Six Stage Model Evaluation - Coggle Diagram
Six Stage Model Evaluation
Usefulness of the model
Useful because it suggests that the most effective strategy to use in reducing addiction is determined by current stage the individual is in.
Haslam and Draper 2000
Found that women further along the cycle of change were more convinced about dangers of smoking during pregnancy.
First stage = most resistant, further along = more convinced about health risks.
That interventions need to be tailored to an individual’s particular stage of change in order to maximise their effectiveness.
Evidence does not always demonstrate behavioural outcomes
Whitelaw et al 2000
Critical review of Prochaska’s model,
Concluded that only a few studies have used behavioural outcomes as a way of measuring the usefulness of this model.
Most research focuses on stage progression which does not necessarily equate to behaviour change
E.g. may be that the intention to quit smoking changes, not the behaviour itself
Whiteclaw et al 2000
Highlighted many methodological issues with supporting studies
Some have not used control groups
Others have only used self-selecting samples
Others have used a variety of interventions as part of the treatment (e.g. NRT alongside behavioural counselling)
Difficult to disentangle the specific effects of a ‘stages of change’ approach from the more generalised effects of intervention
More methodologically sound evidence questions the effectiveness of of stages intervention in the treatment of addiction.
Baumann et al 2015
Randomly allocated problem drinkers (not intending to change) to either
Experimental group (received intervention tailored to motivational stage)
Control group (received minimal intervention only)
Found: very few participants gave up drinking completely (2%) although 35% did decrease quantity and frequency
No significant difference in effects between staged intervention and control group - suggests advantages of Prochaska’s model may be overstated.
Description vs prediction
Most researchapplying the 6 stage modell to addiction desicbes the stages that people are at in the recovery process and correlates this with addiction related and tresemtn seeking behaviour.
This research has produce mixed findings.
This suggests that it is unclear whether or not the model is a good predictor of who is liekly to make chnages… which is the mai nail of a useful mode.
Attidues to replase
Carlo DiClemente et al 2004
‘Relapse is the rule rather than the expection’
The model does not view relapse as failure, but as an inevitable part of the ‘untidy’ non linear, dynamic process of behaviour change.
As it views replase as more than just a sli-p, the model also takes it seriously and does not underestimate its potential to blow change entirel off course.
Lots of chnages to behaviour reqrtuie several attempts to get it right, to make it last, or to reach the maintenance or termination stages.
Arbitrary nature of the stages
The difference between stages is probably too arbitrary.
Stephen Sutton 2001
Points out that if an individuals plans to stop smoking in 30 days time they are in the preparation stage, but if they plan to give up in 31 days time they are in the contemplation stage.
Albert Bandura 1997
Claims that the first two stages are not even quality alert different, becuase the only differences between them is how much the individuals wants to change.
Pal Kraft et al 1999
Argues that the six stages can be reduced to just tai useful one… precontemplation plus all the toehr grouped together.
Dynamic nature of behaviour
More tradioanl theories have ignored the importance of dynamic process, considering recovery form addiction as a single ‘all or nothing’ event.
This medal empahsies the importance of time, viewing overcoming an addiction such as smoking as a continuing process.
This is why…
The model pros oes that behaviour hcnage occurs through six stages of varying duration ofr each persons, and tht the stages are recycled backwards and forwards to different degrees.
A strength of this model is that it recognised that changing addictive behaviours is a dynamic process.
One weakness of the model is that the difference between stages is often “blurry” e.g. the difference between contemplation and preparedness is vague. So it is questionable whether they are in fact two distinct stages.
A further weakness is that the model neglects the influence of social factors for example living conditions and unemployment within this environment. It also fails to recognise the influence of wider social norms such as in some societies it is expected that when people socialise they will drink alcohol so abstaining would be very difficult.
The research carried out on the effectiveness of this model is inconclusive. Velicer et al. (2007) reviewed 5 studies and found a 22-26 success rate which compared well with other interventions. Furthermore, Aveyard et al. (2009) found that tailoring intervention to the stages of change did not increase its effectiveness in individuals who were trying to stop smoking. Similarly, Baumann et al. (2015) carried out a study on randomly allocated alcohol addicts to an experimental group and to a control group. They found no beneficial effect to staged intervention.