Transtheoretical model (TTM)

I encountered this transtheoretical behavior change model which is very different from the single interaction-driven persuasive approach. Here are some notes I jog down from the Wikipedia for reference. One more thing is that TTM is often used in health context such as drug, alcohol or smoke.

Stages of Change

Stage 1 Precontemplation (“not ready”)

People are not intending to take action in the foreseeable future and can be unaware that their behavior is problematic. One of the most effective steps is to encourage them to become more mindful of their decision making and more conscious of the multiple benefits of changing an unhealthy behavior.

Stage 2 Contemplation (“getting ready”)

People are beginning to recognize that their behavior is problematic, and start to look at the pros and cons of their continued actions. People here learn about the kind of person they could be if they changed their behavior and learn more from people who behave in healthy ways.

Stage 3 Preparation (“ready”)

People are intending to take action in the immediate future and may begin taking small steps toward behavior change. People in this stage should be encouraged to seek support from friends they trust, tell people about their plan to change the way they act. Their number one concern is: when they act, will they fail? (self-efficacy)

Stage 4 Action

People have made specific overt modifications in modifying their problem behavior or in acquiring new healthy behaviours. People in this stage reward themselves for taking steps toward changing, and avoiding people and situations that tempt them to behave in unhealthy ways.

Stage 5 Maintenance

People have been able to sustain action for at least six months and are working to prevent relapse. It is recommended that people in this stage seek support from and talk with people whom they trust, spend time with people who behave in healthy ways and remember to engage in healthy activities to cope with stress instead of relying on unhealthy behavior.

Stage 6 Termination

Individuals have zero temptation and they are sure they will not return to their old unhealthy habit as a way of coping. Achieving a long-term behavior change often requires ongoing support from family members, a health coach, a physician, or another motivational source.

In general, for people to progress they need:

• A growing awareness that the advantages (the “pros”) of changing outweigh the disadvantages (the “cons”) — decisional balance.
• Confidence that they can make and maintain changes in situations that tempt them to return to their old, unhealthy behavior — self-efficacy.
• Strategies that can help them make and maintain change — processes of change.

Processes of Change

1. Consciousness-raising (Get the facts) — increasing awareness via information, education, and personal feedback about healthy behavior.
2. Dramatic relief (Pay attention to feelings) — feeling fear, anxiety, or worry because of the unhealthy behavior, or feeling inspiration and hope when they hear about how people are able to change to healthy behaviors.
3. Self-reevaluation (Create a new self-image) — realizing that healthy behavior is an important part of who they are and want to be.
4. Environmental reevaluation (Notice your effect on others) — realizing how their unhealthy behavior affects others and how they could have more positive effects by changing.
5. Social liberation (Notice public support) — realizing that society is more supportive of the healthy behavior.
6. Self-liberation (Make a commitment) — believing in one’s ability to change and making commitments and re-commitments to act on that belief.
7. Helping relationships (Get support) — finding people who are supportive of their change.
8. Counter-conditioning (Use substitutes) — substituting healthy ways of acting and thinking for unhealthy ways.
9. Reinforcement management (Use rewards) — increasing the rewards that come from positive behavior and reducing those that come from negative behavior.
10. Stimulus control (Manage your environment) — using reminders and cues that encourage healthy behavior as substitutes for those that encourage unhealthy behavior.