Analysis of the Transtheoretical Model in Smoking Behaviour Change - Essay Example

Behaviour Change Name of Student Student Number Institution Course Code Name of Lecturer Date of Submission Analysis of the Transtheoretical Model in Smoking Behaviour Change Contents Introduction 2 Case Overview 2 Critical Analysis 3 Conclusion 7 References 8 Appendix 11 Introduction Behaviour change is a critical step undertaken by individuals either through their volition or under cohesion to make positive impacts in their lives. The step to recovery from a vice in life to embracing the right attitude or trait is critical and initiatives to ensure the individuals goes through recovery are done with care to avert eventualities of relapses. To help people in making a positive change of behaviour, it would be necessary to look at how people change and the causative factors and promoters of this change (Roberts, Kerr & Smith, 2013). By understanding difficulties that individuals go about while they aim to change behaviour, it would be easy to treatment providers in helping their clients out of their unwanted behaviours (Etter & Sutton, 2002; Jepson et al., 2010; Koyun & Eroglu 2013b). This paper utilises the findings of two separate individuals who tried to change their smoking behaviour without the help of a counsellor. Case Overview The essay is based on two interviews conducted on individuals who have been engaged in smoking and have tried to quit. With the use of Transtheoretical Model (TTM), this essay outlines the behaviour change stages and the effectiveness of interventions to ensure overall realisations of target goals. The data was collected by way of an interview where the two face-to-face interviews were conducted on the methodology utilised in the behaviour change process. The reason behind the utilisation of an interview was to ensure having a one-on-one interaction with the respondents (Norton & Abbott, 2016), and hence have a self-assessment of the recovery from the point of TTM. The individual respondents were labelled as case 1 and case 2 respectively. Case 1 happened to be successful in his endeavour to change the unhealthy smoking behaviour while the latter had failed and regressed back to his unwanted behaviour. With the utilisation of the data obtained, the paper critically analyses the findings by contrasting the processes and stages of change that both individuals cases with the Transtheoretical Model in a bid to understand why one person was successful while the other was not. The respondents were assured of the confidentiality of the information given since this was to be used for study purposes only. They were not supposed at any instant required to give their identity. The validity of the study tool was authenticated by conducting a pre-test of one individual at a university who had engaged in smoking and later tried quitting. The pre-test enabled evaluating the reliability of the interview guide to acquiring effective data for analysis. Critical Analysis The Transtheoretical Model of behaviour was created by Prochaska and DiClemente (1983) and has been utilised as a basis to understand behaviour change. The model stipulates how people change problem behaviour or acquires a positive behaviour (Guillot, et al., 2004). The decision-making abilities of the individual stand of great importance in this model, unlike in other theoretical models of behaviour change which focus more social and biological influences on behaviour. Velicer et al. (1998) argue that the model is focused on intentional change. Boyle et al. (1998) stipulate that the theory is based on four constructs which include: stages of change, processes of change, self-efficacy and decisional balance. According to Prochaska and Velicer (1997), the TTM utilises interventions that are necessary for change phases of an individual concerning behaviour. These phases enable the healthcare providers and social workers to construct a treatment or behavioural change plan for the individual. Stages of change explain individuals’ thought and action concerning changing their behaviours. Subsequently, processes of change explain what methods are used by the individuals while trying to change behaviour. Self-Efficacy talks of the self-confidence of the individual against forces that draw someone to regressing towards the unwanted behaviour and a good example in this regard involves the desire to go back to smoking (Koyun & Eroğlu, 2013a). Finally, Decisional balance explains the factor of measuring merits and demerits that the changing to the target behaviour may exhibit. Behaviour change occurs over time and therefore, the model argue for the idea that one has to progress through five stages of change. By closely examining what each stage of change is, about the findings of the individual respondents, it enhances the understanding on why case 2 may have been fixated on a particular stage or why they regressed. The first stage of the TTM is the pre-contemplation stage, here people are said to have no intentions of changing behaviour in the future (West, 2005). In this stage, the future is normally measured in six months. It is at this juncture that one lacks information on the need for behaviour change or ignores the urge to due to many failed attempts (Ergul and Temel, 2009). Case 1 who was successful in smoking cessation seemed not to have had difficulties in this stage because he did get the urge to fight the addiction again even after several failed attempts. According to Prochaska et al. (1997) multiple unsuccessful attempts to change can demoralise one’s ability to embrace behaviour change fully. Case 2 had not previously attempted to quit smoking and therefore, did not feel demotivated, he just decided to try stopping; it would have been successful if he had tried to do thorough research on the processes involved and the energies needed to go through the later stages. The next stage