Lecture 7 Transtheoretical Model (TTM) exam with 100% correct answers.

Why was the transtheoretical model originally developed? To better understand smoking cessation Also known as stages of change model or stages of motivational readiness for change model Why it is called transtheoretical? Because concepts are derived from different theories explaining human behaviour and beliefs of how to modify behaviour What are the core constructs of the TTM? 1)Stages of change (5 steps) 2)Process of change (10 processes) 3)Decisional balance (pros/cons) 4)Self-efficacy (confidence/temptation) What is the stages of change construct? Looks at the various stages people go through during behaviour change -Helps us understand the process of behaviour change Behaviour change involves progress through 5 steps -Assess person's readiness to change (occurs overtime and not a finite process) What are the 5 stages of change? 1)Precontemplation 2)Contemplation 3)Preparation 4)Action 5)Maintenance What is involved in the precontemplation stage? Person has little or no intention of changing current behaviour pattern in the near future Involves those who are unaware of risk and those who are aware of risks but not considering change What assessment is commonly seen during the precontemplation stage? "I have not thought about changing or have no intention to change now" -Not thinking of changing in within next 6 months What are the goals commonly seen during the precontemplation stage? Get patient to seriously consider changing behaviour Help patient develop reason for changing What are the change techniques commonly seen during the precontemplation stage? Give personalized info about the problem and consequences to increase awareness of need to change Modify social and physical environment to support change What is involved in the contemplation stage? Aware that a problem exists and seriously thinking about overcoming it but not made a firm commitment to take action Person weighing potential for change in a risk-reward analysis Can get stuck in ready mode What assessment is commonly seen during the contemplation stage? "I intend to start exercising within the next 6 month timeframe" What are the goals commonly seen during the contemplation stage? Motivate and increase confidence in ability to change What are change techniques commonly seen during the contemplation stage? Analysis of pros and cons of current behaviour pattern/changing Discussing barriers to change Increase confidence in ability to change What is involved in the preparation stage? Person makes commitment to take action in the next month and develops a plan and strategy for change May have already taken steps toward action (increasing or decreasing frequency of target behaviour) Shortest stage (lasts 1 month vs 6 months in other stages) What assessment is commonly seen in the preparation stage? "I intend to start exercising this week" What goal is commonly seen in the preparation stage? Negotiate an action plan to be implemented in the near future What change techniques are commonly seen in the preparation stage? Praise decision to change Set realistic goals Recommend a plan Provide options Identify and assist in problem solving (i.e. obstacles) Follow up with patients What is involved in the action stage? Person implements plan and takes steps to change current behaviour pattern and begins to create a new behaviour pattern What assessment is commonly seen in the action stage? "I have started exercising in the last 6 months" What goals are commonly seen in the action stage? Reaffirm commitment and follow up What change techniques are commonly seen in the action stage? Reaffirm plan Schedule follow-up visit Revise plan as needed Sustain commitment Reduce temptations Mobilize support What is involved in the maintenance stage? New behaviour pattern is sustained for extended period of time and consolidated into person's lifestyle Doesn't mean patient can't regress but may be less tempted to relapse and more confident if doing behaviour for more than 6 months What assessments are commonly seen in the maintenance stage? "I have been exercising regularly for 1 year" What goals are commonly seen in the maintenance stage? Encourage active problem-solving to prevent relapse What change techniques are commonly seen in the maintenance stage? Same as action: Encourage solutions to potential problems Reinforce internal rewards Discuss coping with relapse What is movement through the stages described as? Cyclic vs linear -Many individuals do not succeed in efforts at starting and sticking with lifestyle changes --> move back and forth between stages -Many cycles necessary to succeed in changing habit -Can digress even if have reached maintenance stage (most people do) How fast can someone move through the different stage? Speed of transition varies Is it possible to skip a stage? Yes but less likely to succeed What are the reasons for relapse? Stressors/major life events Triggers Low self-efficacy What is the decisional balance core construct of the TTM? Reflects individual's relative weighing of pros and cons of changing target behaviour Varies by stage of change Pros should be higher than cons to move into action stage What is the "self-efficacy" core construct of TTM? *Situation specific confidence that one can cope w/high risk situations w/out relapsing to unhealthy or high risk behaviour" What is temptation in terms of TTM? The intensity of urges to engage in a specific habit when in the midst of difficult situations such as: -Negative affect or emotional distress -Social occasions -Cravings