Motivational Interviewing and TTM to Support Behavioral Change

This essay explores the application of the Transtheoretical Model of Stages of Change and Motivational Interviewing techniques to facilitate behavioral change in a client aiming to manage weight and overcome obesity. It details how the Transtheoretical Model can guide the client through precontemplation, contemplation, preparation, action, and maintenance stages by addressing ambivalence, providing education, and reinforcing positive impacts. Furthermore, the essay explains how Motivational Interviewing, with its focus on engagement, focusing, evoking motivation, and planning, can be employed to build a strong therapist-client relationship, clarify strategies, and instill confidence in the client's ability to adopt a healthier lifestyle. The ultimate goal is to motivate the client to embrace behavioral changes, improve their health, and prevent weight-related complications.

Running head: BEHAVIORAL CHANGE
Behavioral Change through Motivational Interviewing and Transtheoretical Model of
Change
Name of the Student
Name of the University
Author Note

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Introduction:
Transtheoretical Model is an approach of behavioral modification or behavioral
change which helps to assess the readiness of an individual towards a change to healthier
behaviors and guides individuals to change their behavior. The model is comprised of 5
stages that an individual passes through in order to change their behavior, such as
precontemplation stage, contemplation stage, preparation stage, action stage and maintenance
stage (Kushnir et al., 2016).
Motivational Interviewing is a form of client centered counseling approach that aims
to resolves ambivalence to support change in behavior through the development of
interpersonal relation between the therapist and the client. In this approach, the therapists try
to change the behavior of the clients by motivating them to make the correct choice that can
support the behavioral change (Lindson‐Hawley et al., 2015).
The aim of this study is to identify how Transtheoretical Model of Stages of change
and Motivational Interviewing can be used to help the client to change his behavior so that he
can maintain a healthy weight and overcome the problem of obesity.
Discussion:
Using Transtheoretical Model of Stages of Change:
Using the Stages of change theory, the client can be moved through the stages of
change implement and maintain a healthy behavior of the patient. In the given scenario, the
client will be undergoing a Total Knee Replacement Surgery. The client is overweight and is
concerned about his own health and is afraid that his health condition is caused due to his
overweight problem (Mastellos et al., 2014).

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This concern shows that the patient is already aware how his overweight problem has
led to his current health condition and the need for a knee replacement surgery. Thus the
patient might be ready to contemplate on the need to change his behavior in order to improve
his health condition (Friman et al., 2017). Therefore, the patient might have already crossed
the precontemplative stage and have entered the contemplative stage, where he understood
the relation between his condition and his behavior. At this stage the patient might have
ambivalences about the change that needs to be made on his behavior and analyze the
advantage and disadvantages of changing the behavior (Garcia & Benavidez, 2016). An
individual is also prone to procrastinate the necessary actions, due to which it is vital to move
the client to the next stage of change that is the preparation stage. To do this, any
ambivalence or confusions he might be facing related to the necessity of changing his
behavior can be educated to him along with the possible benefits of the change (Lipschitz et
al., 2015). The therapist can educate the client on how overweight can increase the risks of
obesity and many other related health conditions (such as diabetes, hypertension, osteo-
arthritis, coronary heart diseases, stroke and even cancer), thus showing that the behavioral
change to lose weight and maintain healthy weight can certainly be beneficial to his health
and wellbeing (Romain et al., 2016).
One all the doubts are cleared, the client can move towards the preparation stage,
where the client is ready to change his behavior and adopt a healthy lifestyle and restrict his
weight gain process. At this stage the client also needs to know about specific action that can
help them to lose weight and maintain a healthy weight, such as improving diet and
increasing physical activities. Involving dieticians, lifestyle therapists and physicians can be
helpful to assist the client in this stage and thus help to move to the next stage that is the
Action Stage (Lee et al., 2017).