is the contemplation stage where individuals become aware of the existing problem and are seriously engaged in thinking on the way to overcome their troubles (Erol & Erdogan, 2008). However, there is no commitment to the action taking on this stage, or any consideration of ways to solve the problem. People can remain stuck at this stage, an occurrence that can go all through an individual’s lifetime (Sutton, 2001). It was noted that case 2 regressed to this stage after failing to change the smoking behaviour. On being questioned on whether he would attempt to quit smoking again, he stated of actually stated of having great desire to give a second change and try to change. Individual’s fixation in this stage may be as a result of the failure, as well as the case where individuals search for information on their predicament but never engage in the actual change process (Jepson et al., 2010). Conners et al. (2001) stipulate that at this stage there is an abrupt emotional response to the problems that comes with the unwanted behaviour, and this empowers the individual towards the action of changing the problem for the betterment of their situation. Case 1 at this stage visualised himself as a non-smoker and was motivated to conquer his smoking addiction. His desire to change outdid his past failures and therefore came out strong in aligning with his struggles. After the contemplation stage, the next involves the preparation stage where individuals at this stage have already made a commitment to change (DiClemente, 2001). Their motivation for change may be reflected in statements such as” I have got to do something to change this” during the interview. The initial steps towards cessation are evident to be taking place at this stage. Individuals try to gather information about their unhealthy behaviour and look into action they need to take to quit their behaviours (Norman et al., 2000; Kocijan & Harris, 2016). Case 1 at this stage resorted to a friend who had successfully quit smoking, and here he gathered advice on the way forward. Case 2, on the other hand, skipped this preparation stage something that can also be attributed to his failure to realise effective behaviour change. On being questioned on whether he sought any guidance after deciding to take action, he answered with a definite no. Often people skip the preparation stage and try to move from contemplation directly into action (Lorencatti et al., 2012). Without researching on what takes to go through this change, the individuals are prone to fail. The action stage is where individuals actively get involved in taking steps towards changing their unhealthy behaviour and replacing it with a desirable behaviour. Roberts et al. (2013) argue that individuals at this stage make overt behavioural changes. According to Cohen (1988), individuals trying to work on changing their unwanted behaviours actively utilise the most of the experiential processes along with methods of behaviour change. People in action are still working hard to convince themselves about the desirability of change and may be exposed to the high risk of relapse (Velicer et al., 1990). Case 2 was prone to fail at this stage since he failed to do a self-analysis and evaluate on the behaviours necessary to allow for smoking cessation and this occurred due to skipping the preparation stage. After 3 to 6 months the last stage of maintenance begins. The focus here is on life modification so as to reduce the probability of relapse and stabilise the behaviour change. Vilela et al., (2009) argue that maintenance involves sustaining and incorporating new habits in our environments. The main motive in this stage is to avoid relapse and keep tight the gains made during previous stages. The processes of change in the Transtheoretical Model describe the temporal aspect of shifts in behaviours, intentions and attitudes that happen, and are the second major issue of the theory that describes how changes occur (Patten et al., 2000). The processes are put into two classifications; the first five being the experiential while, the latter five are behaviour processes. The experiential ratings include: consciousness raising, dramatic relief, self-re-evaluation, environmental re-evaluation and self-liberation (Prochaska et al., 1992). Consciousness rising is the process where an individual sees the negative consequences and gets the urge to look at the causes and cures of the unhealthy behaviour. Our respondent here recalled information people had given them on how to quit smoking and thus, increased their awareness. Dramatic relief is the situation where the individual experience negative emotions in association with the unhealthy behaviour. Patten et al. (2000) suggest that occurrences such as the deaths of close relatives or friends may cause pre-contemplation on the part of the individual especially if the death was attributed to the unhealthy behaviour. Case 1 stated that his moving factor was the loss of his friend who battled lung cancer. This sparked him into the pre-contemplation stage and motivated him through the process of change. Media campaigns motivated case 2 on the other hand. Self-re-evaluation is the realisation that the behaviour change is of importance to an individual’s identity. It is the cognitive and affective assessment of one’s self-image concerning the unhealthy behaviour and the view of how one would look if the behaviour was absent (Zimmerman et al., 2000). People here become guilty of their unwanted behaviours. Environmental re-evaluation is the individual’s assessment of how their unwanted behaviour impact on the social environment (Etter & Sutton, 2002). Case 1 felt that he was being a negative role model for his younger siblings and therefore, this constituted environmental re-evaluation unlike him Case 2 who had no guilt as far as the environment was concerned. This is because the people around him were smokers