Employing the Transtheorectical Model to Transform Behavior:

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Employing the Transtheorectical Model to
Transform Behavior

• A Tool Box for Change Agents

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Objectives

• Understand the usefulness of the stages of change
  as a change agent.
• Understanding the process of change involved for
  each stage of change.
• Practical applications or techniques of the
  processes involved in the stages of change.

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Stages of Change

• Theory of how change takes place
• Asserts that for change to occur people will go
  through defined
• stages and that these stages are common to
  everyone. This
• theory purports to underlie all other
  psychological theories
• in explaining how people change. It is not a
  developmental or
• psychological theory. It is how change takes
  place in people
• once our personalities are formed.

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Brief Review of the Five Stages

• Stage 1 Pre-contemplation Acknowledging the
  Problem
• Stage II Contemplation Resolving Ambivalence
  the desire to change vs. the desire to stay the
  same.
• Stage III Preparing to Change Strengthening the
  will
• Stage IV Action Stage of Change Making It
  Happen
• Stage V Maintenance Maintaining vigilence

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Stage I Pre-Contemplation Acknowledging problem

• Active resistance
• Given up
• Demoralized
• Avoidance
• Denial
• Lack information
• Hopeless
• Fated
• Responsibility out of their control

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Attitudes

• Mind your own Business
• Avoidance of learning
• Avoid taking responsibility
• Paradox How do you help people to change who do
  not intend to change?

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To the Pre-contemplator

• Change does not action
• Nagging or creates anger
• Apathy or giving up approval
• Minimizing or softening the damage of behavior
  enabling

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Major Processes at Work Consciousness Raising

• Raises the level of awareness
• Gain insight into thoughts and feelings
• Develop a real conviction around the value
• of change
• Increases information

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Consciousness Raising Techniques

• Ask Powerful Questions
• Questions that raise clients awareness
• Questions that gauge clients emotional
• reactions
• Gauge your clients perception of their loved
  ones reaction

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Consciousness Raising Techniques

• Educate on Defenses
• Denial and minimization
• Rationalization
• Projection and displacement
• Internalization

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Stage II Contemplation Resolving Ambivalence

• The desire to change vs. the desire to
• stay the same.
• Substitute thinking for action
• Someday Promise suspension of conflict
• Educate themselves on the subject
• Need a greater understanding
• Remaining unaware of ones ambivalence can keep
  one can trapped in this stage for a long time.

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Resolving Ambivalence Essential

• Contemplation Traps Delay tactics
• Search for absolute certainty
• Waiting for the Magic Moment
• Wishful thinking
• Pre-mature action

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Major Processes at Work Emotional Arousal

• Drama regarding the negative troubling
  consequences of ones behavior
• Increases awareness
• Increases depth of feeling
• Moves towards action
• Films
• Psychodrama
• Other fear-arousing methods

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Process Emotional Arousal

• Ask Powerful Questions
• That address advantages and
• disadvantages of change
• That address optimism and pessimism about
• change
• That address intention or lack of intention to
• change

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Emotional Arousal Techniques

• Movies
• Websites
• Propaganda
• Contracts
• Continue with consciousness raising by asking the
  right questions in
• search of the right answers.

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Process Self Re-evaluation

• Taking stock
• Reveals essential values are in conflict
• Feeling, thinking, and believing Life would be
  improved
• Requires the contemplator to abandon all hope
  that change is effortless

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Process Self Re-evaluation

• Ask Powerful Questions that address
• How can one feel good about themselves
• while continuing the behavior essential values
• How they would feel if the did not have the
• behavior lines up with values positive
  feelings
• Cost of change giving up the belief that change
  is easy

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Re-evaluation techniques

• Think before you act
• Create a new self image
• Make a decision evaluate the pros and cons
• Solicit Input

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End of Contemplation

• Ambivalence that undermines determination
• has been resolved. Change is necessary,
• Change is not effortless.
• Ready to start making plans to change
• Dangers contemplation traps or premature action

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Stage III Preparation

• Hopeful Vision of themselves
• Stronger commitment develops
• Feel more confident
• Small steps toward action
• Focus is on the future
• Focus is on the positive aspects of change
• Focus is on alternatives

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Process Commitment

• Strengthening and encouraging the will
• Pledge to yourself
• Pledge to behavior change
• Pledge to just and reasonable cause life instead
  of death

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Process Commitment

• Ask Powerful Questions that address
• Anxiety
• Obstacles
• Options
• Resources

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Ask Powerful Questions

• What have you heard others say about what has
  worked for them?
• What have you considered doing?
• What have you tried in the past?
• What worked?
• What are your options?
• What your life will be like when you change your
  behavior?
• How will your life be enhanced?
• What will it free me up to become? List the
  benefits and keep it before you.

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Countering Anxiety

• Do something concrete
• Take small steps to reduce anxiety
• Set a date
• Have courage and go public
• Prepare for major surgery
• Create a plan of action that your client buys
  into

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Plan of Action

• Setting Goals
• Set concrete goals
• Make goals realistic
• State them positively
• Make them measurable
• Create the specific steps you will take to reach
• those goals.

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• Now that they have created a detailed,
• specific, realistic and concrete plan of
• action, it is time to move into the fourth
• stage of change, action.

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Stage IV Action Making It Happen

• This is where one pulls it all together. This
  is where the all the work of going through the
  stages starts to pay off in action and in
  results. Theoretically this is where one follows
  through and takes action. They involve others
  for support and accountability, they engage in
  change and move forward.

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Stage IV Action Making It Happen

• Pitfalls
• Poor preparation
• Cheap change
• No simple solutions
• Same ole, same ole

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Ask Powerful Questions

• What could you do instead?
• What has worked in the past?
• What do you think will work in the future?
• What moves you to change?
• What were your original reasons to make a change?
  
• What would help you take action?
• Is there some concrete reminder of where you want
  to be in the future?
• Is there some concrete reminder of where you
  dont want to be in the future?

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Process Countering

• Substituting healthy behaviors for
• problematic ones
• If you do not provide a different behavior one is
  likely to return to old behaviors

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Countering Techniques

• Active Diversion
• Exercise
• Relaxation
• Counter Thinking
• Assertiveness

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Process Environment Control

• The process of restructuring your environment to
  remove as much as possible the likely occurrence
  of the problem behavior

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Environment Control Techniques

• Avoidance
• Cue exposure
• Reminders

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Process Reward

• Environment control modifies the cues
• that precede and trigger problem behavior
• reward modifies the consequences that
• follow and reinforce it.

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Reward Techniques

• Covert management
• Contracting
• Shaping

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Using helpful relationships

• Identify your helpers
• Exercise together
• Have a buddy
• Use your family

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Stage V Maintenance

• Keeping what you got.by far the most
• difficult of the stages. This is because
• success is measured in years and decades
• and lifetimes.
• Combating the erosion of commitment

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Process All of the above

• Dont forget
• Keep your distance
• Create a new lifestyle
• Be aware of your thinking
• Use your support
• Guard against backsliding

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Resources

• Changing for Good A Revolutionary Six-Stage
  Program for Overcoming Bad Habits and Moving Your
  Life Positively Forward. James O. Prochaska,
  John Norcross, Carlo, DiClemente n. 1994.
• Miller (1999). Enhancing Motivation for Change in
  Substance Abuse Treatment.
• Miller Rollnick (2002). Motivational
  Interviewing Preparing People for Change.
• http//www.motivationalinterview.org