Transtheoretical model

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The Transtheoretical Model

The Transtheoretical Model (TTM, “Transtheoretical Model”) is a concept for describing, explaining, predicting and influencing intentional changes in behavior. The model developed by James O. Prochaska from the University of Rhode Island and his colleagues is based on the assumption that change processes go through several qualitatively different and successively building stages. This is why the transtheoretical model is also known as the “stages of change”. The model was based on different health behaviors, e.g. B. tobacco smoking, alcohol consumption, diet, physical activity / sports are adapted.

Stages of behavior change

In essence, the model postulates six stages of behavior change ("Stages of Change"):

  1. In the stage of non-intentional ("precontemplation") people have no intention of changing problematic behavior.
  2. In the intention-forming stage ("contemplation") people have the intention to change the problematic behavior at some point.
  3. In the preparation stage (“preparation”) people plan specifically to change their problematic behavior in the near future and take the first steps towards changing their behavior.
  4. In the “action” stage, people change their behavior.
  5. In the “maintenance” stage, people have given up problematic behavior for a long time.
  6. In the final stage (“termination”) the old behavior is permanently given up, the new behavior is internalized and is maintained.

The 6th stage is not included in the original literature by Prochaska and di Clemente. It was later added occasionally by other authors and is not equally useful for all fields of application (addiction, movement).

Change processes

Further includes TTM change processes ( "Processes of Change"), defined as activities and events that problematic behavior and related cognitions and emotions influence and change. The change processes enable and promote the passage through the stages of willingness to change, i.e. that is, they describe how people progress from one stage to the next.

We identified ten processes of change along two dimensions as related to the experience, cognitive- affective be categorized processes ( "Cognitive-Affective Processes") and behavioral processes ( "Behavioral Processes").

The five cognitive-affective processes are

  • "Increasing awareness of the problem" ("Consciousness Raising"),
  • "Emotional experience" ("Dramatic Relief"),
  • "Re-evaluation of the personal environment" ("Environmental Reevaluation"),
  • “Self-Reevaluation”, and
  • "Perception of beneficial environmental conditions" ("Social Liberation"),

which are five behavioral processes

  • " Counterconditioning " ( "counterconditioning")
  • "Control of the environment" ("Stimulus Control"),
  • "Using Helping Relationships",
  • "(Self-) reinforcement " ( "Reinforcement Management"), and
  • “Self-Liberation”.

In addition to the stages and processes the model contains the decision balance ( "decisional balance") and the self-efficacy ( "Self-efficacy"). The decision balance addresses the perceived advantages (“pros”) and disadvantages (“cons”) of a change in behavior. The expectation of self-efficacy describes, on the one hand, the confidence ("Confidence") to be able to exercise a desired behavior in difficult situations, and on the other hand, the temptation ("Temptation") to show the undesired behavior in difficult situations.

Three general types of temptation situations can be distinguished, namely situations with positive affect or social situations ("Positive Affect / Social Situations"), situations with negative affect or emotional stress ("Negative Affect Situations"), and habitual situations or habit ("Habitual / Craving Situations ").

In the TTM, characteristic processes are postulated for the change processes, the advantages and disadvantages, as well as the expectation of self-efficacy across the stages of willingness to change. Cognitive-affective processes are particularly important in the early stages of change, behavioral processes are particularly important in the later stages of change. Across the levels, the weighting of perceived positive action outcome expectations increases, whereas the weighting of negative aspects of a change in behavior decreases. This means that there is a positive balance in favor of the perceived benefits of changing behavior. The point in time at which the negative-positive relationship is reversed is approximately after the 3rd phase (preparatory phase). So in the transition from pre-action to action. The temptation should decrease continuously from the stageless to the maintenance stage, the confidence should increase accordingly.

The TTM has undergone extensive empirical testing in numerous scientific studies . The usefulness and practicability of the model could also be proven through intervention studies (especially on tobacco smoking).

literature

  • CC DiClemente, JO Prochaska, SK Fairhurst, WF Velicer, MM Velasquez, JS Rossi: The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. In: Journal of Consulting and Clinical Psychology. 59 (2), 1991, pp. 295-304.
  • F. Faselt, S. Hoffmann: Transtheoretisches Modell. In: S. Hoffmann, S. Müller (Ed.): Health marketing: health psychology prevention . Hans Huber, Bern 2010, ISBN 978-3-456-84801-3 , pp. 77-88.
  • S. Keller (Ed.): Motivation to change behavior. The Transtheoretical Model in Research and Practice . Lambertus, Freiburg 1999, ISBN 3-7841-1195-5 .
  • JO Prochaska, WF Velicer: The transtheoretical model of health behavior change. In: American Journal of Health Promotion. 12, 1997, pp. 38-48.
  • JO Prochaska, WF Velicer, CC DiClemente, J. Fava: Measuring processes of change: applications to the cessation of smoking. In: Journal of Consulting and Clinical Psychology. 56 (4), 5, 1988, pp. 520-528.
  • WF Velicer, C. DiClemente, JO Prochaska, N. Brandenburg: Decisional balance measure for assessing and predicting smoking status. In: Journal of Personality and Social Psychology. 48 (5), 1985, pp. 1279-1289.
  • WF Velicer, CC DiClemente, JS Rossi, JO Prochaska: Relapse situations and self-efficacy: An integrative model. In: Addictive Behaviors. 15, 1990, pp. 271-283.
  • WF Velicer, JL Fava, JO Prochaska, DB Abrams, KM Emmons, JP Pierce: Distribution of smokers by stage in three representative samples. In: Preventive Medicine. 24, 1995, pp. 401-411.
  • WF Velicer, JO Prochaska, JL Fava, GJ Norman, CA Redding: Smoking cessation and stress management: applications of the transtheoretical model of behavior change. In: Homeostasis. 38 (5-6), 1998, pp. 216-233.

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