RD

Behavior Change - TTM and Related Concepts

Behavior Change Notes (TTM)

  • Source material focuses on reaching wellness through lifestyle management and behavior change, highlighting a central framework: the Transtheoretical Model (TTM) of Change.

  • Primary learning objectives highlighted in the transcript:

    • Identify the primary step in beginning a behavior change (target behavior).
    • Explain the importance of one’s locus of control in making life changes.
    • List and describe each stage of the Transtheoretical Model of Behavior Change and strategies to move from stage to stage.

  • Core idea of the Transtheoretical Model (TTM):

    • TTM is driven by personal experiences (Intellectual Wellness) and a willingness to undergo a paradigm shift in values, beliefs, attitudes, and behaviors, achieved through reflective practices.
    • Change is viewed as a process that unfolds across stages, not as a single event.

  • First step in behavior change: Identify a Target Behavior

    • Target Behavior defined: An isolated behavior that is the specific focus of a behavior change program.
    • Why it matters: Without a specific target, it’s not possible to begin the change process.
    • Examples of Target Behaviors:
    • beginning to exercise
    • quitting smoking
    • starting to floss
    • wearing a seatbelt
    • reducing binge drinking
    • eating more fruits and veggies
    • Key point: A Target Behavior can be any specific change you want to achieve.

  • Self-Efficacy and Locus of Control (key concepts for change motivation):

    • Self-Efficacy: The belief in one’s ability to take action and perform a specific task.
    • Locus of Control: The figurative “place” a person designates as the source of responsibility for events in life.
    • Internal Locus of Control: You believe it is your responsibility and you practice personal control to improve behaviors.
    • External Locus of Control: You believe external factors control your life and you have little say or responsibility in outcomes.

  • Additional framing and tools (context from the transcript):

    • There are “Other Tools for Change” (with emphasis on reading and continued learning).
    • A quiz-style application (behavior change scenario) is used to practice applying the model to real-life problems.
    • Encouragement to review behavior change pages (12–21 in current editions), noting that page numbers vary by edition.

  • Structure of the Transtheoretical Model (TTM) as presented in the transcript:

    • Not thinking (Pre-contemplation)
    • Contemplation (Thinking)
    • Preparation
    • Action (making changes)
    • Maintenance
    • Relapse (recognizes potential setback; not always a formal stage but a common experience)
    • Termination (sometimes called “stable, improved lifestyle”; ultimate goal where old temptations are no longer present)
    • Note: One slide also lists these in a slightly different order, but standard practice places Pre-contemplation, Contemplation, Preparation, Action, Maintenance, Termination, with Relapse as a possible event rather than a formal stage.

