Applying theories of behaviour change to addiction: Prochaska Flashcards
Assumptions of model
Prochaska’s model
Recognises that overcoming addiction is a cyclical process - clients progess through stages but also return to previous ones or skip some
Based on 2 major insights:
- People who are addicted differ in how ready they are to change behaviour
- Usefulness of treatment intervention depends on stage person is in
Precontemplation
Prochaska’s model
People in this stage aren’t thinking about changing addiction-related behaviour in near future
May be because of denial or demotivation
Intervention - focus on helping person to consider need for change
Contemplation
Prochaska’s model
At this stage people think about major change to behaviour in next 6 months
They’ve become awre of need to change & also consequences)
People can remain in chronic state of contemplation for long time
Intervention - help person finally see pros of overcoming addiction outweigh the cons
Preparation
Prochaska’s model
People believe benefits are better than costs, deciding to change behaviour within next month - don’t know how or when
Intervention - construct plan or present them w/ option
Action
Prochaska’s model
People at this stage have done something to change behaviour (e.g. CBT or got rid of cigs/alc)
Action taken must substantially reduce risk
Intervention - focus on developing coping skills client needs to quit & maintain change in behaviour
Maintenance
Prochaska’s model
Person has maintained some change of behaviour for more than 6 months - focus now on relapse prevention
Person more confident that abstaining can be continued longer term
Intervention - focuses on relapse prevention & aims to help client apply coping skills they’ve learned
Termination
Prochaska’s model
Newly acquired behaviours become automatic & person no longer returns to addictive behaviours to cope
Stage not realistic for everyone
Most appropriate goal may be to prolong maintenance for as long as possible
Intervention - none
Evaluation - Dynamic process
Prochaska’s model
Strength - model views recovery as dynamic process
6 stage model emphasises importance of time
Which is why model proposes behaviour change occurs through 6 stages of varying duration for each person
Process through stages same for everyone, some may go back or skip stages
There4, stage model provides realistic view of complex nature of recovery
Evaluation - Dynamic process (Counterpoint)
Prochaska’s model
However, stages have been criticised for being arbitrary
Kraft et al (1999) argue that 6 stages can be reduced to two - precontemplation & all others grouped together
Important implications as model suggests each stage is matched w/ specific type of intervention
There4, Prochaska’s model has little usefulness for understanding changes over time & for treatment recommendations
Evaluation - Positive view of relapse
Prochaska’s model
Strength - Model views relapse realistically
DiClemente et al (2004) - ‘Relapse is a rule rather than an exception’
Model views relapse as a part of the dynamic process & doesn’t underestimate potential to blow change entirely off course
Recovering from addiction can take several attempts
There4, model has face validity w/ clients as it is more realistic about relapse
Evaluation - Contradictory research
Prochaska’s model
Limit - evidence challenging the model
Taylor et al (2006) conducted meta-analysis of 6 stage model for NICE
Concluded model was no more effective than alternatives in changing nicotine related behaviours
There4, overall research picture is negative, despiet optimistic claims made for model by some
