This is an excerpt from Essential Guide for Mental Performance Consultants (Digital Resource), The by Association for Applied Sport Psychology (AASP).
The transtheoretical model (TTM), which is arguably the most dominant model of health behavior change, is universally relied on in all disciplines of psychology (Armitage, 2009). First proposed by Prochaska and DiClemente (1983) as a result of smoking cessation studies, TTM has since helped account for behavior change across multiple contexts. The TTM is a stages of change model that illustrates how behavior changes over time, progressing through six discrete stages: precontemplation, contemplation, preparation, action, maintenance, and termination (see figure 1.1). Following is a brief definition of each stage (Prochaska, 2008) with implications for MPCs.
Movement through the TTM stages is dependent on and facilitated by changes to decisional balance, whereby perceptions of the advantages of changing or maintaining a behavior (e.g., increase in athletic performance as a result of imagery practice) shift over time and eventually outweigh perceptions of the disadvantages (e.g., loss of free time due to imagery practice; Prochaska, 2008). The pros must outweigh the cons before individuals decide that action toward a new behavior is warranted. Further, one’s self-efficacy (i.e., belief in one’s own ability to succeed in specific situations or accomplish a task; Bandura, 1977), or self-belief to carry out the change despite potential adversity, must surpass the temptation to abandon the behavior change efforts. Movement through the stages to achieve one’s ultimate goal is mediated by motivation and readiness to change (Marshall and Biddle, 2001).
Although the TTM is universally popular as a framework to understand behavior change, empirical support for its efficacy is mixed. A 2006 systematic review (Spencer, Adams, Malone, Roy, and Yost, 2006) concluded that only 45 percent of intervention studies using the TTM resulted in long-term positive outcomes, 21 percent were associated with short-term positive outcomes, 13 percent were inconclusive, and 8 percent did not support the use of stage-matched interventions. Spencer and colleagues (2006) noted that interventions that did not support the TTM “often had single-contact, single strategy interventions, while completely supportive studies tended to include multiple strategies with either single or multiple contacts” (p. 433). This emphasizes the importance of ensuring that interventions for behavior change are well designed and stage matched, utilizing all components of the TTM.
While the TTM has been used across domains to conceptualize, guide, and understand behavior change interventions, it has only been integrated into the field of sport psychology in the last 20 years (e.g., Keeler and Watson, 2011; Massey, Meyer, and Hatch, 2011). All studies have supported the use of the TTM to examine behavior change in this context; however, findings remain limited due to the lack of measures to assess the mechanisms of change.