Models Of Behaviour Change Flashcards
What are the two models of behaviour change??
- Theory of planned behaviour
- Prochaska’s six stage model
What does the theory of planned behaviour believe??
The theory of planned behaviour was developed by Azjen and Fishbein in 1967
It is a cognitive theory that assumes that thoughts influence behaviour.
The theory assumes that behaviour is under conscious control.
The conscious plan to do something is called a Behavioural intention
Azjen and Fishbein believe that behavioural intention directly predicts behaviour.
What are the three factors that influence intention?? For theory of planned behaviour
So someone who intends to give up smoking will actually give up.
Azjen and Fishbein, believe that three factors that influence intention.
- attitudes
is a positive or negative evaluation of the behaviour, combined with a belief about the outcome. - subjective norms
are perceptions of what other think/do, and whether they want to conform or not to those norms i,.e whether they want to be like the group or not. - perceived behavioural control
is the belief the person has about how much they can control their own behaviour. The more control people think they have the stronger their intention to perform the behaviour will be.
They will try more and persevere for longer-so will be more successful than people who perceive themselves as not having much control.
What is intention for theory of planned behaviour??
Intention is how likely they will carry this behaviour out.
This leads on to behaviour-this will be a behaviour which will create change if their intention is high.
What are the positive evaluations of theory of planned behaviour???
- There is research evidence to support the TPB as a model of behavioural change. Hagger et al 2011 Tested TPB with regards to alcohol related behaviours, with 486 employees from Estonia, Finland, Sweden and UK. They found 3 factors - personal attitudes, subjective norms & perceived behavioural control all predicted behavioural intentions to limit alcohol intake . The best predictor was perceived behavioural control.
Oh & Hsu (2001) also did research using a questionnaire to assess gamblers’ behavioural intentions, attitudes, subjective norms and perceived behavioural control and found a positive correlation between attitudes and behavioural intentions and actual behaviour change, supporting the TPB
This suggests that the models it has been used as predictor for behaviour and has been shown to have a correlation between intention and behaviour.
What are the negative evaluations for theory of planned behaviour???
- The TPB is considered an effective and economical way tackle addiction instead of drug treatments.
As therapeutic interventions are becoming more popular as ways of resolving issues like addiction this model has been more widely used in the health service to help people recognise, predict and change their attitudes, and help increase perceived control to overcome their addictions
This could imply that using TBP could be a better and more cost effective way to help people with addictions by avoiding the need for medication that is both expensive and can have lasting side effects - The research into TPB is solely correlational and cannot identify causal relationships.
For instance, researchers may well find perceived behavioural control links to addictive behaviour, but both of these issues may be a product of dispositional factors
For example, Impulsivity and traits such as sensation-seeking, may cause some addictions NOT perceived low control causing addictions.
This means the research into TPB can not provide a scientific way to identify the best way to overcome addictions as a general law. - The TPB has been criticised for being too rational, failing to take into account emotions, compulsions or other irrational determinants of human behaviour (Armitage 1999).
When filling out a questionnaire about attitudes and intention, people may find it impossible to anticipate the strong desires and emotions that compel their behaviour in real life. The presence of strong emotions may help to explain why people sometimes act irrationally by failing to carry out an intended behaviour (e.g. stop drinking) even when it is in their best interest for them to do so (Alberracin, 2008)
This doesn’t fully explain why people make a change in their behaviour, and can only be applied to some situations surrounding addiction.
What does Prochaska’s six stage model believe??
Prochaska’s model does not view change as a ‘single event’ but emphasises the Gradual nature of change. I.e., it’s a process!
The model includes ‘pre-action’ and ‘post-action’ stages and is cyclical: individuals move up through the stages in order, BUT relapse to a prior stage might occur at any point.
The final stage (termination) was added to allow for the fact that individuals can actually break out of the cycle and be free of the undesirable behaviour.
What is the 1st stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 1. PRE-CONTEMPLATION
DESCRIPTION
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.
TECHNIQUES TO MOVE THE INDIVIDUAL ON FROM THIS STAGE
Explain and personalise the risk; Encourage re-evaluation of current behaviour; Clarify: decision must be theirs.
WHAT MIGHT SOMEONE IN THIS STAGE SAY?
I am ok right now!!!!
What is the 2nd stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 2. CONTEMPLATION
DESCRIPTION
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.
