Behaviour modification is one of the integral aspects of therapy as humans consistently strive towards a life filled with personal growth and flourishing. Behavioural change has been viewed through various frames of reference. However, one theory which is dominant and holds good comprehensively in the field of behaviour modification till date is the Transtheoretical Model.
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What is the Transtheoretical theory all about?
The Transtheoretical Model, shortly known as TTM came into existence when the need for an integrative approach to treat problematic behaviours was ascertained. The earlier ones were fragmented in nature.
In other words, this is an integrative theory which attempts to understand the nature of behaviour and the context of its alterations.
This theory embraces a unique angle to look at behaviour and its change on a generic ground. The concept of change is directed from four different dimensions and they are:
- Stages of change
- Processes of change
- Markers of change
- Contexts of change
This theory can specifically be enforced during instances of various forms of addictions such as substance abuse, sexual addiction, internet addiction, pornography, video gaming addiction and other emerging patterns of addiction.
The Dimensions of TTM
Stages of change: TTM theorizes that any kind of change doesn’t happen overnight. It takes time and would occur in a stage-by-stage fashion. The change occurs in a certain sequence. This dimension provides a direction in which change takes place and believes that any change develops over five distinct stages and they are:
1. Precontemplation stage: In this stage, a person is comfortable and satisfied with the kind of lifestyle they have adapted themselves to. Individuals in this stage do not consider changes, as change seems irrelevant and unwanted in their eyes.
For example, Maria is at ease with the kind of life she lives, although her doctor advised her to shift to a healthier lifestyle to bring her abnormal weight gain under control.
2. Contemplation stage: This is the awareness stage where an individual acknowledges the existence or the non-existence of a certain behaviour pattern and they contemplate whether to incorporate or curtail a specific behaviour pattern.
Maria recognizes the negative impacts of being sedentary. she realizes she can’t do a lot of things she could easily pull off. She’s starting to wonder if she could bring about lifestyle changes for better health.
3. Preparation stage: The stage in which an individual prepares themselves to make the necessary change by committing themselves to it by devising a plan or a strategy.
After a few days of contemplation and weighing down the pros and cons of adopting a new lifestyle, Maria has finally decided to cut down on junk and engage in some form of physical activity every day. So, she started studying different ways to lead an organic lifestyle and also how she could make changes to her daily schedule.
4. Action stage: The stage where the devised strategy is implemented in order to assimilate a new behaviour pattern or alter the existing pattern of behaviour.
Maria gradually starts to consciously eat healthier meals and slowly engage in physical activity and over time, she realizes the kind of positive change she was experiencing within herself, physically and mentally.
5. Maintenance: In this stage, the individual strives toward sustaining the new behavioural pattern and consolidating it into their lives.
Maria is now well adapted to the changes she knowingly made. she feels like a newborn with better regulated norms. She loves what her life and prospects look like. She is eager to continue this new way of life.
These stages usually occur in the form of a cycle where the person juggles between the stages. However, the change diminishes or comes to a stage of termination when the newly adopted behavioural pattern fails to be maintained.
Processes of change
Processes of change describe the internal and external experiences a person undergoes when they shift from one stage of change to another. This acts as the motivator and determines the maintenance of a behaviour change in an individual. The processes of change are broadly classified into two types: cognitive and behavioural.
Cognitive process of change
It represents the thinking and experiential aspects of change and it includes,
1. Consciousness-raising: This involves acknowledgement and gaining awareness about their current behavioural pattern.
Maria first realized that her filthy lifestyle was slowing her down at a physical and mental level and made it impossible for her to pursue many tasks of her desired task.
Emotional arousal: Experiencing the need for change at an emotional level as a result of emotional awakening.
Maria experienced an inner desire to push herself beyond what she knew she could. She was trying to transform her life.
2. Self-reevaluation: Understanding or evaluating the self and assessing if the behaviour change would align with one’s values, morals and ethics.
Maria realized she wasn’t happy with the kind of life she’s leading. she looks inside herself and realizes that she’s not what she is supposed to be. So, she decides to bring in a productive change.
3. Environmental reevaluation: Assessing whether the behaviour change would have an effect on others and the environment they live in.
Maria also felt that the change would positively impact the environment in which she lives as she decided to reduce her consumption of red meat.
