Application of the Transtheoretical Model to substance abuse: historical development and future directions

Abstract

As a growing literature has documented applications of the Transtheoretical Model (TTM) to substance abuse, the utility or futility of such an application has been debated widely. The purpose of this paper is to critically examine the TTM, and its conceptual and empirical applications to the field of substance abuse. This review focuses not only on the stage of change dimension of the TTM, but also the processes, decisional balance, and self-efficacy dimensions, which have received less attention in earlier reviews. Particular emphasis is placed on the measurement and conceptualization of the stage of change construct. Unanswered questions and directions for future research are identified. It is concluded that, to effectively determine the TTM's applicability to substance abuse, all dimensions must be more fully developed, validated and evaluated across a range of substance abuse problems. Further, prospective studies are needed to determine the predictive utility of the TTM, and evaluation of TTM-matched interventions will help to address the model's specificity.

Using the transtheoretical model of behavioural change to understand the processes through which climate change films might encourage mitigation action

“…The TTM has been used to design interventions to promote positive behaviours such as physical activity/exercise (Adams and White, 2003;Spencer et al, 2006), healthy eating (Armitage et al, 2004;Horwath, 1999;Spencer et al, 2007), and mammography screening (Ashworth, 1997;Spencer, Pagell, and Adams, 2005), as well as to help people avoid pregnancy and sexuallytransmitted diseases (Horowitz, 2003) and overcome harmful behaviours such as smoking and substance abuse (Migneault, Adams, and Read, 2005;Spencer et al, 2002). The apparent success of some of these communication and intervention programmes suggests that it might be worth applying insights from the model to the promotion of lower-carbon and other sustainability-related behaviours.…”

Smoking Cessation for Adolescents: A Review of Pharmacological and Psychosocial Treatments

“…Many behavioral interventions include aspects of CBT, motivational interviewing (MI), contingency management (CM), and/or the Transtheoretical model of Behavior Change For further review of these theoretical approaches, please see 42,43 . Sussman 25 published an excellent review of behavioral treatments for adolescent cessation, focused on interventions published up to 2000.…”

The use of digital technology in substance misuse recovery

“…These stages may be relevant to the processes of behaviour change related to substance misuse recovery, and may also necessitate specific forms of support for the individual depending on where they are in their substance misuse recovery journey. For example, those in the earlier stages of precontemplation and contemplation may lack the motivation to change their behaviour, and therefore support is needed to increase motivation (Migneault et al, 2005). In contrast, those who are in the maintenance stage are more likely to score low on assessments measuring the perceived difficulty of changing their behaviour (indicating that they do not consider maintaining behaviour change difficult), and are more likely to seek helping relationships to sustain this change (Carbonari & DiClemente, 2000;Connors, DiClemente, Velasquez, & Donovan, 2012).…”