Virtually all of us
seek basic life guidelines whose applications readily promote our health and
function. Accordingly, this blog post will describe one approach to helping you
in that endeavor.
Although behavioral
science has not created any simple, E=mc₂-elegant formulas, it has suggested stages and processes to guide our efforts toward physical and mental
health. One of the most well-respected of these is the transtheoretical model
of Prochaska, DiClemente, and Norcross (1992).
The Prochaska model attempts to match our healthful lifestyle change
interventions to given stages. Five stages have been suggested:
precontemplation precedes all of our change efforts; contemplation involves
planning to change; preparation has us assembling the resources to act on our
healthful intention; action is the period during which we overtly implement our
plan; and maintenance is our continuing efforts toward change. Prochaska and
his colleagues hoped that their model could be used to guide many
health-oriented goals.
The five stages
were described in terms of five cognitive-affective processes and five
behavioral processes. The former
concerned: gathering information, considering consequences on oneself,
experiencing and expressing emotion, evaluating consequences on others, and
paying attention to norms of society. The latter included: substituting new
behaviors for the old ones, controlling
cues within the environment, rewards to the self and others, taking advantage
of social supports, and making a change commitment.
In theory,
every stage could be influenced by the way an individual dealt with the
cognitive-affective processes and behavioral processes. Craig S. Rosen (2000)
was not convinced, so he set out to test the transtheoretical model to ensure
that it could be used to greatest effect.
His research focused on the usefulness of the Prochaska model for
persons attempting smoking cessation, diet change, exercise adoption,
elimination of substance abuse, and benefit from psychotherapy.
After analyzing
forty-seven studies, Rosen concluded that the Prochaska stages worked well
across the five targeted health goals.
However, the processes were not the same for all. Specifically, for smoking cessation, in the early
stages of change, cognitive processes were more central than behavioral
processes. For diet change and exercise
adoption, the cognitive and behavioral processes worked consistently with each
other. And for elimination of substance abuse, and benefit from psychotherapy
there was general inconsistency.
Rosen’s research
was noteworthy because the Prochaska transtheoretical model is well-respected
and frequently employed by health professionals to treat their patients. I,
too, regard the model as one that has merit, and that can be used with
discretion to help guide healthful lifestyle change. However, the stages do not
necessarily proceed smoothly from one to the other, and the processes can
assume different value from person to person. My point in writing about the
model today is to underscore my perennial advice: You must match any change
model to what I call your ego strength—the unique “you” that is a result of
interactions among your history, temperament, personality, and environments.
Remain open-minded to others’ recommendations, but customize them to fit what
you are willing and able to do. In order to perform the customization,
tactfully "challenge" whoever is advising you. That is, you need to let them know at which
points their advice seems to align with who you are and where it does not seem
to do so. After that, you can carefully observe the advisor's response and
decide whether you then have more or less confidence in their recommendations.
References
Prochaska,
J., DiClemente, C., & Norcross, J. (1992).
In search of how people change: Applications to addictive behaviors. American Psychologist 47, 9,1102-1114.
Rosen,
C. (2000). Is the sequencing of change
processes by stage consistent across health problems? A meta-analysis. Health Psychology, 19, 6, 593-604. doi:
http://dx.doi.org/10.1037/0278-6133.19.6.593
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