The transtheoretical model and substance dependence: theoretical and practical aspects

Abstract

aqueles relacionados a outras condições de saúde foram excluídos. Propostas de tratamento foram consideradas (exceto Modelo Minnesota e internação). Resultados: Novas diretrizes surgem sobre a idéia inicial da teoria, apesar da mesma já ser estudada há mais de 20 anos: estudos transversais empregando o modelo, bem como a avaliação do potencial prescritivo ou descritivo do mesmo. Discussão: Esta teoria enfoca a mudança intencional de comportamento, o que ampliou a compreensão dos comportamentos aditivos. O Modelo Transteórico sugere aos profissionais que a efetividade do tratamento depende da capacidade do mesmo de aplicar a técnica adequada à situação motivacional do paciente no processo de mudança. Isto demonstra porque é tão importante identificar o estágio de mudança do paciente quando este ingressa no tratamento. O artigo descreve os principais elementos da teoria bem como os principais instrumentos usados atualmente para identificar os estágios. Por fim, são discutidas as críticas e as limitações do modelo. Descritores: Abuso de substâncias; Comportamento; Efetividade de tratamento; Motivação; Literatura de revisão como assunto IntroductionThe past two decades have been marked by numerous studies on intentional behavior change, especially concerning addictive behaviors. Some of those studies 1,2 have attempted to outline the behavior change process. One such study was conducted by Prochaska and DiClemente, 3 who proposed the Transtheoretical Model (TTM), which is known worldwide as the stages-ofchange model and commonly adopted as a guideline for clinical interventions for a wide range of health problems, such as substance use disorders. 4 The authors stated that the development of their theory was related to the need for coherent organization of the processes of intentional behavior change. The theory is based on experimental data obtained through surveys completed by individuals with nicotine dependence who achieved smoking cessation without enrolling in treatment. 3,5 This model emphasize the importance of a wider view of the individual, which allows a more accurate evaluation of patient condition, in comparison with the historic conception that success or failure in changing the addictive behavior is a function of denial.

Motivações de dependentes químicos para o tratamento: percepção de familiares

“…Among them, there is the motivation of the addict as one of the main criteria involving the demand and treatment maintenance. This condition is characterized as a state of readiness or willingness to change the problematic behavior (6)(7) .…”

Commitment to health: a predictor of dietary change

“…The importance of the findings of Ory et al. (2002), as substantiated by Vilela et al. (2009), is the recognition that measuring readiness to change or stage of change should become a standard part of assessing dietary behaviour and part of therapeutic decision‐making.…”

A cluster randomized pilot trial of a tailored worksite smoking cessation intervention targeting Hispanic/Latino construction workers: Intervention development and research design

“…28 If there are no contraindications, participants will be given their preferred form of NRT (gum or patch) and will be provided information on side effects and proper use. After screening, participants will complete a baseline assessment to collect information about demographics, job characteristics, job stress, 40 acculturation, 41 , smoking history and nicotine dependence, 42 withdrawal symptoms, stages of change, 43 quit ladder, 44 smoking self-efficacy, 45 depression, 46 social support, 47 exposure to secondhand smoke, quality of life, expired CO, and cotinine saliva (Table 3). 48 …”