Ep 62 – Transtheoretical Model Stages of Change & MI

Transtheoretical Model Cycle of Change & MI

Glenn and Sebastian were excited to have Mary Marden Velasquez, PhD, on the podcast to discuss the Transtheoretical Model, including the Stages of Change. Dr. Velasquez is Centennial Professor in Leadership for Community, Professional and Corporate Excellence, Director of the Health Behavior Research and Training Institute (HBRT), and former Associate Dean for Research (2006-2013) at The University of Texas at Austin Steve Hicks School of Social Work. She also holds appointments in the Department of Population Health and Psychiatry at UT-Austin’s Dell Medical School. Prior to moving to UT-Austin to become Associate Dean for Research, Dr. Velasquez served on the research faculty in the Psychology Department at the University of Houston and as tenured faculty and Director of Research in Family and Community Medicine at the UT McGovern Medical School in Houston. Her program of research focuses on the development and implementation of interventions using the Transtheoretical Model and Motivational Interviewing. With over 30 years of continued support from the National Institutes of Health and the Centers for Disease Control and Prevention, Dr. Velasquez has developed and studied behavioral interventions in the areas of integrated primary care, screening and brief interventions, fetal alcohol spectrum disorder, alcohol and other drug abuse, prenatal health, HIV prevention, and smoking cessation. A current emphasis is on teaching graduate students and health professionals to work in interdisciplinary teams and to use brief motivational interventions in medical settings.

Dr. Velasquez recently completed a four-year term as a study section member on the NIH-Center for Scientific Review “Interventions to Prevent and Treat Addictions” (IPTA). She is an internationally recognized trainer in the Transtheoretical Model and Motivational Interviewing and is a member of the international Motivational Interviewing Network of Trainers

Episode index:

Stages of Change and Motivational Interviewing

Mary Marden Velasquez explores the Transtheoretical Model, commonly associated with the Stages of Change, and its relationship with Motivational Interviewing. The episode distinguishes two influential approaches to understanding behaviour change and considers how practitioners can use them without assuming that people move through change in a simple linear sequence.

The discussion connects theory with brief motivational interventions and healthcare practice. It also helps clarify a common misconception: the Stages of Change model and MI developed separately, although practitioners often use them alongside one another. Related topics include Change Talk, Sustain Talk and Motivational Interviewing in Healthcare.

In this episode

00:00 – Introduction and episode preview

05:37 – Mary’s early TTM and MI story

17:50 – The 10 Processes of Change

21:21 – Experiential Process #1: Consciousness raising

24:08 – Experiential Process #2: Emotional arousal

26:21 – Experiential Process #3: Self-evaluation

28:57 – Experiential Process #4: Environmental re-evaluation

30:52 – Experiential Process #5: Social liberation

33:31 – The Stages of Change

39:35 – Experiential processes linked to long-term change

47:25 – Behavioral Process #1: Stimulus control

48:13 – Behavioral Process #2: Counter conditioning

49:23 – Behavioral Process #3: Reinforcement management

51:01 – Behavioral Process #4: Self-liberation

52:09 – Behavioral Process #5: Helping relationships

55:05 – Applying the model flexibly

1:00:35 – The stages of change and MI: The “kissing cousins”

1:02:25 – Decisional balance and self-efficacy

1:10:43 – Temptation

1:12:25 – Spending time with giants in the field

1:16:57 – End of episode

Links and contact information:

Study cited in episode:

Stotts AL, DiClemente CC, Carbonari JP, Mullen PD. Pregnancy smoking cessation: a case of mistaken identity. Addict Behav. 1996 Jul-Aug;2