6.3 Behaviour Modification
Making permanent lifestyle changes is one of the greatest challenges a person can face. This section will explore how changes to behaviour occur, the psychological barriers that hamper efforts to change, and tips for making lasting change.
How Changes in Behaviour Occur
The Transtheoretical Model, also called the Stages of Change Model, was developed by James Prochaska and Carlo DiClemente in the late 1970s. Considered the dominant model for describing how behaviour changes occur, it evolved through studies examining the experiences of smokers who quit on their own and comparing them with the experiences of those requiring further treatment. The goal of those studies was to understand why some people were capable of quitting on their own. It was determined that people quit smoking if they were ready to do so. Thus, the Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change. The TTM operates on the assumption that people do not change behaviours quickly and decisively. Rather, change in behaviour, especially habitual behaviour, occurs continuously through a cyclical process. The TTM is not a theory but a model; different behavioural theories and constructs can be applied to various stages of the model where they may be most effective.
The TTM posits that individuals move through six stages of change: pre-contemplation, contemplation, preparation, action, maintenance, and termination. Termination was not part of the original model and is less often used in the application of stages of change for health-related behaviours. For each stage of change, different intervention strategies are most effective at moving the person to the next stage of change and, subsequently, through the model to maintenance, the ideal stage of behaviour.
Six Stages of Change
Stage 1: Precontemplation: People do not intend to take action in the foreseeable future (defined as within the next six months). People are often unaware that their behaviour is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behaviour and place too much emphasis on the cons of changing behaviour.
Stage 2: Contemplation: People intend to start healthy behaviour in the foreseeable future (defined as within the next six months). People recognize that their behaviour may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behaviour takes place, with equal emphasis placed on both. Despite this recognition, people may still feel ambivalent about changing their behaviour.
Stage 3: Preparation (Determination): People are ready to take action within the next 30 days. People start to take small steps toward behaviour change, and they believe changing their behaviour can lead to a healthier life.
Stage 4: Action: In this stage, people have recently changed their behaviour (defined as within the last six months) and intend to keep moving forward with that behaviour change. People may exhibit this by modifying their problems or acquiring new healthy behaviours.
Stage 5: Maintenance: In this stage, people have sustained their behaviour change for a while (defined as more than six months) and intend to maintain the behaviour change going forward—people in this stage work to prevent relapse to earlier stages.
Stage 6: Termination: In this stage, people have no desire to return to their unhealthy behaviours and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs.
Goal Setting
One of the most effective tools for changing behaviour is goal setting. The link below provides information on how to set goals effectively to achieve greater success in goal attainment.
“Behavior Modification” from Fitness for Paramedics: A Guide for Students at Cambrian College Copyright © 2019 by Dawn Markell and Diane Peterson is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.
