Transtheoretical Model of Change – * Developed by Prochaska & DiClemente
- Views ae metatheoretical and integrative
- Based on analysis of processes of change – comparison of 18 models
- The stages describe attitudes, intention, and behaviors about change
- Each stage refers to a time period and to tasks one must complete before moving to
the next stage
What are the 5 stages of Change? – 1. Precontemplation
- Contemplation
- Preparation/Decision Making
- Action
- Maintenance
What are characteristics of the precontemplation stage? – * defensive, resistant
- uncommitted or passive in treatment
- feeling coerced by significant other
- denial
- not voluntarily coming to treatment in this stage
- Trying to justify it/not recognizing it is an issue or concern
- Active denial, Clients invest little time and energy in exploring the consequences of
their behavior or actions - Lack of awareness of substance abuse problem
- There is an issue, but they are not recognizing it
What are the characteristics of the contemplation stage? – * characterized by more
openness and receptivity to feedback from others - Weighing pros and cons of quitting
- shift from external focus to internal focus
- more willing to undergo formal assessment/talk to someone
- may come voluntarily and not forced (some)
- distress, shame, seeking to evaluate and understand behavior, thinking about making
change - have not begun to take action and not yet prepared to do so
What are characteristics of the Preparation/Decision Making Stage? – * planning to
initiate change, ready to change in terms of attitude and behavior - maybe they will try to talk to someone
- on verge of taking action
- engaged in change process
- might look at treatment programs
What are the characteristics of the Action Stage? – * clients begin to actively make
changes in behavior - take the next step (i.e., AA)
- severe condition (alcohol) detox usually happens before SUD treatment
- commtited to change
- motivated, efforts are being taken, willing to follow activities and strategies to change
- high level of motivation usually
What are the characteristics of the maintenance stage? – * first goal = sustaining
changes made in action stage - second goal = avoid relapse/recurrence
- generally starts 6-9 months following successful action such as last drink or drug use
- likely to have recurrence slip back
- engagement in going to meetings
What is substance abuse assessment and when does it occur? – Assessment is the
collection and use of information to obtain an understanding of ian individual usualyl for
purposes of treatment planning, modification, and evaluation - may occur before, during, or after any defined period of treatment
What are some Substance Abuse Screening Tools? – * Clinical Questions - Self-Report Questionnaires
- Biological Markers or Tests
- Multidimensional Evaluation
What are some Clinical Questions? – CAGE –
C- do you feel you need to cut down on drinking?
A – are you Annoyed by criticism of your drinking?
G – Do you feel guilty about your drinking?
E – Do you need an Eye opener drink in the morning? - can be as simple as a single question to screen for an SUD
- screening questionnaires like AUDIT and DUDIT
What are some Self-Report Questionnaires? – * MAST – helps identify not diagnose
individuals with alcohol problems - Drug Abuse Screening Test: MAST counterpart for drug probs
What are some screening tools for Stages of Change – * assessing motivation for
change - URICA
- SOCRATES
- 12-item Readiness to Change Questionnaire
- Commitment to Sobriety Scale (CSS