4. Social liberation: Observing the existing social norms and alternatives which could act as a supportive factor in sustaining the behaviour change.
Maria discovered that there was a community health centre in her locality that was raising awareness of healthy living. she wanted to visit those places to find more help from the like-minded people.
Behavioural process of change
This focuses on the behavioural commitment to building or breaking a habit. It involves:
1. Self-liberation: Believing in oneself and making behavioural commitments and taking responsibility of it.
Maria knew that she was capable of bringing in this change as she strategized the whole process well considering her strengths and weaknesses.
2. Stimulus management or control: Controlling or altering the external stimulus in order to maintain the new behaviour or cut down the non-serving behaviours.
Maria decided to delete some of the food apps from her phone that acts as the predominant source of trigger to order food online. Instead, she alternated them with some workout apps.
3. Conditioning or counter conditioning: Conditioning oneself to sustain the newly adopted behaviour pattern by making connections with other activities or environmental stimuli.
Maria conditioned herself to work out every day by associating it with day-to-day household chores.
4. Reinforcement management: Using positive or negative reinforcement to sustain the new behaviour or break down the toxic behaviour.
Maria also knew that moderation was the key and that she needed to be reinforced to maintain this change. So, she decided to assign Sunday as the cheat day when she could enjoy one meal to her heart’s content.
5. Helping relationships: Seeking out support and appreciation from friends, family etc. for the changes an individual undertakes.
Maria discussed this decision with her friends and family and sought suggestions and support from them frequently.
Markers of change
Markers of change are the determinants that influence the movement through the stages of change. Research has finalized two important aspects that assure a movement in the stages. They are Decisional balance and Self-efficacy.
Decisional balance proposes that a person would choose to take action by weighing down the pros and cons of that action that they plan on pursuing. People contemplate about the value and utility of adding or removing a certain behaviour from their life and arrive at a state of balance where the pros and cons of the new behaviour and letting go of the old behaviour are consciously assessed.
For example, when Maria chose to shed some weight, she considered the value behind working out and pushing herself beyond her zone of comfort as it helps her give a boost to her self-esteem.
Self-efficacy refers to the confidence a person has in themselves about pursuing and prolonging a newly formed behavioural pattern. Before taking on any significant change, a sense of apprehension can typically be experienced wondering if one can pull off the change.
Researchers have proved that those with high self-efficacy are more likely to initiate and sustain a behaviour change. It is considered as a major determinant of movement between the stages of change.
Context of changes
Change in any form can automatically cause a ripple effect in the other significant areas of an individual’s life. Context is an important aspect to be considered when the topic of change is discussed. Humans are highly influenced by the surrounding in which they live. Hence, the nature of the context can foster or hinder successful behavioural modifications. The contributions of context to the process of change come in five areas of functioning.
1. Current life situation: This involves the internal and external factors of a person aspiring the change. These factors involve the physical and mental stability of a person, family situation, financial and educational resources, levels of anxiety and depression, coping mechanisms etc.
2. Beliefs and attitude: The individual’s current belief system and attitude about the change would determine the initiation, sustenance or termination of a behaviour.
For example, Maria’s beliefs and attitude about health and food were witnessing a shift and that made her adopt a new routine much easier.
3. Interpersonal relationships: Interactions with significant individuals such as family, spouses, friends etc. can have a massive influence on the decision-making process of behavioural change. Researches show that the pros and cons of action are decided based on the interactions with close ones.
Maria’s spouse and her friends acted as a major source of motivation to pursue this novel change in her life.
4. Social systems: The family system, social setting, cultural norms, societal system etc. can decide a great deal in an individual taking up change and maintaining it. Society can either support or interfere with the change.
Although Maria had faced many people ridiculing and demotivating her, she chose to surround herself with appreciative and encouraging people in undertaking this change.
5. Enduring personal characteristics: This covers the overall personality traits of a person that may or may not serve in successfully espousing a change. Impulsivity, extraversion, personal identity, compulsivity, self-identity, agreeableness etc. are some of the personality factors which may play a role in behavioural alterations.
Maria was someone who always had a certain level of the moral standard of life. Hence, that was a motivating factor in making a significant lifestyle change.