OK, so we are a few weeks into 2016, and many of us may already be wavering from our New Year’s resolutions, if not completely forgotten them. Why is it so hard to make changes? James Prochaska, from the University of Rhode Island, has studied this question for more than thirty years, and has applied his theory to many health behaviors, including behaviors important in diabetes management. Show Prochaska has found that people who have successfully made positive change in their lives go through five specific stages: precontemplation, contemplation, preparation, action, and maintenance.
Most people I work with, who have diabetes, could be categorized in the contemplation stage. They are seriously thinking about life changes, but have not yet made a commitment to take action. Therefore, I think it valuable to further explore this stage. Within each stage, specific actions called, “processes of change,” help someone mentally move through each stage successfully. In the contemplation stage, the processes of change are “consciousness raising” and “self-reevaluation.” Consciousness raising is the process of actively becoming more aware, mindful or conscious of the current situation. Some activities include, keeping a food diary to learn more about how much I am eating, monitoring blood sugar to learn how well or if my treatment plan is working, or reading food labels to learn about how much carbohydrate is in different foods. Self-reevaluation flows naturally from consciousness raising. Self-reevaluation means taking stock or appraisal of the behavior that needs to be changed, and reveals how your values conflict with the problem behaviors. An activity which will help clarify your values, or “why” you want to change is called “decisional balance”. The decisional balance takes into consideration the pros and cons of behavior change. Understanding pros and cons helps one acknowledge that behavior change has good consequences, but requires sacrifice. Take a piece of paper. Divide the paper into two columns. Label one “pros” and the other column “cons”. Under each column answer each question: What will be the consequences of my behavior change be for me?
I once heard a radio interview with James Prochaska. He said that making a behavior change should be approached as if you were getting ready for a major surgery. How much pre-planning would you do? How much support would you solicit from friends and family? How much mental attention would you put towards it? It would be your number one priority, and you would choose a time when there would be nothing else within your control that would take precedence. You would not choose a time when you are making a marital change, job change, major vacation, getting ready to move to a new house, etc. Healthy behavior change is that difficult, and it is that important. By: Donna Webb, RD, LD, CDE Cecelia Health Diabetes Health Coach Cancer Prevention Research Center. University of Rhode Island, 2016. Web. 10 Jan. 2016. <http://web.uri.edu/cprc/about-ttm/> Prochaska, J. O. and W. F. Velicer (in press). “The transtheoretical model of health behavior change.” American Journal of Health Promotion. Prochaska, PH.D., James O., John C. Norcross, PH.D., and Carlo C. Diclemente, PH.D. Changing For Good. New York, NY: Harperollins Publishers, 1994. Print. What is the contemplation stage of change?Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action. Preparation is a stage that combines intention and behavioral criteria.
What are the different stages of change?The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination.
What is an example of pre contemplation?Description. The Precontemplation stage occurs when the client has no intention, now, or in the future (typically seen as six months), to change their behavior. For example, “I have no intention of taking up a sport or going running.” Most likely, they are either under-informed or uninformed.
How do I get from Precontemplation to contemplation?A key strategy to helping clients move from the Precontemplation stage to contemplating change is to raise their level of concern and awareness of the risk associated with their current substance use behaviors. Involving family members and significant others (SOs) can increase clients' concern about substance use.
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