Addiction- Prochaska's six stage model

Question 1

Prochaska’s model does not view change as a ‘single event’ but emphasises the ……..

Answer 1

Gradual nature of change. I.e., it’s a process!

Question 2

The model includes ‘pre-action’ and ‘post-action’ stages and is cyclical: individuals move up through the stages in order, BUT …….

Answer 2

relapse to a prior stage might occur at any point.

Question 3

The final stage (_________) was added to allow for the fact that individuals can actually break out of the cycle and be free of the undesirable behaviour.

Answer 3

Termination

Question 4

What is the pre-contemplation stage

Answer 4

This is when the individual will be aware that what they are doing is unhealthy, but they do not feel they need to do anything about it at this point. No intention to change behaviour, but feel pressure from others. The individual may be in denial, be ill-informed about it or not willing to take responsibility for it.

Question 5

In the pre-contemplation stage, what techniques may be used to encourage the individual to move along

Answer 5

Explain and personalise the risk; Encourage re-evaluation of current behaviour; Clarify: decisions must be theirs.

Question 6

What may someone in the pre-contemplation stage say

Answer 6

I am ok right now!!!!

Question 7

What is the contemplation stage

Answer 7

Individuals show an awareness that they need to take action, but they don’t do it. It is often described as a stage of inertia, when people know the right thing to do but they do not act on it, maybe because of the perceived costs of giving up. The individual may procrastinate about change for ages or may insist on the perfect solution before acting.

Question 8

In the contemplation stage, what techniques may be used to encourage the individual to move along

Answer 8

Encourage evaluation of pros and cons of behaviour change;
Identify and promote new, positive outcome expectations.

Question 9

What may someone in the pre-contemplation stage say

Answer 9

I will change tomorrow!

Question 10

What is the preparation stage

Answer 10

This is an important stage as, if the behaviour change is planned, it has a greater chance of succeeding. Preparation could include: cutting down to start with, ensuring that there are no social events that might tempt a relapse; and deciding on rewards to keep motivation strong. Individuals should counter anxiety by taking small steps, setting a time-frame for action, telling people about their decision and making an action plan.

Question 11

In the preparation stage, what techniques may be used to encourage the individual to move along

Answer 11

Help individuals identify social support; Verify that individual has underlying skills required for behaviour change to occur; Encourage small initial steps.

Question 12

What may someone in the preparation stage say

Answer 12

It’s happening next month!

Question 13

What is the action stage

Answer 13

This is the behavioural stage where the plan is put into action (e.g., smoking is stopped) and this is the first time the person actually makes the change of behaviour. It needs commitment. This stage can typically last six months until it is deemed to be the next stage of maintenance. Relapse can happen at this stage. The individual should control their environment (e.g., remove cigarettes, avoid drinking pals), and use a ‘to do list’ and other reminders to help abstinence. They may engage with therapy or NRP.

Question 14

In the action stage, what techniques may be used to encourage the individual to move along

Answer 14

Focus on restructuring cues and social support; Bolster self-efficacy for dealing with obstacles; Combat feelings of loss and reiterate long-term benefits.

Question 15

What may someone in the action stage say

Answer 15

I have done it, I have stopped!

Question 16

What is the maintenance stage

Answer 16

Maintenance strategies are employed, such as recognising the benefits of adopting healthier behaviour, rewarding oneself for stopping, and keeping focused on the long-term goal of termination. This stage can be lengthy (after 6 months) and is focused on ensuring that the initial enthusiasm and motivation do not wane. Relapse can still occur at this stage and the individual should look out for social pressures, internal challenges and special situations; Reviewing a list of negative aspects of the problem regularly can help with motivation.

Question 17

In the maintenance stage, what techniques may be used to encourage the individual to move along

Answer 17

Plan for follow-up support; Reinforce internal rewards; Discuss coping with relapse.

Question 18

What may someone in the maintenance stage say

Answer 18

I have still stopped!

Question 19

What is termination

Answer 19

At this point there is no longer any temptation and there is maximum confidence in the ability to resist the addictive behaviour. The individual has a new self-image, increased self-efficacy and no temptation in any new situation.
Some people never achieve this stage, instead staying in the stage of maintenance for many years. However, this stage means the change is complete. Relapse rarely happens.

Question 20

What may someone in the termination stage say

Answer 20

I can’t believe i used to do that!

Question 21

Evaluation, evidence
Velicer

Answer 21

Velicer et al. (2007) conducted a meta-analysis and found there was a robust 22–26% success rate for reducing addictive behaviours using models.

There were also no demographic differences (e.g. age etc.). However, success was dependent on the smoking habits (e.g. frequency). This suggests that the model can be put to good effect in positive behavioural change.

However, these results could also indicate that it was unsuccessful 78-74% of the time, so maybe it is not the most effective way of changing addictive behaviour.

Question 22

______ et al. (2007) conducted a meta-analysis and found there was a robust __–__% success rate for reducing addictive behaviours using models. There were also no demographic differences (e.g. age etc.). However, success was dependent on the smoking habits (e.g. frequency). This suggests that the model can be put to good effect in positive behavioural change. However, these results could also indicate that it was unsuccessful __-__% of the time, so maybe it is not the most effective way of changing addictive behaviour.

Answer 22

Velicer
22-26
78-74

Question 23

Evaluation, application

Answer 23

Appropriate interventions can be administered depending on the stage and treatment can be personalised to suit the needs of the individual.

For instance, someone in the contemplation phase may be advised to re-evaluate the pros and cons of the behaviour. Whereas someone in the action phase may be encouraged to use NRP to help in stopping smoking.

Model can be tailor made

Question 24

Evaluation, contradictory evidence

Answer 24

Aveyard et al. (2009) found no increase in effectiveness if the intervention was tailored to Prochaska’s stages of change for individuals trying to stop smoking.

Suggest that aspects of the model may be unreliable

Question 25

Evaluation, theoretical issues

Answer 25

Littell & Girvin (2002) suggests that the stages are not mutually exclusive.

For example, they see very little difference between contemplation and preparation as well as between action and maintenance.

Implies that the stages identified may be a bit arbitary and should not be seen as stages at all, questioning the validity of the model

Question 26

______ & ______ (2002) suggests that the stages are not mutually exclusive.
For example, they see very little difference between contemplation and preparation as well as between action and maintenance.

Answer 26

Littell
Girvin

Question 27

Evaluation, cultural relatvism

Answer 27

Daoud et al. (2015) found that, in Arab cultures, it was more difficult for people to quit smoking as it is a ritualised part of formal occasions. They found 62% of a sample of male smokers were still in the precontemplation stage and only 14% in the preparation compared with studies in the US and Europe (which have found averages of 40% in precontemplation and 20% in preparation).

These findings indicate the ability to move forward through the stages identified by Prochaska may be influenced by the social norms of a given culture.

Question 28

_____ et al. (2015) found that, in Arab cultures, it was more difficult for people to quit smoking as it is a ritualised part of formal occasions. They found __% of a sample of male smokers were still in the precontemplation stage and only __% in the preparation compared with studies in the US and Europe (which have found averages of __% in precontemplation and __% in preparation).

Answer 28

Daoud
62
14
40
20