Skip to main content

The Transtheoretical Model of Behavior Change: Prochaska and DiClemente’s Model

  • Chapter
  • First Online:
Psychology of Substance Abuse

Abstract

This chapter aims to present the Transtheoretical Model of Behavioral Change (TTM) and its main constructs. The intention is to expose the applicability in the treatment of substance dependence and it explains how the model is structured. TTM has two central constructs: the Stages of Change and the Mechanisms of Change. The Stages of Change are called the temporal part of the model, with a definition of stages in relation to the motivation of a person. The Stages of Change are Precontemplation, Contemplation, Preparation, Action, and Maintenance. In addition to the stages, an explanation about the Mechanisms of Change will be carried out in the text. The mechanisms are the “gears” that make people change motivational stages. Mechanisms of change are the self-efficacy, the temptation to return to drug use, the decision-making balance (pros and cons), the processes of change, and the external factors. Many research works were cited in order to illustrate the applicability of the model in different contexts. And finally, the main instruments of evaluation of TTM in Brazil have been described. In light of the above, it is clear promising results the model has to offer in the treatment of substance abuse.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ávila, A. C., Yates, M. B., Silva, D. C., Rodrigues, V. S., & Oliveira, M. S. (2016). Avaliação da autoeficácia e tentação em dependentes de cocaína/crack após tratamento com o modelo transteórico de mudança (MTT). Aletheia, 49, 74–88.

    Google Scholar 

  • Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Paja (Ed.), Self-efficacy beliefs of adolescents. Greenwich, UK: Information Age Publishing.

    Google Scholar 

  • Bedendo, A., Ferri, C. P., Souza, A. A. L., Andrade, A. L. M., & Noto, A. R. (2019). Pragmatic randomized controlled trial of a web-based intervention for alcohol use among Brazilian college students: Motivation as a moderating effect. Drug and Alcohol Dependence, 199, 92–100. https://doi.org/10.1016/j.drugalcdep.2019.02.021.

  • Carlson, L. E., Taenzer, P., Koopmans, J., & Casebeer, A. (2003). Predictive value of aspects of the Transtheoretical Model on smoking cessation in a community-based, large-group cognitive behavioral program. Addictive Behaviors, 28(4), 725–740. https://doi.org/10.1016/s0306-4603(01)00268-4

    Article  Google Scholar 

  • Connors, G. J., Velasquez, M. M., DiClemente, C. C., & Donovan, D. (2013). Substance abuse treatment and the stages of change: Selecting and planning interventions. New York, NY, USA: The Guilford Press.

    Google Scholar 

  • Crouch, T. B., DiClemente, C. C., & Pitts, S. C. (2015). End-of-treatment abstinence self-efficacy, behavioral processes of change, and posttreatment drinking outcomes in project MATCH psychology of addictive behaviors. American Psychological Association, 29(3), 706–715. https://doi.org/10.1037/adb0000086

    Article  Google Scholar 

  • Daoud, N., Hayek, S., Muhammad, A. S., Abu-Saad, K., Osman, A., Thrasher, J. F., & Kalter-Leibovici, O. (2015). Stages of change of the readiness to quit smoking among a random sample of minority Arab male smokers in Israel. BMC Public Health, 15, 672. https://doi.org/10.1186/s12889-015-1950-8

    Article  Google Scholar 

  • De Micheli, D. Andrade, A. L. M., Silva, E. A. & Souza-Formigoni, M. L. O. (2016). Drug Abuse in Adolescence. 1. ed. New York: Springer International Publishing. https://doi.org/10.1007/978-3-319-17795-3.

  • DiClemente, C. C. (2003). Addiction and change: How addictions develop and addicted people recover. New York, NY, USA: Guilford Press.

    Google Scholar 

  • DiClemente, C. C. (2017). O Modelo Transteórico: Implicações para a Clínica e para a Saúde Pública. In M. S. Oliveira, R. M. Boff, M. J. Cazassa, & C. C. DiClemente (Eds.), Por que é tão difícil mudar?: contribuições do modelo transteórico de mudança do comportamento na prática clínica e na promoção de saúde (pp. 23–32). Novo Hamburgo, Brazil: Sinopsys.

