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The Transtheoretical Model (also called the Stages of Change Model), developed by Prochaska and DiClemente in the late s, evolved through studies. [Episode 53] Today's podcast is on Prochaska and DiClemente's Stages of Change Model. This model describes five stages that people. Prochaska & DiClemente Trans-theoretical Model of Change Model of Health Behaviour Change.
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The Transtheoretical Model (Stages of Change)
Whilst it is generally agreed that models are visual representations or metaphors that seek to simplify complexity, there are different views on the extent to which it is appropriate and necessary to abridge this complexity [this tension is beautifully articulated by Isaiah Berlin's essay The Hedgehog and the Fox Berlin, ].
For some, models offer a way of narrowing and simplifying our prochaska and diclemente of behaviour, highlighting areas in which action can pragmatically be taken. Prochaska and diclemente others, there is less desire to restrict this vision, with attempts made to maintain a recognition of complexity.
From these values, a range of other positions arises, summarized in Table Iand these will be deployed later in considering the Stages of Change model.
Locating the present prochaska and diclemente in the context of existing critiques Given the intensity of debates in the published literature [e. As far back asa critical Editorial by Robin Davidson had prompted a series of responses in the British Journal of Addiction Davidson, and various themes can subsequently prochaska and diclemente identified from further publications.
At a fundamental level, some have questioned the core internal validity of the model and this has been expressed in a range of ways.
Ahijevych and Wewers Ahijevych and Wewers, and Farkas et al. Building on this, Pierce et al. In discussing the narrative expressed by smokers, McKie et al. In a broader sense, cross-national studies have shown large variations in the distribution of populations across stages; Kearney et al.
The validity of self-reported behaviour with respect to stage has also prochaska and diclemente questioned Lechner et al.
Behavioral Change Models
Consequently, there is evidence that significant proportions of individuals are unassignable to recognized stages Marcus, ; Pierce et al. The external validity of the model has also been questioned with respect to its transfer into other topic domains.
These include the potential for the model to exclude pre-contemplative individuals from intervention and the potential for the model to act as a prochaska and diclemente form of coercive control.
Despite the presence of these perspectives in the literature, there are still three broad problems. Finally, with the exception of Ashworth's review Ashworth,the critical focus has tended to be on prochaska and diclemente themes at the expense of any comprehensive consideration of outcome.
The review of the Stages of Change literature Specific coverage of the full review processes has been reported in detail elsewhere Bunton et al. The search was limited to the period —, and derived from the major electronic databases including: In specifically considering outcome, this group was further reduced to empirical studies with an associated data prochaska and diclemente.
Of these, Reflection Three specific themes arise from this work. The general paucity of sophisticated outcome trials The most striking feature of these data is the small number of studies that have assessed outcome.
Despite the origins of the model in the early s, it was not until the early s that any work considering behavioural outcomes was reported.
This paucity of evidence is acknowledged by Heather [ Heather,p. Despite such confidence, much of the literature has avoided measuring behaviour change as an outcome, preferring either softer indicators such as prochaska and diclemente in knowledge or recall of an intervention [e.
Dramatic Relief - Emotional arousal about the health behavior, whether positive or negative arousal. Self-Reevaluation prochaska and diclemente Self reappraisal to realize the healthy behavior is part of who they want to be.
Environmental Reevaluation - Social reappraisal to realize how their unhealthy behavior affects others.