TECHNIQUES TO MOVE THE INDIVIDUAL ON FROM THIS STAGE
Encourage evaluation of pros and cons of behaviour change;
Identify and promote new, positive outcome expectations.
WHAT MIGHT SOMEONE IN THIS STAGE SAY?
I will change tomorrow!
What is the 3rd stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 3. PREPARATION
DESCRIPTION
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.
TECHNIQUES TO MOVE THE INDIVIDUAL ON FROM THIS STAGE
Help individual identify social support; Verify that individual has underlying skills required for behaviour change to occur; Encourage small initial step.
WHAT MIGHT SOMEONE IN THIS STAGE SAY? It is happening next month! For sure!
What is the 4th stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 4. ACTION
DESCRIPTION
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.
TECHNIQUES TO MOVE THE INDIVIDUAL ON FROM THIS STAGE
Focus on restructuring cues and social support; Bolster self-efficacy for dealing with obstacles; Combat feelings of loss and reiterate long-term benefits.
WHAT MIGHT SOMEONE IN THIS STAGE SAY? I’ve done it - I’ve stopped!
What is the 5th stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 5. MAINTENANCE
DESCRIPTION
Maintenance strategies are employed, such as recognising the benefits of adopting the 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 situation; Reviewing a list of negative aspects of the problem regularly can help with motivation.
TECHNIQUES TO MOVE THE INDIVIDUAL ON FROM THIS STAGE
Plan for follow-up support; Reinforce internal rewards; Discuss coping with relapse.
WHAT MIGHT SOMEONE IN THIS STAGE SAY? I’ve still stopped!
What is the 6th stage of the Prochaska’s model and what might the techniques be for this stage and what might someone in this stage say???
STAGE 6. TERMINATION
DESCRIPTION
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.
WHAT MIGHT SOMEONE IN THIS STAGE SAY?
I can’t believe I did that for so long - crazy!
What are the positive evaluations of Prochaska’s six stage model???
- There is evidence to support Prochaska’s model of behavioural change and is usefulness as a way of facilitating behaviour change (e.g. to recover from addiction).
For example, Velicer et al 2007 conducted a meta analysis of 5 studies and found that there was a robust 22–26% success rate for reducing addictive behaviours using this model. There were no demographic differences in success rate (e.g. age & gender ) BUT success was dependent on the smoking habits (e.g. frequency)
This suggests that this model has been a key feature in helping therapists structure programmes to support behaviour change using the information in the model - The model has clear practical applications as it has led to measures being developed For example, 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 think more about moving on to act on to actually start committing to the decisions Whereas someone in the action phase may be helped to move to the maintenance stage to help stop relapse.
This is a clear strength because help can be tailored to help the client move onto the next stage as the model is flexible and reflects the changing attitudes and intentions of individuals regarding their condition, as well as reducing stigma and feelings of failure by normalising relapse.
What are the negative evaluations of Prochaska’s six stage model???
- However, other research refutes these findings about Prochaska’s model.
For example, Aveyard et al. (2009) found no increase in effectiveness if an intervention was tailored to the stages of change to the individual trying to stop smoking.
This clearly contradicts the evidence found by Velicer et al. (2007) and suggests aspects of the model may be UNRELIABLE so we cannot be sure that evidence suggesting the model can be used to change behaviour, actually works. - A weakness of Prochaska’s stage model is that the divisions between the stages may not be as clear cut as suggested by Prochaska.
Littell and Girvin, 2002 suggests that the stages are not mutually exclusive and that there is limited evidence of sequential movement through the stages in studies of specific problem behaviours such as smoking and substance abuse.
This implies that the ‘stages’ identified seem vague and difficult to distinguish, especially the boundary between contemplation and preparedness, which can make it difficult to tailor interventions which questions the validity of the model. - Prochaska’s model may be affected by cultural relativism, making it difficult to view it as a universal theory of behaviour change.
Daoud et al (2015) found that in Arab cultures, social smoking as a ritualised part of formal occasions, made it more difficult for people to quit.
62% of a sample of male smokers were still in the precontemplation stage and only 14% in the preparation stage, compared with studies in the US and Europe which have found averages of 40% in precontemplation and 20% in preparation.
These findings indicate that the ability to move forward through the stages identified by Prochaska may be influenced by the social norms of a given culture so these stages could not be applied universally.
