Application of Behavior Change Theory to the Development

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BEHAVIOR CHANGE THEORY
hazardous driving behaviors after amazingly short, written treatments. The question is
why? That answer might lead to treatments effective with the most critical traffic safety
issue: crashes.
Quantum Change
Negligent-operator treatment systems that utilize “warning letters” are predicated upon
an implicit theory that links a brief contact with a distant, governmental regulatory
agency to an abrupt and profound decisional shift in driving behavior, a phenomenon
Miller and C’de Baca (1994) described as a sudden transformational or quantum
change.
Quantum change is fundamentally different from personal, gradual growth attributable
to traditional learning or maturation (James, 1902; Premack, 1970) and may require
acceptance of a second kind of learning (Hunt & Matarazzo, 1970). While behavioral
scientists have been captivated but perplexed by the quantum changes observed in
patients, the Transtheoretical Model (TTM) presented in 1982 (Prochaska &
DiClemente) allowed the systematic, experimental study of the phenomenon. Miller
and Rollnick (1991) incorporated the TTM into their work and brought the concept of
quantum change to a broader audience with the publication of their book, Motivational
Interviewing: Preparing People to Change Addictive Behavior.
Because behavior change is a major goal of injury prevention (Christoffel & Gallagher,
1999), a review of treatments found to be effective with highly resistant groups might
assist in those efforts.
Transtheoretical Model of Change
People change. To the behavioral scientist, this knowledge sustains practice but the
methods implemented to catalyze change are often too particularistic and parochial in
their application to have collective appeal. Prochaska and DiClemente (1982) adopted a
more universal approach by studying the steps traversed by individuals in the course of
unassisted self-change efforts and, in the process, discovered an underlying, systematic
process capable of predicting readiness to change. Their subsequent research confirmed
that the change phenomenon progresses through the same steps with or without
professional assistance (Prochaska & DiClemente, 1984).
The stages through which individuals pass in the process of changing a behavior
include: pre-contemplation, contemplation, determination, action, maintenance, and
relapse. Each stage describes a person’s readiness to change and specifies effective
strategies to motivate the individual to move toward the next stage. In this context,
motivation can be defined as the probability a person will persevere in a change
strategy. The stage-specific motivational tasks facing a developer of treatments for
negligent operators include the following:
• Pre-contemplation: Raise doubt about the advisability of continuing the hazardous
behaviors.