Prochaska's model

Question 1

Who devised the model?

Answer 1

Prochaska and DiClemente

Question 2

What does the six-stage model recognise/do?

Answer 2

• Recognises that overcoming addiction does not happen quickly or in linear order
• Quitting= cyclical process- progression through stages but return to previous ones too or may miss out some stages

Question 3

What 2 insights are the model based on?

Answer 3

1) People who are addicted differ in how ready they are to change their behaviour
2) Usefulness of treatment intervention depends on the stage the person is currently in

Question 4

What are the 6 stages of behavioural change?

Answer 4

1) Precontemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
6) Termination

Question 5

What is precontemplation?

Answer 5

• People in this stage do not think about changing their behaviours in the near future (perhaps due to denial or demoralisation- past attempts were unsuccessful)
• Intervention= focus on helping them consider the need for change

Question 6

What is contemplation?

Answer 6

• Person thinks about making a change in the next 6 months- no actual decision to change
• Aware of need for change but aware of the costs
• Intervention= help them see how the pros outweigh the cons

Question 7

What is preparation?

Answer 7

• Person believes that benefits are greater than costs so decide to change behaviour within the next month
• Not decided how or when
• Intervention= provide support in constructing a plan or presenting them with options

Question 8

What is action?

Answer 8

• Person has done something to change behaviour in the last 6 months (i.e. therapy)
• Action must substantially reduced risk of relapse
• Intervention= develop coping skills needed to quit and maintain behavioural change

Question 9

What is maintenance?

Answer 9

• Person has maintained some behavioural change for more than 6 months
• Focus on relapse prevention by avoiding triggering situations (cues)
• Confident that abstaining can be continued in the long term as it becomes a way of life
• Intervention= relapse prevention, help apply coping skills and use sources of support

Question 10

What is termination?

Answer 10

• Newly acquired behaviours become autatic
• Person no longer returns to addictive behaviours to cope with anxiety, stress of loneliness
• Most appropriate to prolong maintenance and accept that relapse is inevitable, but provide skills to work through earlier stages
• No intervention needed

Question 11

Strength-
I- Views recovery as a dynamic process

Answer 11

D- Earlier theories consider recovery an ‘all-or-nothin’ process. Model emphasises importance of time- overcoming addiction is a continual process. Proposes that change occurs through 6 stages of varying duration- there may be recycling or missing out stages
E= Suggests the model provides a realistic view of the complex/active nature of recovery

Question 12

Limitation-
I- Stages criticised for being arbitrary (based on choice)

Answer 12

D- No research evidence to distinguish stages. Kraft et al argues 6 stages can be reduced to 2: precontemplation and the others grouped together. Important implications as each stage is matched with unique interventions
E- Suggests little usefulness in understanding changes over time and for treatment recommendations

Question 13

Strength-
I- Positive view of relapse

Answer 13

D- DiClemente- relapse is the rule rather than the exception. Views relapse as an inevitable part of the untidy, non-linear, dynamic process of change, NOT as failure. Takes relapse seriously and does not underestimate its potential to bloew change enitrely off course. Recovery may take several attempts
E- Means the model has face validity and is more acceptable as it is realistic about relapse

Question 14

Limitation-
I- Contradictory research

Answer 14

D- Taylor et al conducted major review for National Institute for Health and Care Excellence (NICE) analysinf 24 reviews and meta-analyses of the model. Concluded it was no more effective than alternatives in changing nicotine-related behaviour. Key concept of defined behaviour change stages could not be validated by data
E- Suggests the overall picture is negative, despite optimistic claims

Question 15

Evaluation extra-
I- Model of behaviour change?

Answer 15

Strength- Change unfolds over time and depends on whether someone is ready to change. Assumes effective interventions move the client onto next stage by motivation. Without planned intervention, most stay stuck on current stage

Limitation- Not a model of behaviour change as clients move between stages regardless of whether behaviour changes first. Successful progression through first 3 stages without any behavioural change

E- Model may be more about the thought process at different stages, which may, or may not, be linked to useful intervention, rather than being a model of behaviour change