Transtheoretical Model (TTM) Flashcards
Transtheoretical Model (TTM)
- aka?
- originally developed to?
“Stages of Change” Model
to treat addictive disorders
TTM
- includes several different constructs (4)
- assesses individual’s readiness to act on healthier behavior & provides strategies (processes of change) to guide them through stages of change
1) Stages of Change - dependent variable
2) Decisional Balance
3) Confidence vs. Temptation
4) Processes of Change
1) Stages of Change
specifies that individuals move through (5) stages of change
1-3 → pre-action
4-5 → post-action
- people are assumed to move through stages in order but may relapse to earlier stage*
- this stage model is conceptualized as a spiral since relapse is a rule rather than an exception*
- may cycle through stages several times before achieving long-term behavior change
2) Decisional Balance
aka pros & cons
- percieved advantages & disadvantages of changes one’s behavior
- decisional balance shifts in critical ways as individuals progress through stages of change*
3) Confidence
- define
- similar to?
- related construct?
similar to Bandura’s construct → self-efficacy (SE)
refers to confidence that one can carry out recommended behavior across range of potentially difficult situations
related construct = temptation
3) Confidence
- related construct → Temptation
- refers to?
refers to temptation to engage in unhealthy behavior across range of difficult situations
4) Processes of Change
covert & overt activities that people engage in to progress through stages of change
- result in strategies that help people make & maintain change
4) Processes of Change
* divided into (2) groups
Experiential
Behavioral
4) Processes of Change → Experiential (5)
cognitive-affective processes
a) Consciousness raising
b) Dramatic Relief
c) Environmental Reevaluation
d) Social Liberation
e) Self Reevaluation
4) Processes of Change → Experiential
a) Consciousness raising
increasing awareness of facts/ideas/tips that support healthy behavior change
& of causes/consequences/cures for problem behavior
Interventions: feedback, information/education
1-2
4) Processes of Change → Experiential
b) Dramatic Relief
experiencing negative emotions that accompany unhealthy behavioral risks
Intervention(s): provide fear-arousing feedback on risks & success stories to move people emotionally
1-2
4) Processes of Change → Experiental
c) Environmental Reevaluation
Assessing positive/negative impact of healthy/unhealthy behavior on one’s social/physical environment
- realizing negative effect of behavior & positive impact of change on others
1-2
4) Processes of Change → Experiential
d) Social Liberation
Realizing that social norms are supportive of healthy behavior change
- requires existing environmental opportunities that show society is supportive of healthy behavior change
1-2
4) Processes of Change → Experiential
e) Self Reevaluation
Realizing behavior change is important part of one’s identity (who they want to be)
- cognitive & affective assessments of self-image with & without unhealthy behavior
Intervention: identify healthy role models, imagery
2-3
Process of Change → Behavioral (5)
a) Stimulus Control
b) Helping Relationships
c) Counter Conditioning
d) Reinforcement Management
e) Self Liberation
Process of Change → Behavioral
a) Stimulus Control
removing cues for unhealthy habits & adding prompts for healthier alternatives
- changing environment to support healthy behavior
Intervention(s): provide recommendations
4-5
Process of Change → Behavioral
b) Helping Relationships
Seeking & using social support for healthy behavior change
Intervention(s): buddy system, supportive calls, rapport building
3-5
Process of Change → Behavioral
c) Counter Conditioning
learning healthier alternative behaviors & cognitions as substitutes for unhealthy behavior
3-5
Process of Change → Behavioral
d) Reinforcement Management
Increase rewards for healthy behavior changes & decrease rewards for unhealthy behaviors
4-5
Process of Change → Behavioral
e) Self Liberation
making firm commitment to change & beleiving that one can change
3-4
Strategies (Processes of Change) most effective at which stages of change?
→ Experiential
a) Consciousness raising
b) Dramatic Relief
c) Environmental Reevaluation
d) Social Liberation
e) Self Reevaluation
a, b, c, d → 1-2
- consciousness raising, dramatic relief, env reeval, social lib
e → 2-3
- self-reeval
Strategies (Processes of Change) most effective at which stages of change?
→ Behavioral
a) Stimulus Control
b) Helping Relationships
c) Counter Conditioning
d) Reinforcement Management
e) Self-Liberation
e → 3-4
b, c → 3-5
a, d → 4-5
Stages of Change (5)
1) Pre-Contemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
1) Pre-Contemplation
* (4)
NO intention to change behavior
may be unaware they have a problem
may seek help
- usually only if pressured by others or feel coerced into changing behavior
Poor targets for intervention
2) Contemplation
* (3)
→ this stage can last years
aware problem exists but not yet committed to take action
still weighing pros & cons
those who decide to change behavior have typicially formed favorable expectations about ability to do so & rewards that will result (SE & outcome expectancies)
3) Preparation
* (2)
individuals intend to change behavior but haven’t done so
may have already modifed target behavior but not yet committed to eliminate behavior completely
4) Action
* (3)
stage in which individuals modify behavior to overcome problem
requires commitment of time & energy
includes stopping behavior & modifying lifestyle/environment to eliminate cues associated with unhealthy behavior
5) Maintenance
* (2)
working to prevent relapse & consolidate gains made
In this phase if 6+ months free of addictive unhealthy behavior
Stage Model conceptualized as a Spiral
- explain?
because relapse is the rule rather than the exception
may cycle through stages several times before achieving long-term behavior change
Application of TTM
TTM suggests that particular interventions are more valuable during certain stages in helping them move to next stage
#1 - Pre-contemplation: providing info about problem (consciousness raising)
#2 - Contemplation: induce assessment of feelings & thoughts about problem (dramatic relief)
#3 - Preparation: get people to make explicit commitment to when/how they will change behavior (self-liberation)
#4 - Action: self-reinforcement (reinforcement management), social support (helping relationships), stimulus control & coping skills (counter conditioning)
Stages of Change → 1) Pre-Contemplation
- Intervention Techniques (4)
- validate lack of readiness
- clarify: decision is theirs
- encourage re-evaluation of current behavior & self-exploration
- explain & personalize risk
Stages of Change → 2) Contemplation
- Intervention Techniques (4)
- validate lack of readiness
- clarify: decision is theirs
- encourage evaluation of pros & cons of behavior change
- identify & promote positive outcome expectations
Stages of Change → 3) Preparation
- Intervention Techniques (4)
- identify & assist in problem-solving (obstacles)
- help identify social support
- verifyt individual has underlying skills for behavior change
- encourage small initial steps
Stages of Change → 4) Action
Intervention Techniques (3)
focus on restructuring cues & social support
strengthen SE for dealing with obstacles
resist feelings of loss & reiterate long-term benefits