  • Stage-by-stage details, including characteristics and suggested strategies

    • Pre-contemplation (Not thinking)
    • Characteristics:
      • There is no problem
      • Unaware of the risks involved
      • Perceived benefits of continuing outweigh perceived costs (cost/benefit analysis favors continuing)
    • Strategies:
      • Raise consciousness about risks and the problem
      • Examine defense mechanisms (e.g., procrastinating, rationalizing, blaming)
      • Talk with others to increase awareness
      • Identify available resources to support change
    • Contemplation (Thinking)
    • Characteristics:
      • Acknowledge that a problem exists
      • Aware of benefits and costs but not yet ready to act
      • Barriers to action feel overwhelming
    • Strategies:
      • Increase consciousness (continue info gathering)
      • Keep a written record of thoughts and benefits/costs
      • Conduct cost-benefit analysis
      • Identify key barriers
      • Boost self-efficacy
      • Emotional arousal to motivate change
      • Use social strategies (talk with others, seek support)
    • Preparation
    • Characteristics:
      • Plan to take action within a month
      • May already be making small attempts or testing the waters
      • Begin creating a concrete plan; may worry about failure
    • Strategies:
      • Develop a detailed action plan
      • Prioritize the change
      • Use visualization and self-talk
      • Try small steps
      • Talk with others for support
    • Action (Making changes)
    • Characteristics:
      • There are outward signs of modifying behavior and environment
      • Requires substantial time and energy
      • At risk for reverting to unhealthy behavior
    • Strategies:
      • Monitor self and progress
      • Change the environment to support the new behavior
      • Identify alternatives to old behaviors
      • Use rewards and incentives
      • Substitute healthier behaviors for old ones
      • Talk with others and maintain a positive attitude
    • Maintenance
    • Characteristics:
      • Have maintained new healthier behavior for at least 6 ext{ months} (see note: emphasis on duration; some sources may quote different time frames or contexts)
      • Relapse is not a stage, but it can occur; rebound is possible
      • The maintenance phase can last for months or years
    • Strategies:
      • Continue positive strategies from Action
      • Do not take the new behavior for granted
      • Seek ongoing social support and talk with others
      • Be a role model for others
      • Recognize that relapse can happen and plan to respond constructively
    • Relapse
    • Position in the model: Not a formal stage, but a common event that can occur during or after maintenance
    • Practical implication: Re-engaging in contemplation or preparation to re-enter Action if needed
    • Termination (sometimes called “termination” or eventual termination of temptation)
    • Characteristics:
      • For some behaviors, fully eliminated risk of relapse; total control and confidence in the new behavior
      • The old unhealthy behavior is essentially never tempting again
    • Strategies:
      • New habits replace the old ones and are now deeply embedded
      • No longer tempted to lapse back into the old behavior
      • The behavior feels as if it never existed

  • Practical application example (Quiz/Scenario):

    • A behavior problem is analyzed by applying the model to determine what a hypothetical individual would be doing at each stage
    • This exercise helps connect theory to real-life decision making and readiness for change

  • Tools to assist with behavior change (summary):

    • Reading and continuous education are encouraged as supportive tools
    • The course provides quizzes and structured activities to practice applying the model

  • Real-world relevance and implications

    • Emphasizes personal responsibility and self-efficacy in making changes
    • Highlights how beliefs about control (internal vs external) influence motivation and persistence
    • Encourages reflective practice, accountability, and social support across stages
    • Ethical/practical considerations: empowering individuals with knowledge while recognizing that readiness and context vary; avoid shaming those in earlier stages; provide resources and supportive coaching

  • Connections to foundational principles (educational and wellness context)

    • Aligns with concepts of Intellectual Wellness through reflective practice and experiential learning
    • Integrates behavioral science ideas about readiness to change, motivation, habit formation, and relapse management
    • Related to broader health behavior theories that emphasize self-efficacy, perceived control, and stage-based interventions

  • Notes on edition differences and page references

    • Page numbers referenced (12–21) may vary by edition of the text; the core concepts and stage details remain consistent across versions
    • The transcript includes a mix of labels for stages (e.g., Not thinking vs. Pre-contemplation) and a slightly rearranged sequence in one slide; the standard order used here follows the conventional Pre-contemplation → Contemplation → Preparation → Action → Maintenance → Relapse (non-stage) → Termination sequence, with Relapse treated as a possible event rather than a formal phase

  • Quick recap of key definitions in LaTeX for study reference

    • Target Behavior: the isolated behavior to be changed in a program; a precise specification is essential for action. In symbols, one might denote a target as T_{ ext{target}} where the elements of the behavior are clearly defined.
    • Self-Efficacy: the belief in one's ability to perform a specific task; can be represented as SE = P( ext{will perform task}) in practical terms, though this is a qualitative measure rather than a strict probability.
    • Locus of Control: the perceived source of control over events; internal vs external can be considered as LOC{ ext{internal}} ext{ or } LOC{ ext{external}}.
    • Time frame in Maintenance: the benchmark of 6 ext{ months} for sustained change as cited in the material, i.e., t_{ ext{maintenance}} o 6 ext{ months}.