Example Of The Transtheoretical Model And The Health Belief Models Essay
In the Treatment of Alcohol and Drug Addiction
In the Treatment of Alcohol and Drug Addiction
The Transtheoretical Model for Behavior Change (TTM) and the Health Belief Model (HBM) are both popular models used in health care for changing behaviors. Professionals in the field of addiction, alcohol and drug, commonly refer to both models in their treatment of addicts. Both models are useful and have both positive and negative aspects.
The Transtheorietical Model states that there chronological stages that a person will travel through as they battle an addiction (Korcha, Polcin, Bond, Lapp & Galloway 2011). The first stage is pre-contemplation, the addict is active in their addiction and not aware of any negative effects. The contemplation stage is when the addict begins to recognize the consequences of their using or drinking. They may be getting physically ill, there are problems with the family or on the job. The preparation stage is when the addict begins to consider quitting and researching options how to best quit drinking or using. The fourth stage is action, the alcoholic or addict finally performs a behavior to quit their bad habit. An example might be entering rehab or joining Alcoholics Anonymous. There is no set period of time for any of these stages. People can be in pre-contemplation for twenty or thirty years with alcoholism before seeking help. The final, and lifelong step is maintenance. In this step, former addicts continue their sobriety and stay away from alcohol or drugs. Relapse is the term that describes moving backwards in these steps. If a person has maintained sobriety for a period of years and then drinks again, they have experienced relapse (Heather, Honnekopp & Smailes 2009). In order to maintain sobriety from alcohol or drugs many recovery programs recommend a twelve step program for success (Wolf & Nochaski 2010).
The TTM model has worked well in addiction treatment. Counselors often present the model and use it as a teaching tool for people recovering from drug and alcohol abuse. Have a model to follow helps therapists to explain the cycle of addiction in a behavioral manner. The model is also very easy for a patient to follow and understand. Drawbacks if the model according to Sharma and Atri (2006) is that it helps as a guide through recovery but it does not fully explain underlying psychological, behavioral and physical causes for addiction.
The Health Belief Model is also popular in recovery. It is based on a person’s beliefs of a health issue, the perceived barriers or benefits from taking action and self-efficacy. To start the process a cue or stimulus must be present (Champion & Skinner 2008). With an addiction a person must be aware that their behavior is having serious health and other effects. There are six constructs of the model. The first is perceived susceptibility where person weighs the chances of acquiring the disease. The second is perceived severity, meaning how serious the disease is in their case. The person will consider both the medical and social aspects of the disease. When considering taking action to prevent or treat a disease the person is perceiving the benefits. Barriers or obstacles such as insurance coverage and cost is considered perceived barriers. The cue to action prompts this line of thought. The cue could be being fired from a job due to drug use or a partner leaving a relationship because of excessive drinking. Self-efficacy represents a person’s confidence in following through with treatment (Boston University School of Health 2013).
Health Belief Model
El-Rahamn, Mahmoud, Amal, & Mahmoud (2014) found that when alcoholics are hospitalized for withdrawal from the alcohol, the Health Belief Model is helpful in helping them to seek out long term treatment. It provides an excellent start to the process of recovery. By presenting the Health Belief Model to a hospitalized alcoholic, they can easily answer the questions and think deeply about seeking help to overcome the addiction. Orji, Vassileva and Mandryck (2012) however, contend that the Health Belief Model is best used in preventive practices and education. Making people aware of potential health problems and introducing them to ways to prevent illness uses the Health Belief Model very effectively.
The similarities between the models is self-awareness. In order for either model to be initiated, an addict needs to become aware of their health problem. The differences are more apparent. The Transtheoretical Model is chronological in nature and a person will progress through each stage in order. It is possible through relapse to return to a previous step, but a person will have to work through them again. The Health Belief Model has the initial cue, but the constructs identified can be experienced in any order and quite possibly simultaneously. In the case of addiction and alcoholism, the Transtheoretical Model works much better. Because addiction is a chronic, life-long disease it is important for someone suffering from it to see the disease in these terms.
Boston University School of Public Health. (2013). The health belief model. Retrieved from:
Champion, V., & Skinner, C. (2008). Health Behavior and Health Education. San Francisco:
John Wiley & Sons.
El-Rahamn Mona, A., Mahmoud, A., Amal, M. & Mahmoud, S. (2014). The application of
alcohol brief intervention using the health belief model in hospitalized alcohol use disorders
patients. International Journal of Caring Sciences, 7(3), 843-854. Retrieved from:
Heather, N., Honnekopp, J. & Smailes, D. (2009). Progressive stage transition does mean getting
better: A further test of the transtheoretical model in recovery from alcohol problems.
Addiction 104(6), 949-958. DOI: 10.1111/j.1360-0443.2009.02578.x
Korcha, R., Polcin, D., Bond, J., Lapp, W., & Galloway, G. (2011). Substance use and
Motivation: A longitudinal perspective. American Journal of Drug and Alcohol Abuse,
37(1), 48-53. DOI: 10.3109/00952990.2010.535583
Orji, R., Vassileva, J. & Mandryck, R. (2012). Towards an effective health interventions
design: An extension of the health belief model. Online Journal of Public Health
Informatics, 4(3). Retrieved from: http://hci.usask.ca/uploads/304-Towards-an-Effective-
Sharma, M., & Atri, A. (2006). Application of transtheoretical model (TTM) to addictive
behaviors: The need for fine tuning. Journal of Drug and Alcohol Education 50(4), 3-6.
Retrieved from: http://eds.a.ebscohost.com/eds/detail/detail?vid=4&sid=06679ae1-21ed-
Wolf, S., & Nochaski, T. (2010). Combining the transtheoretical stages of change model and the
Work Practice in the Addictions 10(2), 224-227. Retrieved from: http://eds.a.ebscohost.com
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