and actually contributed negatively towards his endeavour to modify behaviour. This explains his eventual regression towards the unhealthy behaviour. Self-liberation is an individual’s firm commitment to change. By finding the society changing in ways to accommodate easy life for a non-smoker, Case 1 took the initiative to liberate socially by quitting smoking. Prochaska and Velicer (1997) state that motivation is the binding factor in self-liberation involved in the eventual realisation of behaviour change and avoid relapse. The other five processes of change are said to be behavioural processes and they include social liberation, counter conditioning, stimulus control, contingency management and helping relationships. Social liberation is based on the realisation that the social norms are changing towards the direction of supporting behaviour change. Prochaska & Velicer, (1997) argue that advocating the rights of the repressed, empowerment and policy interventions will increase social liberation. Counterconditioning is the tendency of individuals to substitute healthy behaviours for problem behaviours (Baranowski, 1993). Case 1 opted to take a banana whenever he felt the urge to smoke while Case 2 struggled to let the urge die out. Case 1 had his success attributed to finding other ways to feed his oral orientation with smoking or doing other things with his hands as a substitute for smoking. Stimulus control relates to avoidance where cues that lead to engaging in unhealthy behaviour are removed and replaced with those that advocate engagement in healthy behaviour (Sutton, 2001). Contingency management is the situation where an individual increases rewards for healthy behaviours. Case 1 reward was by buying a new pair of shoe every week for person use that went on keeping him out of smoking. The use of reward as a reinforcement fostered his urge to move forward in his battling of the problematic behaviour. Helping relationships relate to an individual being open about his or her problem behaviour. This may involve seeking social support for healthy behaviour change such as support groups or buddy systems (Littel and Girvin, 2002). In context, self-actualisation pegged towards change and critical engagement of the individuals greatly helps in the realisation of behaviour change. Thus, behaviour change involves moving from one stage to the other by critically engaging appropriately and overcoming the challenges in each stage to triumph and embraced new behavioural attributes acceptable in the society. Conclusion In conclusion, it is evident that utilising cessation interventions enhance behaviour change among smokers. The Transtheoretical Model is a practical theory for individuals and institutions dealing with behaviour change. For individuals engaging in behaviour change, it is important to apply the entire model and not the stage of change construct alone. This is because it ensures that the participants use the appropriate process of change as they move through the stages of change which is of much importance in ensuring success in behaviour change. The processes of change which are broken into two categories: pre-action and action categories are best used to assist individuals in the pre-contemplation, contemplation, preparation, and action and maintenance stages of change. It is evident that Case 2 failure was caused due to avoidance to see change as a process. The skipping of the preparation stage where he went from deciding to quitting directly into action may have caused the relapse he experienced. However, it is important to note that motivation is an important factor in the process of change. Having failed many times in trying to change, Case 1 was motivated and new the causes of failure and therefore tried to avoid this regression unlike Case 2 who was trying quitting for the first time. Maintenance of the achieved state is of importance since the individual is now battling against relapse. By joining social support groups, Case 1 struggled to make his case known as well as seek support in maintaining the status quo. Thus, behaviour change involves a continuous process that requires critical support from within and people surrounding the person in the process of change. Monitoring and giving support for change are significant steps in the eventual realisation of success in behaviour change. References Baranowski, T. (1993). Beliefs as motivational influences at stages in behaviour change. International Quarterly of Community Health Education, 13 (1), 3-29. Bartlett, Y., Sheeran, P. & Hawley, M.S. (2013). Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: A meta-analysis. British Journal of Health Psychology, 19(1), 181-203. Boyle, R.G., O’Connor, P.J., Pronk, N. & Tan, A. (1998). 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Describe the situation that made you see the need to adjust your unhealthy behaviour to a more desirable behaviour 2. What difficulties did you encounter in making the decision to quit smoking or not? 3. Had you previously tried to quit smoking? 4. If yes in (3) above what situation caused our relapse to smoking? 5. On deciding to quit smoking did you source any information on how to go about the change process? 6. Please describe the information gathered before embarking to the action of quitting? 7. Describe the difficulties experienced in the first three weeks after quitting smoking 8. What measures did you put in place to battle the difficulties in (7) above? 9. How successful do you think the measures put in (8) above were in dealing with the difficulties stated in (7) above Very successful Somewhat successful Not very successful Not at all successful Don’t know 10. After six months without smoking what measures did you put in place to ensure you didn’t revert to smoking? 11. Did you seek any social support for healthy behaviour change? 12. Is there anything you would like to add? Read More