Transtheoretical Model

Terms in this set (81)

1) Change should be thought of as a process that may take months or even years.

2) Many 'behavioral change' programs are characterized as lasting for a predetermined number of weeks and consisting of structured content. Such programs do not take into account the uniqueness of each client, and the subtle changes that often go unnoticed. Some clients will respond very positively and make significant changes. However, for those who do not, they are said to lack motivation and/or willpower.

3) We tend to acknowledge change has occurred when we see a change in behavior, e.g. a period of abstinence, leaving an unhealthy relationship. These are then categorized as successes.

4) The stages of change model suggests that change occurs along a
continuum and therefore cannot be measured by one criteria alone, i.e. a change in a specific problem behavior. If we view change as a process then we can report positive changes each time an individual progresses from one stage to the next. Small steps constitute changes and should therefore be recognized and supported.

5) Since clients differ in their readiness to make changes Prochaska
and DiClemente suggest matching interventions to the appropriate stage (or readiness). "Success, moreover, is defined not just by changing the behavior but by any movement toward change, such as a shift from one stage of readiness to another."

6) There is an emphasis on the maintenance of change. Relapse is
common and should not be seen as a sign of failure. Clients are encouraged to learn from their relapse.

7) A great deal of importance is placed on the decision making capability of the individual
an assessment of the common antecedents and consequences of substance use.

Through functional analysis, you help clients understand what has "triggered" them to drink or use drugs in the past and the effects they experienced from using alcohol or drugs. With this information, you and your clients can then work on developing coping strategies to maintain abstinence.

"Tell me about situations in which you have been most likely to drink or use drugs in the past, or times when you have tended to drink or use more. These might be when you were with specific people, in specific places, or at certain times of day, or perhaps when you were feeling a particular way." Make sure to use the past tense because the present or future tense may unsettle currently abstinent clients.

Once the client has finished giving antecedents and consequences, you can point out how a certain trigger can lead to a certain effect. First, pick out one item from the Triggers column and one from the Effects column that clearly seem to go together. Then ask the client to identify pairs, letting the client draw connecting lines on the paper or blackboard.

For trigger items that have not been paired, ask the client to tell you what alcohol or drug use might have done for her in that situation, and draw a line to the appropriate item in the Effects column. Sometimes there is no corresponding item in the Effects column, which suggests that something has to be added. Then do
the same thing for the Effects column. It is not necessary, however, to pair all entries.

With this information, you can develop maintenance strategies. Point out that some of the pairs your client identified are common among most users. Next, you can say that if the only way a client can go from the Triggers column to the Effects column is through substance use, then the client is psychologically dependent on it. Then make clear that freedom of choice is about having options--different ways--of moving from the Triggers to the Effects column. You
can then review the pairs, beginning with those the client finds most important, and develop a coping plan that will enable the client to achieve the desired effects without using substances

(Miller and Pechacek, 1987)