Many people treat changes negatively because they are afraid to face troubles. Of course, not all changes end with success but they are to be applied to achieve improvement. To prevent amiss situations, psychologists offer concepts of change. They include different theories, frameworks, and models meant to define personal and situational factors that have an impact on health behavior and describe the ways to maintain or change it.
An approach that makes sure that the process of change runs without any problems and is likely to achieve beneficial outcomes is called organizational change. Taking it into consideration, three concepts of health will be evaluated. They are theories of change that explain the way the behavior changes over time and the way it can be amended.
Lewin’s Change Theory
Kurt Lewin was a psychologist who found himself occupied in both practical research and theoretical works. At the end of his life, Lewin made an immense contribution to the studies connected with organizational behavior. He concentrated on group dynamics and action research through democratic values and humanist sympathies. Lewin lived in Germany and the United States. It is interesting that with the change of location, his interests in the field also seemed to change. At first, he focused on child development and became a member of the School of Home Economics at Cornell University. However, soon the psychologist turned his attention from individuals to groups and joined the Research Center for Group Dynamics where he held the position of the director (Miner 80). Lewin supported disadvantaged groups of people who were often engaged in racial and religious conflicts, which placed him on the political left.
Lewin’s Change Theory was created in the 1950s and became a basis for several new approaches. It concentrates on the group work and claims it to promote changes in habitual behaviors. It is offered to use an unfreezing-refreezing dynamic “in which habitual behaviors are lifted to scrutiny by the group and reconfigured, before being left to fall back into everyday routines” (Darnton 15).
The theory is more appropriate for the situations that need main structural change. The condition that occurred due to World War II made researchers concentrate on the change of consumers’ behavior and provoked the works in group dynamics and change projects.
Kurt Lewin created the three-step change model meant to assist in shifting the balance of the planned change rather than the unplanned one. This theory deals with the situation when driving forces promote the change as they aim the personnel in the desired direction while restraining forces prevent any changes as the personnel is aimed in the opposite direction.
The theory consists of three steps:
- Unfreeze. One is to make sure that people are ready for a change. This step is important as it helps to find out barriers to performance both individual and group and overcome them. Three different methods can be applied to do these: to enlarge the driving forces that move away from the agitating situation or balancing state; to decrease the restraining forces that prevent this process; the combination of the two above-mentioned methods (Kritsonis 2).
- Movement. The change is to be performed.
- Refreeze. Here one is to make sure that this change became permanent. There is a possibility that the change will be temporary, and soon everything will return to the previous state if this step is not successful.
This theory can be applied in different fields related to new project management in organizational change, as it was made for the field of group dynamics and organization development. The theory can be used to enhance team-building. Now it is commonly used in nursing.
Thus, the influence of the forces is shown in the theory. It does not offer any extremes and is easy to understand and use that is why people prefer it. However, the process of implementation is time-consuming, and all its aspects are treated separately. Moreover, it is appropriate only for small-scale change projects maintained in a stable environment; thus, organizational politics is neglected. It is also hard to freeze a change.
To implement the theory one should create dissatisfaction, agitating situation or balancing state (status quo). Among the activities is the participation in the recognition of problems and finding the solutions, the motivation of the group by qualifying its members for the change, and encouragement of understanding the need to change.
Then it is necessary to persuade the group that they need a change and that balancing state is of no advantage for them anymore. The roles and responsibilities should be reorganized and new skills training. It is necessary to stabilize and enroot the new approach by balancing driving and restraining forces. With the help of policies and some procedures, the patterns are to be enhanced, for example with the adoption of the pay and reward system.
Prochaska and DiClemente’s Change Theory
Prochaska and DiClemente’s Change Theory provides people with a general overview of a change process, as the authors found out that while facing a change people go through several stages that occur in a cyclical progression. They are “pre-contemplation, contemplation, preparation, action, and maintenance” (Kritsonis 3). The reason the progression is not linear lies in the fact that many people are not able to get successful outcomes from the first time.
It was developed in 1977 based on psychotherapy theories. It offers a staged model that treats a change as a process that is divided into several stages. While getting through these stages, people make progress. From the very beginning, it was aimed at smoking cessation and showed the stage where the consumer was in the process of changing health behaviors. But later the theory extended its context and audience and began to be used by non-patients. The harmful effect of smoking was obvious at that time, and this habit was also known to be culturally dependent and connected with the economic state. The model was questioned about being sensible for smoking citations.
