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Transtheoretical Model

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Transtheoretical Model

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    1. Transtheoretical Model Part One

    2. James O. Prochaska Director of the Cancer Prevention Research Center Professor of Clinical and Health Psychology at the University of Rhode Island

    3. Carlo DiClemente Professor and Chair, Department of Psychology, University of Maryland

    4. Transtheoretical Model (TTM) Biopsychosocial model of behavior change Represents an attempt to integrate key constructs and processes from a variety of behavior change models into one comprehensive model Its primary focus is on the mechanisms of intentional behavior change and the decision-making process

    5. Transtheoretical Model Views change as a process occurring over time rather than a discreet event Addresses dimensions relevant to change Presents a temporal progression for change Provides methods to determine when change occurs Identifies covert and overt activities that individuals use to change

    6. Transtheoretical Model Has been demonstrated to be applicable to a variety of problem behaviors Substance abuse Weight reduction High-risk sexual behavior Stress Management

    7. Dimensions of Change Stages of Change Key organizing concept in TTM Divides the process of change into distinct segments Defines stage specific tasks that need to be accomplished before movement is possible Processes of Change Internal and external experiences and activities Enable an individual to move through the change process

    8. Dimensions of Change Markers of Change Decisional balance Self-efficacy/temptation Context of Change Individual’s internal processes Environmental influences That either help or hinder movement through the change process

    9. Stages of Change Precontemplation Contemplation Preparation Action Maintenance

    10. Precontemplation Unaware or under aware that there is a problem Resignation Lack of control

    11. Precontemplation Tasks: Increase awareness of the need for change Increase concern about the current pattern of behavior Imagine the possibility of change Goals: Serious consideration of change for this behavior

    12. Contemplation Awareness that a problem exists Seriously thinking of overcoming it No commitment to take action

    13. Contemplation Tasks: Analysis of the pros and cons of current behavior Analysis of the costs and benefits of behavior change Decision-making Goal: A considered evaluation that leads to a decision to make some form of behavior change

    14. Preparation Intention to take action soon May have taken actions that were unsuccessful in past year May be taking small steps toward behavior changes

    15. Preparation Tasks: Increasing commitment to change Developing a change plan Goal: Implementing an action plan

    16. Action Modification of behavior Investment of time and energy into change Level of investment obvious to others

    17. Action Tasks: Implementing strategies for change Revising plan as needed Sustaining change Goal: New pattern of behavior established for 3 to 6 months

    18. Maintenance Works to prevent relapse Consolidates gains of action stages Long duration - possibly throughout one’s life

    19. Maintenance Tasks: Sustaining change over time and across a variety of situations Integrating the new behavior Avoiding slips and relapses back into old behavior patterns Goal: Long-term sustained change

    20. Stages of Change Precontemplation

    21. Measurement Tools For Stages of Change Readiness Ruler University of Rhode Island Change Assessment (URICA) Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES)

    22. Readiness Ruler

    23. URICA 32-item self-report inventory using a 5-point Likert scale Includes 4 subscales measuring stages of change Precontemplation Contemplation Action Maintenance

    24. URICA Norms available for adult alcohol out-patient treatment clients Tested for Internal reliability Content validity Construct validity Criterion validity

    25. SOCRATES 19-item self-administered inventory No norms are available Tested for Test-retest reliability Consistency reliability Construct validity Criterion validity

    26. References Connors, G. J., Dovovan, D. M., & DiClemente, C. C. (2001). Substance abuse treatment and the stages of change. New York, NY: Guilford Press. DiClemente, C. C. (2003). Addiction and change: How addictions develop and addicted people recover. New York, NY: Guilford Press. Substance Abuse and Mental Health Services Administration(SAMSHA). (1999) TIP 35:  Enhancing motivation for change in substance abuse treatment. Rockville, MD: SAMSHA. Prochaska, J.O., & DiClemente, C.C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 19(3), 276-287. Prochaska, J.O., DiClemente, C.C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102-1114. Velicer, W. F, Prochaska, J. O., Fava, J. L.,Norman, G. J., & Redding, C. A. (1998) Smoking cessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 38, 216-233.

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