Stages of Change – Transtheoretical Model – Flashcards
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Common Questions
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- Have you tried to change a behavior that may be considered problematic? - How did you feel about this process? - Were you successful?
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Stages of Change Definition
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Behavior change is conceptualized as a process that unfolds over time and involves progression through a series of five stages: precontemplation, contemplation, preparation, action, and maintenance.
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Transtheoretical Model
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A model of intentional change. It is a model that focuses on the decision-making of the individual.
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Authors
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James Prochaska & Carlo DiClemente
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Historical Relevance
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Produced during smoking cessation study at University of Rhode Island
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Why?
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New direction for health promotion
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Focus
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Promoting wellness through changing problematic health behaviors
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Problematic Health Behaviors
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- People with problem behaviors - Applied to changing health behaviors - All of these behaviors have important health or mental consequences
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Stages of Change Steps
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- Precontemplation - Contemplation - Preparation - Action - Maintenance
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Stages of Change Steps direction
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Can progress, relapse, or move backwards or forwards depending on barriers and supports
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1. Precontemplation
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- No intention to change behavior in the foreseeable future - Individuals are unaware or underaware of their problems - Often seek help due to pressure from others - The goal for client in this stage is to begin to think about changing a behavior
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Role of OT during Precontemplation
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That of a nurturing parent
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Behavior of OT during Precontemplation
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- Ask questions - Reflect with empathy - Don't jump in & provide advice - Don't be (or appear) judgmental - Gently point out discrepancies between goals and statements
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Question OT could ask during Precontemplation
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"What warning signs would let you know that this is a problem?"
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2. Contemplation
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- Stage wherein individuals are aware that a problem exists - Struggle with dysfunctional behavior - Individual is ambivalent about changing - Giving up enjoyable behavior causes them to feel a sense of loss despite perceived gain
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Role of OT during Contemplation
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Socratic teacher
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Behavior of OT during Contemplation
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- Develop & maintain a positive relationship - Personalize risk factors - Pose questions that provoke thoughts about patient risk factors and the perceived "bottom line"
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Question OT could ask during Contemplation
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"What are the barriers today that keep you from change?"
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3. Preparation
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- Individuals prepare to make a specific change - Experiment with small changes - Determination increases - Shifting into more decisive action
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Role on OT during Prepration
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experience coach
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Behavior of OT during Preparation
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- Encourage them to address the barriers to full-fledged action - Continue to explore ambivalence - Strategies should shift from motivational to behavioral skills - Provide resources - Help create routines - Modify environments
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4. Action
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- Individuals modify their behavior, experiences, and/or environment to overcome their problems. - Individual has successfully altered dysfunctional behavior for period of 1 day to 6 months. - Any action taken by clients should be praised because it demonstrates the desire for lifestyle change.
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Role of OT during Action
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consultant
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Behavior of OT during Action
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- Continue to ask about successes and difficulties - Be generous with praise and admiration
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5. Maintenance/Relapse
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- Incorporating the new behavior "over the long haul" - Discouragement over occasional slips may cause clients to give up - Most clients find themselves "recycling" through these stages of change several times before the change is truly established
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Role of OT during Relapse
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consultant with expert advice
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Behavior of OT during Relapse
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- Continue to ask about successes & difficulties, & be generous with praise & admiration - Encourage advancing through the stages again rather than giving up - When they relapse, which stage did they go back to?
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Assessment
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- URICA - SOCRATES - Motivational Interviewing - Assess the clients readiness for change with the Readiness to Change Ruler - Assess the client's stage of change - Tailor relationships and interventions accordingly
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Intervention
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- Usually performed by (but not limited to!) mental health professionals - Tailor/match treatment to the client's stage of change - Interventions may be subjective to each patient to enhance success - Often used in correlation with Cognitive Behavioral Therapy
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Strengths
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- Proven useful in adapting and tailoring treatment to the individual - Applicable to any individual with a problem behavior - Promotes health
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Limitations
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- The majority of published research concerns health behaviors and addictive disorders - Not specific to occupational therapy - Model does not explicitly incorporate environmental factors
