Transtheoretical Model

Substance abuse and dependency persist as a major health and social concern in America. Author Joseph A. Califano, a former secretary of Health, Education, and Welfare notes, “it is hard to find an American family or circle of friends that substance abuse has not touched directly (Califano, J. A., p. 1, 2008).” Califano further explains that although Americans are 4 percent of the world’s population, Americans consume 65 percent of the world’s illegal drugs. Furthermore, one in four Americans will have an alcohol or drug disorder at some point in his or her life. Most of these individuals have parents, children, siblings, friends, community and colleagues who will “undergo psychological and social harm" (Califano, J. A., p. 1, 2008.).” Authors
Although recovery is complicated by physiological and psychological dependence, the intention and motivation of the abuser are critical parts of this process (Diclemente, C. C., p. 2, 1999). A popular perspective being used to understand the process of changing addictive behaviors is a model of intentional behavior change called the transtheoretical model. Transtheoretical model (also known as the stages- of- change theory) suggests that one of the major challenges in substance abuse treatment is to “creatively adapt to the complexities of change using a selection of change processes dependent upon individual’s readiness" (Diclemente, C. C., p. 2, 1999). In this model, there are three critical elements in the change process: stages, processes of change, and levels of change (Diclemente, C. C., p. 2, 1999). Using this framework, this research will examine patients', with Substance Abuse disorder, readiness to change upon detoxification admission and discharge. This examination is critical for UPMC Mercy Medical Detoxification unit’s treatment effectiveness as motivation level influences treatment engagement, retention, and outcomes and higher motivation for change prospectively predict greater reductions in substance