Prochaskas model of behavioural change Flashcards
Prochaskas model
Prochaska and diclemente (1983) developed a model of behavioural change which is now widely used to explain how people overcome their addictions
6 stages and suggests addicts don’t take an immediate jump from unhealthy to healthy behaviours, but there are a series of stages that can lead to someone changing their behaviour
Model argues that once their behaviour has changed, it is not a constant state and relapse can occur at any stage
Stage 1
Pre-contemplation
No change in behaviour due to:
1. Denial: don’t believe they have a problem and are good at convincing themselves of this
2. Demotivated: they have convinced themselves they can’t quit because they have tried and failed before
Intervention should focus on helping the addicted person to consider the need for change
Stage 2
Contemplation
Addict starts to realise they have a problem and starts to consider changing their behaviour
They are not yet committed to changing their behaviour as they are aware of the benefits and costs
Intervention should focus on helping the person see that the pros outweigh the cons and can help them reach a decision to change
Stage 3
Preparation
Addict has accepted that their addiction is a problem and seek change because they now believe that benefits of quitting are greater than costs
Haven’t yet decided when or how they are going to change their behaviour but begin to make plans
Intervention is support in constructing a plan (e.g. see counsellor)
Stage 4
Action
Addict has taken action towards changing their behaviour and made changes to their lifestyle (e.g. thrown cigs away)
Action the addict takes must reduce their risk to continuing (e.g. having nicotine patches)
Intervention should focus on developing coping skills needed to quit
Stage 5
Maintenance
Addict has continued to follow their lifestyle changes and are committed to avoiding returning to their previous ways
Addict develops a growing confidence that the changes can be continued into long-term
Intervention should focus on relapse prevention by encouraging application of coping skills and using resources of support available to them
Stage 6
Termination/relapse
If termination is achieved, the desired change is complete, the new behaviour now is normal and relapse cannot occur
OR
Whilst this is then end goal for all addicts, not everyone achieves this and many will relapse and return to earlier stages
Intervention not required but is may not be possible or realistic for everyone to reach this point
Strength
Supporting research evidence
Parker and Parikh (2001)
Interventions tailored to stages of change were more effective at reducing unhealthy behaviours compared to interventions that were a one size fits all
Suggests that models ability to recognise that the different stages of addiction will require different interventions benefits society, increasing validity
Limit
Received contradicting research
Aveyard et al (2009)
Found that tailoring intervention to different stages did not increase effectiveness in individuals who were trying to quit smoking
This decreases validity of model as it suggests each stage should require a different intervention if it is to be successful
Limit 2
Culturally biased
Which is when a theory is developed from one culture and applied to others
In a study of Arabian smokers, 62% were in pre-contemplation, 14% in preparation compared to US smokers, 40% in pre-contemplation and 20% in preparation.
Suggests model doesn’t consider a lower readiness to quit smoking in some cultures may be a product of cultural norms, suggesting it shouldn’t be applied universally
Strength 2
Positive attitude to relapse
Diclemente et al 2003
Suggests that relapse is the rule rather than the exception. The model doesn’t view relapse as a failure but as a normal part of the addiction process, shifting the blame away from the addict
This is a great strength of Prochaskas model as it will help increase the patients self-esteem and motivation from the addictive behaviour
