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What is the Transtheoretical Model of behaviour change?

'Stages of Change’ assumes that the patient falls into one of five categories of readiness for behaviour change

A common model that can be useful to understand and assist with behaviour change is the Transtheoretical Model — or ‘Stages of Change’.6

This model assumes that the patient falls into one of the following categories of readiness for behaviour change. Please note that ‘relapse’ is listed as a ‘stage of change’, however it can occur at any time during progression through the stages.

Progress -> . Precontemplation (Not thinking about changing their behaviour or the potential benefits) -> Contemplation (Thinking about behaviour change but not yet acting on intention) -> Preparation (Ready to change behaviour but not yet acting on intention -> Action (Beginning steps towards adopting the behaviour but with high risk of relapse) -> Maintenance (Maintaining the behaviour, risk of relapse remains). <- Relapse.

Watch the following short video, hosted on YouTube, to see a simple example of the stages of change:

Understanding stages of change

Understanding what stage of change the patient is in with regards to behaviour change is useful as it can help you tailor your intervention to suit that particular stage:

  1. Assess the individual’s readiness for behaviour change
    This can be done by talking to the patient about where they are at with regards to the behaviour and what steps they have taken so far.
  2. Use motivational interviewing to promote change
    For example, individuals in pre-contemplation can be made aware of the risks and consequences of not changing their behaviour. They should also be encouraged to discuss how their behaviour affects important people in their lives.
  3. Monitor their motivation
    Individuals in the contemplation stage should be encouraged to monitor their motivation to engage in behaviour change and think about what the benefits would be.
  4. Verbalise their commitment
    Individuals in the preparation stage should be asked to verbalise their commitment to engage in change to others, as well as to themselves, and can be helped to set goals and action plans to help them get started.
  5. Offer support and guidance in self-management techniques
    Individuals in action or maintenance should be supported and guided in self-management techniques — such as rewards and support networks — to mitigate the risk of relapse.
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