The Transtheoretical model is a behavior change model, strongly associated with health related changes, which contains 10 processes and six stages.Summary by The World of Work Project
The Transtheoretical Model
The Transtheoretical model is a popular model used to describe behavior change and to support change through therapy. The model includes 6 stages of change as well as 10 different processes of change and is often associated with health related change.
The six stages of change
1 – Pre-contemplation
At the precontemplation stage people are not even aware that they may wish to change their behavior. In some instances they may not be aware that their behavior is problematic or that there are other ways of doing things.
At this stage all that one can do to help people towards change is to aid their thinking about the pros and cons of different behaviors.
2 – Contemplation
At the contemplation stage individuals are starting to think about changing their behavior. They’re assessing the impact of their current way of doing things on themselves and others and are starting to explore new ways of doing things. They remain uncommitted to changing, but are thinking about it. At this stage individuals start to visualize how they could change and to learn from people who behave in the ways they may wish to.
The best way to support individuals at this stage is to help them reduce the negative impacts of any change.
3 – Preparation
At the preparation stage individuals are intending to take action and change in the near future. They may have already made some small changes or be taking steps towards changing. These pre-change behaviors could include things like purchasing equipment, booking activities or telling others about their intentions to change.
The best way to support individuals at this stage is to encourage them to seek support from other, helpful people.
4 – Action
At the action stage individuals are actively implementing their new behaviors or ways of doing things. They are still at the stage where their new behaviors or ways of doing things are effortful and require attention.
The best way to help individuals at this stage is to support them in strengthening their commitments to their new ways of acting. This can be done through a range of changes including substitution, goal setting, commitment, changing social groups and support.
5 – Maintenance
At the maintenance stage, individuals have successfully adopted and embedded new behaviors and ways of doing things. They may still be subject to the risk of relapsing in particular situations, but they are stable in most situations.
Individuals at this stage benefit from the same support as those who are at the action stage, though they may need less support.
6 – Termination
At the termination stage individuals have successfully changed their behaviors. They have eliminated any desire to use their former behaviors or ways of doing things. This can be thought about in relation to specific health related behavior actions such as smoking, drinking or drug consumption as the point when individuals are confident they will not slip back into old behaviors.
Individuals at the termination stage require very little support by definition. However, it’s still advisable for individuals at this stage to retain support and continue to avoid situations that might tempt them to return to their former behaviors.
An alternative to termination is relapse which, of course, can happen at any stage.
The 10 processes of change
The 10 processes of change identified in the Transtheoretical Model are fairly typical of change models. They are most effective when they are matched with specific stages of the change. We list the processes of change below in roughly an order that aligns to the stages of change.
1 – Consciousness-raising
The first process of change relates to increasing knowledge and awareness. Through this process individuals acquire new facts and develop a better understanding about their current behavior as well as about what more helpful behaviors may be.
2 – Dramatic relief
This process relates to an individual’s emotional development in relation to their behaviors. Through this process, based on their recently acquired understanding about their behaviors, individuals start to associate negative emotions with the behaviors they wish to change and positive emotions with the behaviors they wish to develop.
Negative emotions include things such as fear, worry, guilt or anxiety and positive emotions include things like inspiration, hope or determination.
3 – Self-reevaluation
Individuals start to redefine how they see themselves in the easy stages of change. This process is very helpful and requires a re-creation of identity to some extent. Individuals do this by associating the positive behaviors they aspire towards as part of their identity and by eliminating the negative behaviors they wish to drop from their identity.
4 – Environmental reevaluation
The process of environmental reevaluation involves individuals starting to notice and understand the impact that they have on others. They become conscious of how their negative behaviors affect those around them and they understand how the positive behaviors they aspire towards could have a more positive affect on others.
5 – Social liberation
Social liberation is the process by which individuals start to realize that broader society and those around them are supportive of the new behaviors they are seeking to adopt. Generally speaking, society is supportive of positive behaviors and rewards them with recognition, which in turn helps individuals to sustain and progress the positive changes they are seeking to embed.
6 – Self-liberation
The act of making commitments to change and actually believing in your ability to change is known as self-liberation. Through this process individuals are freeing themselves from the negative thoughts and believes that may have been holding them back in their efforts to change.
7 – Helping relationships
Support from the right people is a hugely important process for change.
8 – Counter-conditioning
Counter-conditioning just means the process of using substitutes. Generally speaking, individuals will seek to substitute unhealthy actions and behaviors with more healthy alternatives. Perhaps instead of smoking a cigarette, and individuals will chew gum.
9 – Reinforcement management
The process of using rewards to encourage positive behaviors, and the reduction or rewards to discourage negative behaviors, is known as reinforcement management in the transtheoretical model. You can read more about reinforcement theory in the workplace in our post on the topic.
10 – Stimulus control
Stimulus control relates to the process of an individual managing their environment. This can be done through controlling access, modifying their built environment, pre-commiting to things (e.g. not keeping chocolate at home) or putting up inspiring posters to encourage positive behavior and discourage negative behavior.
The World of Work Project View
The transtheoretical model is a helpful framework through which to think about the stages of changing behavior, and some of the processes that individuals go through when seeking to change their behavior.
From a work perspective, the model provides some useful insights into the change process that can help individuals or leaders in the workplace manage changes to their own behaviors, or help others with their desired changes.
Overall, we think this is a useful framework and way of thinking about things, but like the added depth of some other models.
Sources and further reading
Where possible we always recommend that people read up on the original sources of information and ideas.
This post is based on work from a range of sources and writing relation to the subject. The best starting point for further reading is the article “The Transtheoretical Model of Health Behavior Change“.
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