Addiction - Prochaska's model of behavioural change Flashcards
What is the key insight of Prochaska’s Six-Stage Model of Behavioural Change?
Behaviour change is cyclical, not linear. People can move forward and backward through stages, and some stages may be skipped altogether.
What are the two major insights behind Prochaska’s model?
People differ in how ready they are to change.
The effectiveness of treatment depends on the stage the person is in.
What are the first three stages of Prochaska’s model and what are they collectively known as?
Pre-contemplation, Contemplation, Preparation
Known as the Pre-action or Behavioural Intention stages.
What are the last three stages of Prochaska’s model and what are they collectively known as?
Action, Maintenance, Termination
Known as the Post-action or Behavioural stages.
What characterises the Pre-contemplation stage and what is the best intervention?
The person is not considering change (due to denial or demotivation).
Intervention: Help the person acknowledge the need for change.
What is the Contemplation stage and how should interventions be tailored?
The person is ambivalent—they recognise pros and cons of change.
Intervention: Help them realise benefits outweigh costs.
What happens in the Preparation stage of the model?
The person intends to change soon (e.g. within a month) and may have already made small changes.
Intervention: Help construct a plan or offer practical options (e.g. counselling).
What defines the Action stage, and what kind of support is needed?
The person is actively changing their behaviour (for 1 day to 6 months).
Intervention: Provide coping skills to support ongoing behavioural change.
What is the goal of the Maintenance stage and what support helps?
The person has maintained change for 6+ months.
Intervention: Support with relapse prevention like stimulus control and social support.
What is the Termination stage and what makes it difficult to achieve?
The behaviour change is fully internalised and relapse is unlikely.
Not all addicts reach this; many stay in maintenance long-term.
Intervention is not needed, but relapse prevention may still be useful for others.
What is a major strength of the six-stage model regarding relapse?
It acknowledges relapse as a normal part of the change process. DiClemente et al. (2004) stated that “relapse is the rule rather than the exception.” The model views relapse seriously but not as failure.
Why is recognising relapse a strength of the six-stage model?
It provides a realistic and compassionate explanation of how behaviour change works. It helps people understand that several attempts may be needed to succeed, reducing feelings of failure.
What is a limitation of the six-stage model regarding stage boundaries?
The boundaries between stages are arbitrary. For example, Sutton (2001) notes the difference between planning to quit smoking in 30 vs. 31 days moves a person between stages. This lacks meaningful distinction.
What does Kraft et al (1999) and Bandura (1997) argue about Prochaska’s model?
They argue the early stages are not qualitatively different and the model could be simplified to just two main stages: Pre-contemplation vs. all others. This would suggest that the model is overly complex.
What is a limitation of Prochaska’s model? (Culture bias)
Daoud et al. (2015) found cultural norms, like social smoking in Arab communities, reduce readiness to quit. 62% of Arab male smokers were in pre-contemplation, far higher than in Western countries. It suggests that social and cultural factors are important influences on addiction that the model does not address, making interventions less effective in some populations.
What is a key criticism of the model’s scientific value?
The model is descriptive, not predictive. It describes what stage someone is at but does not effectively predict future behaviour or success in overcoming addiction.
What does research criticising Prochaska’s model state?
Taylor et al. (2006), reviewing evidence for NICE, found that stage-based approaches were no more effective than non-stage-based alternatives in treating nicotine addiction. West (2005) called for the model to be discarded, saying its problems are “so serious” and that it has been “little more than a security blanket” for clinicians and researchers.
