Transtheoretical Integrative Process Model Theory (Core Model)
Transtheoretical Model (TTM) is synthesis within an integrative framework.
Progress in changing behaviours is made through the stages by implementing a series of 10 processes of change, as first identified in an analysis of different methods of psychotherapy.
The Model is an integrative model of behaviour change.
Key constructs from other theories are integrated.
The Core Model theory
The Transtheoretical model of change in health psychology explains or predicts a person's success or failure in achieving a proposed behaviour change, such as developing different habits.
It is a theoretical model of behaviour change, which has been the basis for developing effective interventions to promote health behaviour change.
The TTM has found that individuals move through series of five stages in the adoption of healthy behaviours or cessation of unhealthy ones.
These stages are as follows:
* precontemplation (PC),
* contemplation (C),
* preparation (PR),
* action (A),
* maintenance (M).
Processes of change provide important guides for intervention programs, since the processes are the independent variables that need to be engaged in, to move from stage to stage.
There are certain predictors of progression through the stages of change.
These predictors of progression are as follows:
* decisional balance;
* self-efficacy; and
* the processes of change.
The Transtheoretical Model proposes a set of constructs that form a multivariate outcome space and includes measures that are sensitive to progress through all stages.
These constructs include:
* the Pros and Cons from the Decisional Balance Scale,
* Self-efficacy or Temptation, and
* the target behaviour.
The Decisional Balance construct reflects the individual's relative weighing of the pros and cons of changing. It is derived from the Janis and Mann's model of decision making that included four categories of pros (instrumental gains for self and others and approval for self and others). The four categories of cons were instrumental costs to self and others and disapproval from self and others. Only two factors, the Pros and Cons, were found.
Stage related skills and strategies
The Stages of Change: The TTM explains intentional behaviour change along a temporal dimension that utilizes both cognitive and performance-based components. The phases do not follow a simple linear progression. Progress is developing by the spiral model, with relapses, regresses to previous stages.
The individual is making progress and losing ground, learning from mistakes made over time, and using those gains to move forward. 5 stages:
Pre-Contemplation: an individual is resistant or unmotivated, tends to avoid information, discussion, or thought with regard to the targeted health behaviour, has no intent to change behaviour in the near future usually measured as the next 6 months. He demonstrates lack of awareness that life can be improved by a change in behaviour.
Contemplation: an individual is ambivalent to change, being more aware of the benefits of changing, but remains keenly aware of the costs, openly intends to change behaviour within the next 6 months. He demonstrates recognition of the problem, initial consideration of behaviour change, and information gathering about possible solutions and actions.
Preparation (a transition): individuals intend to take steps to change, usually within the next month. They demonstrate introspection about the decision, reaffirmation of the need and desire to change behaviour, and completion of final pre-action steps.
Action: an individual has made overt, perceptible lifestyle modifications for fewer than 6 months. He demonstrates implementation of the practices needed for successful behaviour change (e.g. exercise class attendance).
Maintenance: work to prevent relapse and consolidate gains secured during A. Consolidation of the behaviours initiated during the action stage.
Termination. Former problem behaviours are no longer perceived as desirable (e.g. skipping a run results in frustration rather than pleasure).
Themes: a wide variety of simple and complex health behaviours, including smoking cessation, weight control, sunscreen use, reduction of dietary fat, exercise acquisition, quitting cocaine, mammography screening, and condom use.
A wide range of therapeutic interventions appropriate to the core model
The Processes of Change are ten cognitive and behaviour activities that facilitate change. The TTM uses the stages of change to integrate cognitive and behavioural processes and principles of change, including 10 processes of change, the benefits and costs of changing, and self-efficacy.
A therapeutic alliance, or helping relationships, combines: rapport building, caring, trust, openness and acceptance as well as support for the healthy behaviour change.
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