAGES OF CHANGE
Self EfficacyDecisional Balance
Processes of change
Stages of Change
HOW WHEN
The stages of change help identify WHEN a person is ready to change
Self efficacy, decisional balance, & process of change help to explain HOW
to facilitate movement through the stages of change
APPLYING THE STAGES OF CHANGE
Precontemplation
Contemplation
Preparation Action Maintenance
Consciousness Raising Dramatic Relief Environmental Re-evaluation
Self-Re-evaluation
Self-liberation
Counter-conditioningHelping Relationships
Reinforcement Management
Stimulus Control
Pro’s of changing increasing
Pro’s of changing increasing
Self-efficacy increasing
HOW TO USE STAGES OF CHANGE TO INCREASE SLEEP
PRECONTEMPLATION TO CONTEMPLATION
• increase the pro’s of changing
Goal:
• Consciousness raising (increase awareness)
• Dramatic Relief (emotional arousal)
• Environmental Re-evaluation
Process:
PRECONTEMPLATION TO CONTEMPLATION
This illustration can be used as educational material to help an individual understand some of the costs of sleep deprivation
CONTEMPLATION TO PREPARATION
• decrease the con’s of changing
Goal:
• Self re-evaluation (self-reappraisal)
Process:
CONTEMPLATION TO PREPARATION
Con’s Pro’s- Less time for
friends- Can’t watch as
much tv- Less time to study- Might miss
deadlines
- Helps repair the body
- Reduce stress- Improve memory- Control body weight- Reduce mood
disorders
PREPARATION TO ACTION
• Pro’s of changing must outweigh con’s
• Increase self-efficacy
Goal:
• Self-liberation (committing)• New Year’s resolutions• Provide several options vs one choice
• ie: 8 hrs of sleep 3 nights a week, 1 extra hr of sleep each night going to bed by midnight 5 nights/week
Process:
ACTION TO MAINTENANCE
• Increase self-efficacy
Goal:
• Counter-conditioning (substituting)
• Helping relationships (supporting)
• Reinforcement Management (rewarding)
• Stimulus Control (re-engineering)
Process:
STIMULUS CONTROL
This process includes using avoidance, environmental reengineering, and self-help groups
Example: Tips to help you sleepKeep a regular sleep/wake scheduleAvoid caffeine 4-6 hrs before bed
Minimize daytime useAvoid alcohol/heavy meals before bedGet regular exerciseMinimize noise, light & excess temperatures
where you sleep
STRENGTHS OF TTM
Individual focus: can be personally tailored
Recognizes behaviour change as dynamic and non-linear
Can help identify readiness to change
Link between stages & processes allows for targeted interventions
LIMITATIONS OF TTM
Does not consider:environmental factorssocial determinants
Focuses on primary preventionReducing risks vs preventing risks
May not be applicable to:Specific populations Complex health behaviorsPopulation health interventions
SUMMARY OF THE TTM
People move through different stages over time
Movement depends on:
the balance of pro’s and con’s
a person’s self-efficacy
Processes of change help move through stages
The model can be:
useful for facilitating individual behavior change
difficult to apply at the population health level
RESOURCES
Cancer prevention research center: http://www.uri.edu/research/cprc/TTM/detailedoverview.htm
Mississippi State University: http://www2.msstate.edu/%7Ebhunt/Stages_of_Change_Theory/
transtheoretical.html
Prochaska, J. O. & DiClemente, C. C. (1984). The transtheoretical
approach: Crossing traditional boundaries of treatment. Melbourne,
Florida: Krieger Publishing Company.
Prochaska, J.O., DiClemente, C.C., and Norcross, J.C. 1992. In
Search of How People Change: Applications to Addictive Behaviors.
American Psychologist 47(9): 1102-1114.
Prochaska, J.O., Johnson, S., and Lee, P. The Transtheoretical Model
of Behavior Change. In: Shumaker, S.A., Schron, E.B., Ockene, J.K.,
and McBee, W.L. [Editors]. 1998. The Handbook of Health Behavior
Change, 2nd Ed. Springer Publishing Company.