    Google Scholar 

  • DiClemente, C. C., Carbonari, J. P., Montgomery, R. P. G., & Hughes, S. O. (1994). The alcohol abstinence self-efficacy scale. Journal of Studies on Alcohol, 55(2), 141–148. https://doi.org/10.15288/jsa.1994.55.141

    Article  Google Scholar 

  • DiClemente, C. C., Fairhurst, S. K., & Piotrowski, N. A. (1995). Self-efficacy and addictive behaviors. In J. E. Maddux (Ed.), The Plenum series in social/clinical psychology. Self-efficacy, adaptation, and adjustment: Theory, research, and application (pp. 109–141). https://doi.org/10.1007/978-1-4419-6868-5_4

    Chapter  Google Scholar 

  • Erol, S., Balci, A. S., & Sisman, F. N. (2018). Effect of transtheoretical model based smoking cessation program on high school students. Journal of Nutrition and Health Sciences, 5(3), 301. https://doi.org/10.15744/2393-9060.5.301

    Article  Google Scholar 

  • Figlie, N. B. I., Dunn, B., & Laranjeira, R. (2004). Estrutura fatorial da Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) em dependentes de álcool tratados ambulatorialmente. Revista Brasileira de Psiquiatria, 26(2), 91–99. https://doi.org/10.1590/S1516-44462004000200005

    Article  Google Scholar 

  • Hashemzadeh, M., Rahimi, A., Zare-Farashbandi, F., Alavi-Naeini, A. M., & Daei, A. (2019). Transtheoretical model of health behavioral change: A systematic review. Iranian Journal of Nursing and Midwifery Research, 24(2), 83–90. https://doi.org/10.4103/ijnmr.IJNMR_94_17

    Article  Google Scholar 

  • Janeiro, L., Faísca, L., & Miguel, M. J. L. (2016). Qualidades psicométricas da versão portuguesa da SOCRATES 8D numa amostra de heroinodependentes em tratamento. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 42, 177–191. https://doi.org/10.21865/RIDEP42_179

    Article  Google Scholar 

  • Koyun, A., & Eroglu. (2016). The effect of transtheoretical model-based individual counseling, training, and a 6-month follow-up on smoking cessation in adult women: a randomized controlled trial. Turkish Journal of Medical Sciences, 46(1), 105–111. https://doi.org/10.3906/sag-1407-100

    Article  Google Scholar 

  • Krebs, P., Norcross, J. C., Nicholson, J. M., & Prochaska, J. O. (2018). Stages of change and psychotherapy outcomes: A review and meta-analysis. Journal of Clinical Psychology, 74, 1964–1979. https://doi.org/10.1002/jclp.22683

    Article  Google Scholar 

  • Luh, D. L., Chenn, H. H., Liao, L. R., Chen, S. L., Yen, A. M., Wang, T. T., … Fann, C. Y. (2015). Stages of change, determinants, and mortality for smoking cessation in adult Taiwanese screenees. Prevention Science, 16(2), 301–312. https://doi.org/10.1007/s11121-014-0471-5

    Article  Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1993). Prevenção da recaída. Estratégia e manutenção no tratamento de comportamentos adictivos. Porto Alegre, Brazil: Artmed.

    Google Scholar 

  • McConnaughy, E. A., DiClemente, C. C., Prochaska, J. O., & Velicer, W. E. (1989). Stages of change in psychotherapy: A follow up report. Psychotherapy: Theory, Research and Practice, 26(4), 494–503. https://doi.org/10.1037/h0085468

    Article  Google Scholar 

  • Oliveira, M. S., DiClemente, C. C., & Szupszynski, K. P. D. R. (2010). Estudo dos estágios motivacionais no tratamento de adolescentes usuários de substâncias psicoativas ilícitas. Psico, 41(1), 40–46.

    Google Scholar 

  • Oliveira, M. S., Ludwig, M. W. B., Moraes, J. F. D., Rodrigues, V. S., & Fernandes, R. S. (2014). Evidências de validade da University of Rhode Island Change Assessment (URICA-24) para dependentes de tabaco. Revista de Ciências Médicas, 23(1), 5. https://doi.org/10.24220/2318-0897v23n1a2410

    Article  Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory Research and Practice, 20, 161–173. https://doi.org/10.1037/h0088437

    Article  Google Scholar 

  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. Applications to addictive behaviours. The American Psychologist, 47(9), 1102–1114. https://doi.org/10.1037/0003-066X.47.9.1102