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At the Action Stage, the client should be able to implement the actions plan that has
been identified in the preparation stage. Here the client should be able to have better diet
plans that are low on saturated fats and sugar content and high in fiber, which can prevent the
rapid gain of weight and help to maintain a healthy weight. The client can be supported at this
stage by providing them the effective diet plans and exercise routines that can help to
increase physical activity and reduce sedentary time. The client can also be educated on the
adverse effects of sugarated drinks which also can cause increase in weight (Lipschitz et al.,
2015). Once the client is able to follow the action phase, he can move into the maintenance
stage.
During the maintenance stage, the client would be able to continue following the
practices that have been suggested and keep following the healthy lifestyle habits in order to
maintain a healthy weight. At this stage the client can be supported through monitoring of his
behavior, to identify any signs of relapses, which is common after the action phase, and help
them to overcome the relapse of the unhealthy behavior (such as unhealthy diet, smoking or
drinking alcohol) (Ligmann-Zielinska et al., 2016). Additionally, information regarding the
progress in the health of the client due to the behavioral change can focused on to reinforce
the positive impacts of the change and thus help the client to understand the necessity of
maintaining the healthy habits to ensure long term benefit and prevent recurrence of weight
related health effects (Romain et al., 2016).
Using Motivational interviewing techniques:
Using the Motivational Interviewing approach, the client can be motivated to improve
his health through behavioral modifications. Informing the client how unhealthy behaviors
can be related to the health condition the patient is experiencing and how changing the
behavior can help to address those concerns can be the main focal points of the motivational

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interviewing process. The process can be conducted in four steps: Engagement with the
client, focusing on the current process, evoking the motivations of the client and planning for
behavioral change or action plan (Christie & Channon, 2014).
In the stage of engaging the client, a working relation needs to be developed between
the client and therapist through effective communication. At this stage the therapists can
understand the perspectives, point of view, concerns and thoughts of the client by actively
listening to what the client has to say. Based on such information, treatment goal can be
developed, which in this case can be to maintain a healthy weight and prevent the risks of
overweightedness and obesity as well as its related health problems. After the goals have
been identified the therapist and patient can then discuss on the actions that can be taken to
reach those goals (such as healthy diet, physical exercise, cessation of smoking or drinking
alcohol, avoiding sedentary lifestyle and unhealthy food) (Zoffmann et al., 2016).
Once an effective engagement has been developed between the therapist and the
client, focus can be made on the strategies that can help the client to manage his weight
within the healthy limit. Here the therapist can help the patient to understand the advantages
and disadvantages of each strategy and how they can be best implemented as well as certain
restriction which might be applicable (such as how the mobility of the client can be restricted
initially after the surgery and how to maintain his physical activity during that time). Once
the ongoing processes are clearly understood by the client, the therapist can then implement
the evocation stage (Resnicow et al., 2015).
During the stage of evocation, the therapists can use the motivations of the client to
encourage them to adopt and maintain the activities that are needed to maintain and manage
his weight. The client can be motivated by informing them how the behavioral change can
help to improve his health condition, and overcome his worries about his wellbeing. Since the

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patient has shown signs of worry regarding his health and its relation to his weight problem,
the therapist can use that to motivate the client to change his behavior in order to adopt a
healthier lifestyle (Zoffmann et al., 2016). The therapist can also give confidence to the
client, assuring him that the goal to manage his weight in order to improve his health and
avoid any more health complications related to weight is completely achievable and possible.
By giving confidence, the client can also feel that the action plans can indeed by helpful for
him on the long term and thus follow the actions and maintain the behavioral change more
effectively. Once the client feels confident and motivated to change his behavior, he can be
considered to be ‘ready’ for change and thus be at the preparation phase of the ‘stages of
change’ model. Once at this stage, the therapist can develop a plan that is applicable for the
client to help him to change his behavior (Resnicow et al., 2015).
At the planning stage, the therapist develops a plan for action that can involve
changes in diet, improvement in physical activity, avoiding unhealthy lifestyle such as
smoking or drinking and unhealthy food. At this stage the client shows a positive
commitment towards change and adoption of the action plan to change his behavior (Ekong
& Kavookjian, 2016).
Conclusion:
In the given scenario client can be assisted to change his behavior to manage his
weight in a better manner and prevent the adverse health effects of being overweight or
obese. The patient is worried that his knee problems were probably because of his weight
problem, and is concerned about his future wellbeing. Such an understanding shows that he
might be at the contemplative stage of change, as he is able to understand how his health
might be affected due to his weight and might be open to change his behavior to improve his
health. The patient can be motivated to adopt a healthier lifestyle, giving him confidence that

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through the behavioral change he would be able to improve his wellbeing and prevent any
further health complications due to weight. It is also vital to educate the patient about the
different health risks that the patient might be at risk of if these behavioral changes are not
implemented and if he keeps on gaining more weight. I believe that these techniques can be
quire efficient to support the patient to change his behavior and maintain healthy lifestyle in
the future.

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