Appplying theories of behaviour to change addiction: Prochaska six stage model Flashcards
What is Prochaska’s six stage model
This explains the stages people go through to change their behaviour. It identifies six stages of change from not considering it at all to making permanent changes.
Stages are not necessarily followed in a linear order
What are the Prochaska and DiClemente’s six stages of change?
According to Prochaska and DiClemente (1983), the six stages of behaviour change are:
Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse
Stage 1: Precontemplation
‘Ignorance is bliss’
People in this stage are not thinking about changing their behaviour soon (in the next six months).
They are in denial about their behaviour (they do not believe they are addicted) or because they are demotivated (they have tried to change their behaviour a couple of times before but have not succeeded).
Intervention helps the addicted person recognise the need to change.
Stage 2: Contemplation
‘Sitting on the fence’
At this stage, the addict is thinking about change. They are undecided about changing but are increasingly aware they need to change.
They are aware of the costs and benefits of change. Thinking so much can cause people to be stuck in this stage for a long time.
Intervention helps individuals realise the benefits of overcoming addiction outweigh the disadvantages, as do the pros and cons of remaining addicted.
Stage 3: Preparation
‘OK, I’m ready for this’
Now the addict believes the benefits of quitting outweigh the costs, and they decide to change their addictive behaviour (within the next month). They know they want to change soon, but not how or when.
So they start making plans and goals. At this stage, the best form of intervention is to plan or present some treatment options, such as seeing a counsellor or making an appointment with a doctor.
Encouragement to take the first steps toward change helps immensely.
Stage 4: Action
‘Let’s do this’
People at this stage have changed their behaviour and sought help, possibly from professionals, such as attending CBT therapy or seeking substance abuse treatment.
However, it does not have to be formal treatment. They can also do things like throw away all cigarettes or alcohol. BUT, the action must reduce their risk of relapsing to be effective, meaning that they do not just switch from hard alcohol like whiskey to the less alcoholic option of beer.
Overall, they are actively changing their addictive behaviour.
Stage 5: Maintenance
‘Stay on track’
The addict has already been abstinent for at least six months. Therefore, the focus is on relapse prevention, such as avoiding cues and situations that could lead to relapse, giving the addict confidence that their addiction will not return and that abstinence is a way of life for them.
The intervention involves the addict using the coping strategies they have learned and accessing the support available.
Stage 6: Termination
Abstinence becomes automatic
At this stage, abstinence is automatic and the person no longer return to addictive behaviours to cope with anxiety, stress or loneliness. It may not be realistic for everyone to reach this point
Intervention is not required at this stage
What are two strengths of the six stage model?
Dynamic process
Realistic view of relapse
EVALUATION: Dynamic process
Unlike previous approaches, this model does not consider recovery to be an all-or-nothing event. Time is a crucial component, and the recovery process never ends.
The six stages are always progressed through in the same order, however people can also skip stages or recycle in reverse. This shows that the stage model offers a realistic perspective on how difficult and complex addiction recovery is.
COUNTERPOINT TO IT BEING A DYNAMIC PROCESS
However the stages are arbitrary. Kraft et al says that they can be reduced to precontemplation plus the others grouped. This matters because stages are tied to interventions.
This suggests that Prochaska’s stage model has little usefulness both for understanding changes over time and for treatment recommendations
EVALUATION: Realistic view of relapse
Relapse is seen as a component of dynamic behaviour change rather than a sign of failure in the model since “relapse is the rule” (DiClemente et al.).
However, the model also considers relapse as a serious risk to change, since it may require multiple tries to reach maintenance/termination stages of recovery.
Because clients can perceive the model as realistic regarding relapse, it has face validity with them and is therefore easier to accept.
What is three limitations of the six stage model?
Contradictory research evidence
Description not prediction
Overestimates logic
EVALUATION: Contradictory research evidence
After doing a NICE review of 24 reviews and a meta-analysis, Taylor et al. came to the conclusion that the model wasn’t any more successful in treating nicotine addiction than other options.
They also came to the conclusion that the data at hand did not support the fundamental concept of clearly defined stages in behavioural change. This implies that, despite some people’s overly optimistic claims for the concept, the overall scientific picture is poor.
EVALAUATION: Description not prediction
Most research on the six-stage model describes the stages of recovery that people are in and relates them to treatment-seeking behaviour. However, this has not only produced mixed results but also suggests that the model is not a good predictor of behaviour change, which was its primary goal