    Article  Google Scholar 

  • Prochaska, J. O., Norcross, J. C., & Saul, S. F. (2019). Generating psychotherapy breakthroughs: Transtheoretical strategies from population health psychology. American Psychologist., 75, 996. https://doi.org/10.1037/amp0000568

    Article  Google Scholar 

  • Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, W., … Rossi, S. R. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1), 39–46. https://doi.org/10.1037//0278-6133.13.1.39

    Article  Google Scholar 

  • Prochaska, J. O., Velicer, W. F., DiClemente, C. C., & Fava, J. L. (1988). Measuring the processes of change: Applications to the cessation of smoking. Journal of Consulting and Clinical Psychology, 56(4), 520–528. https://doi.org/10.1037//0022-006x.56.4.520

    Article  Google Scholar 

  • Rios, L. E., Herval, Á. M., Ferreira, R. C., & Freire, M. D. C. M. (2019). Prevalences of stages of change for smoking cessation in adolescents and associated factors: Systematic review and meta-analysis. Journal of Adolescent Health, 64(2), 149–157. https://doi.org/10.1016/j.jadohealth.2018.09.005

    Article  Google Scholar 

  • Rodrigues, V. S. (2013). Programa de tratamento para usuários de cocaína/crack baseado no modelo transteórico de mudança (Doctoral dissertation, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil). Retrieved from http://repositorio.pucrs.br/dspace/handle/10923/5644

  • Searight, H. R. (2018). Counseling patients in primary care: Evidence-based strategies. American Family Physician, 98(12), 719–728.

    Google Scholar 

  • Sharifirad, G. R., Eslami, A. A., Charkazi, A., Mostafavi, F., & Shahnazi, H. (2012). The effect of individual counseling, line follow-up, and free nicotine replacement therapy on smoking cessation in the samples of Iranian smokers: Examination of transtheoretical model. Journal of Research in Medical Sciences, 17(12), 1128–1136.

    Google Scholar 

  • Sousa, P. F., Ribeiro, L. C. M., Melo, J. R. F., Maciel, S. C., & Oliveira, M. X. (2013). Dependentes Químicos em Tratamento: Um Estudo sobre a Motivação para Mudança. Temas em Psicologia, 21(1), 259–268. https://doi.org/10.9788/TP2013.1-18

    Article  Google Scholar 

  • Szupszynski, K. P. D. R. (2012). Estudo dos processos de mudança em usuários de substâncias psicoativas ilícitas (Doctoral dissertation, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil). Retrieved from http://tede2.pucrs.br/tede2/handle/tede/810

  • Szupszynski, K. P. D. R., & Oliveira, M. S. (2008). Adaptação Brasileira da University of Rhode Island Change Assessment (URICA) para usuários de substâncias ilícitas. Psico-USF, 13, 31–39. https://doi.org/10.1590/S1413-82712008000100005

    Article  Google Scholar 

  • Tran, B. X., Nguyen, L. H., Phuc Do, H., Nguyen, N. P. T., Phan, H. T. T., Dunne, & Latkin, C. (2015). Motivation for smoking cessation among drug-using smokers under methadone maintenance treatment in Vietnam. Harm Reduction Journal, 12(50). https://doi.org/10.1186/s12954-015-0085-7

  • Ünver, Z. (2019). Sağlık Davranışlarının Değiştirilmesinde Transteoretik Model Kullanımı. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu Dergisi, 7(2), 218–228. https://doi.org/10.33715/inonusaglik.643162

    Article  Google Scholar 

  • Velasquez, M., Maurer, G., Crouch, C., & DiClemente, C. C. (2001). Group treatment for substance abuse: A stages-of-change therapy manual. New York, NY, USA: The Guilford Press.

    Google Scholar 

  • Velicer, W. F., Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Smoking cessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 38, 216–233.

    Google Scholar 

  • Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy: An International Quarterly, 19, 3. https://doi.org/10.1891/jcop.2005.19.3.211

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Del Rio Szupszynski, K.P., de Ávila, A.C. (2021). The Transtheoretical Model of Behavior Change: Prochaska and DiClemente’s Model. In: Andrade, A.L.M., De Micheli, D., Silva, E.A.d., Lopes, F.M., Pinheiro, B.d.O., Reichert, R.A. (eds) Psychology of Substance Abuse. Springer, Cham. https://doi.org/10.1007/978-3-030-62106-3_14

Download citation

Publish with us

Policies and ethics