Transtheoretical Model (TTM) of Behavior Change Principles Quiz

Transtheoretical Model (TTM) of Behavior Change

• The TTM views behavior change as a process that involves a series of stages, which correspond to an individual's readiness to change.
• The stages of change are:
  • Pre-contemplative: No intention to change behavior, unaware of consequences, or pros of maintaining current behavior outweigh the cons.
  • Contemplative: Acknowledging the need for change, intending to take action, but not ready to change.
  • Preparation: Getting ready to take action, developing a plan, and may have attempted change.
  • Action: Putting the plan into action, concrete steps toward change, and practicing new behavior.
  • Maintenance: Behavior change is incorporated into daily life, consistent over a long period, and less than 6 months is considered relapse.
  • Relapse: A setback, but an opportunity to learn and improve.
  • Termination: Complete behavior change, zero temptation, and 100% self-efficacy.

Application of TTM

• TTM has been applied to various behaviors, including:
  • Smoking cessation
  • Substance use
  • HIV risk reduction
  • Weight loss
  • Stress management

Staging Tool

• Used to determine the stage of readiness for change.
• Consists of questions that gauge clients' feelings, thoughts, and behaviors.
• Reflects what the client is being staged for, such as increased exercise, sexual risk reduction, or giving up cigarettes.

Stage-Based Counseling Strategies

• Pre-contemplative:
  • Consciousness-raising and education
  • Exploring beliefs about health/illness
  • Introducing the concept of a client-provider partnership
  • Storytelling and presenting case studies
• Contemplative:
  • Exploring ambivalence and pros/cons
  • Conducting discussions related to self-image and behavior
  • Identifying barriers to changing behavior
• Preparation:
  • Developing a plan and practicing skills
  • Developing a detailed schedule and planning for anticipated barriers
  • Linking clients with successful peers
• Action:
  • Continuing to assess and build skills
  • Tracking progress and rewarding success
  • Using helping relationships and making environmental changes
• Maintenance:
  • Developing contingency plans to prevent relapse
  • Planning for life transitions and extra support
  • Continuing rewards and recognition
  • Training clients as peer mentors

How Change Occurs

• Consciousness-raising
• Dramatic relief/emotional arousal
• Environmental reevaluation
• Social liberation
• Self-reevaluation
• Stimulus control
• Helping relationships
• Counter conditioning
• Reinforcement management
• Self-liberation

Precaution Adoption Process Model (PAPM)

• PAPM is similar to TTM, but with some differences in stages.
• PAPM identifies seven stages:
  • Unaware: Completely unaware of a health hazard.
  • Unengaged: Aware of the hazard, but not personally engaged.
  • Deciding: Facing a decision about acting.
  • Decided not to act: Decided not to take action.
  • Decided to act: Decision to act, but not necessarily correlating to action.
  • Action: Actively engaging in behavior change.
  • Maintenance: Continued behavior change.

PAPM Constructs

• Stage 1: Unaware
  • Individual is completely unaware of a health hazard.
• Stage 2: Unengaged
  • Aware of the hazard, but not personally engaged.
• Stage 3: Deciding
  • Facing a decision about acting.
• Stage 4: Decided not to act
  • Decided not to take action.
• Stage 5: Decided to act
  • Decision to act, but not necessarily correlating to action.
• Stage 6: Action
  • Actively engaging in behavior change.
• Stage 7: Maintenance
  • Continued behavior change.

Issues Likely to Determine Progress Between Stages

• Stage transition important issues:
  • Media messages about hazard and precaution
  • Communication from significant others
  • Personal experience with hazard
  • Beliefs about hazard likelihood and severity
  • Beliefs about personal susceptibility
  • Beliefs about precaution effectiveness and difficulty
  • Behaviors and recommendations of others
  • Perceived social norms
  • Fear and worry

Lead Time Bias

• Attributing the outcome of a condition to one's own actions, when in reality, the outcome would have occurred anyway.
• Example: Believing that getting a vaccine helped prevent a condition, when in reality, the condition would have been prevented regardless of the vaccine.