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Transtheoretical Model of Behavior Change

TTM
The Prochaska Spiral

At some time in their lives, most people have made various attempts to modify their behavior. It could be to lose weight, start saving money, stop smoking, etc. Sometimes these types of changes occur gradually, sometimes abruptly. Whether quickly, or over time, change usually occurs throughout a series of stages. These stages are outlined in the “Transtheoretical Model of Behavior Change,” or TTM.

TTM was founded in the early 1980s through the work of psychologist James O. Prochaska, PhD. This “readiness to change” model has enthused many to reevaluate theories about the most useful, apposite means of sustaining one’s self to achieve goals in relation to altering their behavior. The process in captured in the Prochaska Spiral.

Initiating one’s self into action is frequently more difficult than “just doing it,” and possibly less productive than anticipated. Without the proper emotional preparedness to tackle a particular goal, a person may actually sabotage their success. Prochaska devised a six-point model to clarify that lasting change seldom takes place due to a single ongoing resolve to act. More often than not, change develops from an understated, multifaceted, and at times, tortuous progression. A process that includes various phases of mental attentiveness such as thinking, pausing, going forward, going backwards, and sometimes starting all over again!

The Six-Stages of the Transtheoretical Model

Prochaska’s TTM hypothesis recognizes that enduring modification in a person’s behavior generally advances through six crucial stages: Precontemplation to Contemplation, and onto Preparation and Action. However, this is just the beginning, as individuals can indubitably slip back into the Preparation or Contemplation stages, if they lose their resolve.

For behavioral changes to be solidified, a person must enter into the Maintenance phase until the changed behavior “sticks,” so to speak. The final stage called Termination, means that the transformation is complete and permanently instilled in the person’s lifestyle.

-Precontemplation
Individuals in this phase desire to change; however, actual plans have not been conceived. This is because they may not be wholly cognizant of the potential advantages; they may be discouraged due to failure of past attempts, or lack energy.

-Contemplation
Those in the Contemplation phase are considering taking action, but are not altogether ready, or, do not understand how to go about getting started. They are open to feedback and information. This is somewhat a “dilly-dallying” stage.

-Preparation
At this stage, people are geared to take action. They are more strong-minded, certain, and dedicated. They are developing their plan of attack and may have already taken action in small steps.

-Action
Apart from just thinking about acting, a person at this stage is actually doing something. This stage is when all the prior small steps, seeming irrelevant choices, and small sacrifices come together to make a significant difference.

-Maintenance
Persons in the Maintenance phase have maintained the “Action” phase for a minimum of six months. This means that they have providentially shunned or conquered the obstructions that could have caused them to lapse into previous behaviors.

-Termination
When individuals in the Maintenance phase prolong their healthier behavior for at least two years, they go into Termination. In the Termination phase, the new behavior is wholly integrated and the temptation to relapse into old behavior has weakened. This constituent of behavior modification is no longer something an individual needs to do. It is part of their standard operating procedure.

Why the Transtheoretical Model of Behavior Change is so Important

The idea of comprehending the art of behavioral change is for a person to develop the life of their highest choosing. By integrating a particular lifestyle change that benefit’s them, they are reinforcing within themselves that they have the ability to do it. When people explore how they may utilize their vigor, awareness of self, and the acumen they’ve gained to embark on new areas of challenge or learning, growth occurs. This is why TTM is so important, it acknowledges that change takes time; thereby, setting individuals up to succeed.

MyPlate Controversy | Pie (chart) to Cure Obesity?

As you probably know by now the United States Department of Agriculture has retired the food pyramid and introduced MyPlate which has caused quite a stir in health and wellness circles. The outgoing food pyramid has been around for ages, but was deemed too complicated to understand (in the opinion of Agriculture Secretary Tom Vilsack). So we now have a pie plate to guide our nutritional choices:

MyPlate

In my opinion, a departure from the food pyramid is a good thing because the previous imagery used by the USDA gave the misconception that a diet with a foundation in carbohydrates (any carbohydrates: cereal, muffins, bagels, etc.) was a healthy approach…

Food Pyramid

MyPlate still suggests eating carbohydrates but now has more of an emphasis on whole grains. In addition, the total area representing grain-based food (on the plate) is significantly less than the pyramid. It should be noted however that carbohydrates are hardly eliminated in the new USDA model. In fact, there is still an arguably large amount of carbohydrates on the plate via fruits and vegetables. It is assumed the rest of MyPlate accounts for protein requirements (apparently there is no room for fats, oils, or sweets anymore | just kidding).

The USDA has built the sub-site ChooseMyPlate to help encourage and educate parents and individuals on quality food sources and MyPlate in general. One admirable aspect of ChooseMyPlate that I like is it gives families ideas of healthy, yet economical dietary choices for those struggling to make the right decisions on a budget.

So the basic paradigm shift is that the food pyramid was founded on the premise that one should consume more of what was at the bottom (of the triangle) and eating less of those things found at the top. In contrast to MyPlate, the pyramid appeared to have more choice. However, the idea behind the design of MyPlate is to provide a simplistic and direct connection to the food we eat. At a rudimentary level, this makes sense.

I commend Michelle Obama’s Let’s Move initiative to a healthier lifestyle and to the degree that people had difficulty understanding the former food symbol, I think we are moving in the right direction.

As with all good science it is important to continue the debate, there are those that believe mixing and matching food groups with nutrients will confuse consumers… and of course, different industry players and experts which might be affected by the promotion of MyPlate have their own opinions about the government’s efforts. There are also people that have conflicting ideologies about food intake, like Paleolithic diet proponents, or the PCRM with their vegetarian Power Plate.

Power Plate

So does all of this guarantee a healthier America? No. I am not a dietitian but portion control is a no-brainer when addressing weight management so it isn’t surprising that dietitians are perplexed by the lack of emphasis on portion control. However, in my opinion as a behavior change model MyPlate is moving us in the right direction… it is more usable, and will be much more helpful to children than its triangular predecessor.