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Grandma and the Transtheoretical Model of Change

Updated on March 28, 2012

One sleepy afternoon, I was diligently doing my readings for my psychology class… trying very hard to maintain my interest in what I was reading, I suddenly thought of my grandma. Grandma can be quite a peculiar character, and in this hub I want to tell her story through the lens of the Transtheoretical Model of Change.


Precontemplation, contemplation, preparation, action, maintenance – these are the stages of change in the Transtheoretical model of change. The transtheoretical model of change is a model first developed by James O. Prochaska and his colleagues at Rhone Island University. This model describes the different stages of change and many therapists have used this to help their clients with issues such as addictive behaviors. For example, the motivational interviewing technique is based on this model of change, which is a popular technique that therapists use to encourage and facilitate clients to move through the different stages of change to achieve successful behavioral changes.

After pondering about the transtheoretical model of change and how therapists can use it to understand patients, I thought of how it could help laypeople understand each other better and improve their communication. One person I immediately thought of is my grandmother – although she is not suffering from any addiction per se, this model seems to give me some insight into how I should interact with her in future.

My grandmother is getting on in years, and her legs are weakening. Recently, the number of occasions that she has fallen has only increased in frequency. Amazingly, she has never broken a bone, and has enjoyed a speedy recovery each time. For the sake of her safety, we have all tried to persuade her to learn to use a walking stick – an idea that she has persistently rejected. My grandmother has iron determination, which when misplaced, becomes stubbornness the color of crimson rust. On several occasions, we have cringed while listening to her boast of how she carried her marketing up the bus and walked all the way back home from the main road. “Popo! Why didn’t you take the taxi?” “Why did you go alone?” “When we asked you if you needed anything at the shop why didn’t you say you needed milk?”…. often we get really exasperated and whenever I hear her on the phone I am really afraid that it is about another fall.

Intuitively, my grandmother seems to be a classic fit into the first stage of the transtheoretical model – precontemplation, where she has no intention to change her habits, or rather, she fails to see how here current choices are not only increasing her risk of falling, and are increasing the harm done should she actually fall down. My grandmother lost her mother at a young age, married early and comes from a very patriarchal Peranakan background, and to her a sense of control in her life is really important; using a walking stick would means admitting defeat or losing her freedom; risking injury and walking without support gives her a sense of control even though she is so wobbly, just like the mice in the experiment which preferred to lived in the darkness or unhealthily than lose their sense of control.

Maybe we have been treating my grandmother as though she is at a higher stage of change, which is why we have not seen any results. Perhaps when I next talk to her and she complains about her legs, I’ll adopt a very indirect strategy, or say something that would cause her to feel empowered to make wiser lifestyle choices like using a walking stick, taking the taxi instead of public transport (she has fallen several times while alighting the bus). Hopefully then she’ll be motivated to adopt a change in behavior as she moves forward from the precontemplation stage of change.


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      SusieQ42 6 years ago

      Poor grandma! My mom is the same way at age 81! It's that era of strong people with enough old fashioned grit to make your head spin. They are a tough bunch, there's no doubt about it. Who knows, maybe I'll be stubborn about using a walking stick too.

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      taylorslaw 6 years ago

      Hmmm She is more comfortable falling in front of others than she would be to use a cane? Maybe you could try asking her about that. There is more independence in becoming self sufficient again than there is in endangering her welfare. I hope she changes her mind. We need our elders to be around as long as possible. They are our rocks from which we learn, grow, and love.