The Psychology of Behavioral Change

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The Psychology of Behavioral Change

• Isabel E. Melgar, PhD
• Executive Director
• Ateneo Wellness Center
• Faculty, Dept. of Psychology
• Ateneo de Manila University

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Overview

• Usual framework of change
• Models of change
• Stages of change
• Processes of change
• Self efficacy
• Clinical implications

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Dyad Exercise

• One positive change that happened in your life in
  the past three (3) years

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The Usual Framework of Change
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Old Framework assumes that

• Behavior change only has to happen once
• People change at the same time
• Others determine the decision to change not the
  people wanting change
• Relapse is a failure
• Rarely focused on interaction between knowledge,
  attitude, behavior and practices

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Health Belief Model(Becker Rosenstock)

• Perceived susceptibility
• Perceived severity
• Perceived benefits
• Perceived barriers

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Theory of Reasoned Model(Ajzen Fishbein)
NORMS
Behavior is determined by intentions Intention
is influenced by subjective norm and attitude
toward the behavior
ATTITUDES
INTENTION
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The Theory of Planned Behavior

• In addition to attitudes and norms, intentions
  are influenced by perceived behavioral control

Dyad. Think of the immediate future. A habit you
want to change
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The Stages of Change(DiClemente Prochaska,
1982)
Precontemplative
Contemplative
Action
Maintenance
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• Pre-Contemplative Stage

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• Contemplative Stage
• A person starts thinking about change

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Preparation Stage

• The person prepares to undertake change by
• Gathering information
• Finding out how to achieve change
• Learning skills
• Consulting other people

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Action Stage

• Making change
• Modifying behavior

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Maintenance Stage

• Once behavior is familiar and occurs without
  requiring active thinking, it can be said that
  behavior is maintained.

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The Revolving Door Model of the Stages of Change
ADDICTION-FREE
Action
Maintenance
Contemplation
Relapse
Enter here
ADDICTED LIFE
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The Common Exits From The Stages of Change
ADDICTION-FREE
Exit 1 Choosing not to Change
Exit 2 No desire
Action
Maintenance
Contemplation
Relapse
Exit 3 Avoid further failure
Enter here
ADDICTED LIFE
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Stages of Change as a Curve
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The Ongoing Spiral of Behavior Change
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The Full Spiral of the Stages of Behavior Change
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HOW PEOPLE MOVE THROUGH THE BEHAVIOR CHANGE SPIRAL
DYAD. What were the motivating factors that
helped bring about change? Record 2 3
words to summarize motivators
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Processes Influencing Movement Through The Stages
of Change
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Precontemplation - Contemplation
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Contemplation - Preparation
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Preparation - Action
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Action - Maintenance

• Helping Relationships
• Reinforcements
• Seeing other options
• Being in control
• Social Support

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The Role of Self-Efficacy Beliefs(Bandura)

• Self-efficacy is
• Situation specific
• Confidence that one can perform necessary
  behaviors
• To produce desired outcomes

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Efficacy Beliefs

• Affect the intentions to change behavior
• Affect amount of effort to attain goal
• Affect persistence to continue in spite of
  barriers and setbacks

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Smoking and Self-Efficacy Findings

• Quitting requires optimistic beliefs
• Efficacy beliefs to resist temptations to smoke
  predict reduction of cigarettes and the amount of
  tobacco per smoke
• Pretreatment efficacy does not predict relapse
  but post-treatment does

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Which is the best predictor of intention to smoke
less or to quit?

• Past behavior
• Risk perception
• Self-efficacy beliefs

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Types of Self-Efficacy (Marlatt et. Al.)

• Resistance self-efficacy
• Harm reduction self-efficacy
• Action self-efficacy
• Coping self-efficacy
• Recovery self-efficacy

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Self-efficacy affects every phase of change
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Bandura (1991) noted that, Entrenched habits
rarely yield to a single attempt at
self-regulation. Success is usually achieved
through renewed effort following failed attempts.
Human attainment, therefore, necessitates a
resilient since of personal efficacy.
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Clinical Implications

• SE theories can guide treatment
• SE ratings can be used to identify clients at
  greater risk for difficulty
• SE judgements can assess which particular times
  or places pose high risk

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PERCEIVED SELF-EFFICACY
OUTCOME EXPECTANCIES
RISK PERCEPTIONS
GOALS INTENTIONS
ACTION PLANS
ACTION CONTROL
HEALTH ACTION
EXTERNAL BARRIERS AND RESOURCES
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Prediction of the Intention Not To Smoke or To
Smoke Less