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Transtheoretical model of behavioral change

With my Health psychology book firmly in hand (7th edition by Shelley E. Taylor) I have been reviewing the cycle of behavioral change. I am not ashamed to admit, I often go back to my text books, and source materials, to refresh all of this information. I would rather take the time to re-read it, than post something that was a misinterpretation!

As we had discussed last time, there are good times for advice, and bad times. If we better understand the process of behavioral changes, we will better understand when our friends will accept support from us, and when our support might push them away.

Prachaska et al. (1992) originally developed the transtheoretical model of behavioral change. I know the name is a bit scary, but bear with me. It is simply the stages we go through to remove an unwanted behavior and adopt a new one. This is often a very long, and sometimes tedious process, as anyone who has successfully given up smoking, or alcohol might tell you. The important thing to keep in mind in this is that people often go from stage to stage, backwards and forwards. Sometimes people go from “I am ready to change,” to “change is too hard for me right now.”

For explanations using this model, we will talk about a person who smokes as they decide to give it up.

Without further ado, here are the components of the model.

1. Precontemplation – At this stage, a person sees no problem with their behavior. They also have no idea of the danger the behavior causes. So if someone was a smoker and you told them “hey that is bad for you!!” when they were in a precontemplative stage, they would be very likely to mistrust you. The smoking person may become defensive and simply ignore the other person giving this information, as it causes less dissonance to the smoker if they ignore this information than accept that they are hurting themselves. This is a dangerous stage to give advice to unless it is presented as educational. If it is shocking material, they will tend to disregard it.

2. Contemplation – This is the where stage a lot of people get stuck. They acknowledge the problem that they have, but they have not made a commitment to changing their behavior yet. For our smoking friend, it would be quite a challenge for them to start the process of giving up smoking as they see it as a large stressful event. At this stage, we do not need to inform them of the shocking ways they can die, but instead show our support for them in general.

3. Preparation – This is when a person has made up there mind that they will try to tackle this behavior. Often times, people relapse, and end up back in this position. Sometimes, a stressful event occurs and people have to manage it before they can deal with the stress of behavioral change. Our smoking friend may have just had a death in the family, and cannot deal with the added stress of giving up smoking, so we should simply wait for them to be clear of other major stressors. At this point, one can help their friends by asking their friends to make clearly defined goals. “What will your life be like when you overcome this obstacle?”

4. Action – This is when the individual begins to actually stop the behavior. This is a very stressful time, at least in the beginning. Our smoking friend is probably struggling to stay on track, but over time our friend gets more stabilized. It is at this time we can really talk about the terrible dangers of smoking, and we can talk about how their new life choices are going to make them live 30 years longer than if they had smoked. By showing them how positive their current behavior is, it really serves to empower them.

5. Maintenance – After the major withdrawals have come and gone, and the person has given up a particular behavior, they now must work to maintain it. This is more about consistency than anything else. Do not expose yourself to stimuli or environment that will lead you to those negative behaviors. Shape your home environment to support you new healthier lifestyle, etc. At this time, you can continue to discuss how their current positive choices have lead them to had a better quality of life.

Giving our support

When it comes to giving our support, we must see on which stage someone is. If we see someone is in preparation or action, the advice we give would be quite different than someone in precontemplation. It really does hurt to see our friends deny that something like smoking causes any health issues, and we have to hold our tongues. The best idea is to refer them to non-politicized educational information about what tobacco does without all of the shock and awe that is typical of the day. The best messages are ones that are not only informative, but also carry the message of empowering the user. “Not only is this behavior bad, but you have the power to rise above it. You are stronger than some minor addiction, and you can remove it from your life.”

Once again, there is not a one-size-fits-all message we can give to everyone to prevent the behaviors from occurring. By looking at the stages, we can get an idea of what type of information may be better than others. Remember – Advise responsibly!

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