Chapter 14: Maintenance of Mental Health Part 2

Question 1

List the 4 main forms of social support:

Answer 1

• Appraisal support
• Tangible assistance
• Informational support
• Emotional support

Question 2

What is appraisal support?

Answer 2

Help from another person that improves someone’s understanding of their mental health problem and the resources and coping strategies that may be needed to deal with it.

Question 3

What is tangible assistance?

Answer 3

The provision of material support, such as services, financial assistance or goods, that may help offset the effects of a mental health problem.

Question 4

What is informational support?

Answer 4

How to cope with a mental health problem, symptoms or contributory factors, provided by community groups and agencies.

Question 5

What is emotional support? Give an example:

Answer 5

Support provided by family, friends and the community.
Eg. Through expressions of empathy and by the reassurance that a person is cared for, valued and will be helped in any way required.

Question 6

What is the transtheoretical model of behaviour change, what is it also called, and what does it describe?

Answer 6

A stage-based model that describes and explains how people intentionally change their behaviour to achieve a health-related goal.

• Also called the stages of change model
• Describes health-related behaviour change as a complex process that takes place gradually over time through a sequence of stages that have to be passed successfully.

Question 7

LIst the 5 stages of the transtheoretical model of behaviour change:

Answer 7

1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance

Question 8

Give an example of why self-efficacy is considered an important influence in the transition from one stage to another in the transtheoretical model of behaviour change:

Answer 8

An individual’s perception of their ability to achieve their target behaviour.

Question 9

Describe the pre-contemplation stage of the transtheoretical model of behaviour change:

Answer 9

People in this stage are not ready to change and have no intention of taking any action to change or abandon a problem behaviour in the foreseeable future, a timeframe defined or operationalised as ‘within the next six months’. -They also tend to defend their problem behaviour.

• Generally, there is no intention to change because they do not view their behaviour as a significant problem, so there is a lack of motivation for change.
• The positives or benefits of the problem behaviour tend to outweigh any costs or adverse consequences so they are happy to maintain their behaviour and not make any change.

Question 10

What do individuals tend to need in order to move out of the pre-contemplation stage of the transtheoretical model of behaviour change:

Answer 10

• Need to experience a negative emotion or mood state in relation to their problem behaviour and its consequences.
• They must be prepared to acknowledge that their behaviour is problematical and feel some motivation to change.

Question 11

Describe the contemplation stage of the transtheoretical model of behaviour change:

Answer 11

When people reach this stage they think about the possibility of changing their behaviour.

• They tend to feel ambivalent, or have ‘mixed feelings’, about taking the next step. On the one hand their problem behaviour has its positives. On the other hand, they are starting to recognise some adverse consequences of the behaviour as well as their personal vulnerability to those consequences.
• People in this stage may also start seeking information on the negative effects of their behaviour as well as strategies for changing their behaviour.
• Weighing up the pros and cons in their cost–benefit analysis of making the change can cause them to remain in this stage for a long time without actually making any adjustments to their behaviour.

Question 12

Describe the preparation stage of the transtheoretical model of behaviour change:

Answer 12

Generally involves mental ‘preparation’ for the desired behaviour change by formulating intentions and an action plan for change.

• Intend to take action to ultimately abandon or change the problem behaviour ‘within the next 30 days’.
• They see the cons of behaviour change as continuing to outweigh the pros but they are less ambivalent about taking the next step.
• The stage may also involve preparation for change with behavioural activity involving small steps towards the desired behaviour change.
• Tend to believe that change is necessary and that the time for change is imminent
• Individuals are more likely to move to the next stage when they have a plan of action that they believe will work and if they feel confident that they can follow through with their plan.

Question 13

Describe the action stage of the transtheoretical model of behaviour change:

Answer 13

This stage is characterised by overt attempts to change or abandon the problem behaviour. It is apparent when the person is actually engaging in behaviour change or has adopted a new behaviour.

• Action requires considerable commitment of time and/or energy. Some people persevere more than others and may try several different techniques to achieve and maintain their desired change.
• When people have made a public commitment to change by telling others about their intention, they often receive a lot of support from their family and friends, which has a reinforcing effect.
• Despite the apparent commitment, ambivalence is still possible in this stage which can make the person vulnerable to setbacks, including relapse.

Question 14

What is relapse and what does the term lapse refer to?

Answer 14

When there is a full-blown return to the original problem behaviour.

• Is common in the action and maintenance stages. It is different from a lapse.
• A lapse is a slip up with a quick return to action (or maintenance).

Question 15

Describe the maintenance stage of the transtheoretical model of behaviour change (when is it reached, what is its focus, how do people cope):

Answer 15

Is reached when people have successfully sustained the changed behaviour over a relatively long period of time without relapse, typically for ‘six months or more’.

• The focus in this stage is on preventing relapse. People tend to receive less social support during this stage because they have already engaged in action, but support can still play a significant role in maintaining the new behaviour.
• Many people learn to anticipate and handle temptations and are able to employ new ways of coping. It is possible to have one or more temporary lapses, but this does not necessarily result in a failure to maintain behaviour change.

Question 16

When is termination reached?

Answer 16

When it is believed that the problem behaviour will never return, and the individual has complete confidence to maintain the new behaviour without fear of relapse.

Question 17

Describe 3 strengths of the transtheoretical model of behaviour change:

Answer 17

• Emphasises that behaviour change is a process that may occur gradually over time. Many of the previous ‘traditional’ models and theories viewed health-related behaviour change as a single event rather than a process.
• It takes account of individual differences. It recognises that different people are in different stages or states of readiness to make changes to their behaviour.
• Allows for minor and significant setbacks from which an individual may recover and re-engage with their change attempt. This is considered to be particularly important when considering addictive and other problematic behaviours for which relapse tends to be more common.
• It is also significat that the model was developed in the context of empirical research and has been tested through further research.

Question 18

Describe 3 of the limitations of the transtheoretical model of behaviour change:

Answer 18

• Has not been enough research on variables that influence stage transitions, which limits the usefulness of the model for treatment interventions.
• It has been questioned as to whether the stages encompass all necessary actions involved in behaviour change.
• Lack of research to justify the relevance or validity of time frames specified in the model for different stages.
• It has been questioned whether the stages are in the right order.
• Some have also suggested that the role of the individual’s decision making in the change process may be overstated and that the role of social and cultural influences may be understated.