Transtheoretical Model of Change

Abstract

The Transtheoretical Model (TTM) outlines the process of altering behavior by integrating leading principles and theories on behavior change. The TTM is comprised of a number of core constructs that include the Stages of Change, Processes of Change, Decisional Balance, Self-Efficacy, and Temptation. The previously identified Stages of Change (or readiness to change) construct is an important dimension of the TTM, as it reflects the model’s critical assumption—behavior change occurs through a series of six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. The Processes of Change construct outlines the ten activities that individuals use to progress from stage to stage. Interventions that employ the TTM for behavior change should aim to accurately identify and match an individual’s specific processes of change to their stage of change to maximize efficacy. The Decisional Balance construct refers to an individual’s weighing of the pros and cons of their behavior change. Lastly, the Self-Efficacy construct outlines an individual’s confidence in their ability to not relapse when in high-risk situations that tempt them to engage in a specific behavior. Although the majority of the applications of TTM have focused on smoking cessation, the model has also been applied to other problem behaviors such as alcohol and substance abuse, eating disorders, and domestic violence. In addition to providing a comprehensive overview of the model, this article discusses the various applications of the TTM. This annotated bibliography contains a comprehensive summary of literature on TTM outlining its empirical evidence, effectiveness in various settings, limitations, and future research directions with an emphasis on resources that are relevant to social work practice.

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