The spiral model was made by the authors to present different stages of the theory. It starts with the step of alteration from the contemplation of the problem to its contemplation. Precontemplation occurs when a person does not know that something is wrong or refuses to admit this until one gets involved in the process of change. The person is not eager to change and tries to prove that the condition and behavior he/she has now is normal. To increase one’s awareness of the issue, media campaigns, explanations, feedback, and confrontation can be used. As soon as the understanding of a problem arises, starts the contemplation stage. One wants to change the behavior but is not ready for serious actions. Clarification of the positive aspects of the change and corrective emotional experience is to help. Then comes preparation. The person sets his/her mind upon changing the behavior within two weeks and feels ready to do this. After this, it starts an action stage when the person engages in the very process of change and conducts necessary activities. During the stage, one will need mentoring, social and psychological support, and help in solving problems. The last step leads to maintenance. One applies the change to his/her life and enforces it. It is the most time-consuming stage, which lasts for six months or even for the whole life. One should concentrate on assertion and positive approach, restructure the self-help group, reward him/herself and be engaged in helping relationships (Lenio 79).
Among the advantages of this theory is the ability to exit it when one thinks no changes are needed. Later this person can return and start from the contemplation stage. It is significant that here people not just circle the problem, but learn even from relapses. The theory was very criticized recently. Practitioners believe it to be not appropriate for practical applications and suggest using this theory for its conceptual lessons. The achievement of the positive outcome needs a minimum of more than a year, which questions the theory’s accommodation. The theory concentrates on the change of single behaviors but not a range of related ones. There are no fixed measures of the stages, and everything depends on the person’s self-evaluation.
As the model is referred to as empirical, it can be applied to a field population as a source of generalized data gained with the help of statistical methods and questionnaires. It can be used in the health field to shift one’s attention from the issue to the relating problem to encourage changes. For example, if a person does not want to stop taking drugs, the focus can be shifted to HIV prevention. It is not commonly used to conduct a process of change but is a good model that helps to understand how this process works.
The process for implementation should start with hiring a group of people who will encourage the staff to change, explain all advantages of this movement and evaluate the process. They are to assist the employees when they face problems and make sure that they achieve improvement.
Ajzen’s Theory of Planned Behaviour
Ajzen’s theory was created in 1980. It helps to realize in what way the behavior can be changed as it foretells deliberate behavior and states that “individual performance of a given behavior is primarily determined by a person’s intention to perform that behavior” (Kritsonis 5). The Theory of Planned Behavior was made based on the Theory of Reasoned Action, in which Ajzen discovered that the behavior is not entirely voluntary.
This theory deals with the concept of “perceived control over the opportunities, resources, and skills necessary to perform the desired behavior” (Kritsonis 5). It claims that the most thing in the process of change is putting behavioral control over the elements needed to perform it, like possibilities, sources, and skills.
It concentrates on such considerations: behavioral beliefs (what will be the consequences of the particular behavior); normative beliefs (what do other people expect); control beliefs (are there any factors that may facilitate or impede the performance of the behavior) (“Summary of the TPB by Ajzen” par. 3).
The theory claims that the behavior can be predicted due to the attitudes towards it. The positive attitude towards the planned behavior is the major factor that ensures the change. The impact made by the social environment and norms is of great importance for shaping one’s attention. Here the connection between the group and individual beliefs is meant. People do what they are supposed to do by their peers as they want to correspond with their opinions.
Ajzen refers to such a method in his work as a questionnaire to find out the elements of behavior and proceeds with direct observation and self-reports (Knabe 39). His theory is a source of decent information relating to the communication strategies and their development.
The theory can be applied in such a field as environmental psychology. A positive belief can be carried by the friendly towards environmental actions. The difference between sustainable attitudes and unsustainable behavior can be explained with the help of the theory (“Summary of the TPB by Ajzen” par. 9). The health fields and nutrition ones refer to the theory in the studies. It provokes people to leave their favorite junk food and try something healthy. Thus, problems with overweight can be solved. It can also be applied to examine political behaviors.
The strengths of this theory lie in distinguishing behavioral intention and real performed behavior. It provides examples of how the model can be used in various spheres related to health. Social behavior is also examined, and the role of a social norm is distinguished. The theory does not pay enough attention to the emotional variables and their influence on the planned behavior and its change. Environmental and economic factors are also neglected. The fact that behavior can change is not considered.
To implement changes one should gain knowledge about the staff’s attitude towards it. The strategy should be designed based on how the employee will act in a particular situation due to the inquiry. This provides one with the opportunity to plan each step of the change and improve the outcomes.
Similarities and Differences of Change Theories
The change theory presented by Lewin is rational and plan oriented. It concentrates on a group of people and does not pay attention to the individual factors. Prochaska and DiClemente’s Change Theory presupposes that the approach can be used by one person, but it does not offer interventions for individuals at each stage and provides general strategies while counseling consumers (Lenio 82). The variety of emotional factors that influence the issue is ignored by all researchers. Prochaska and DiClemente’s Change Theory offers the description of a general process of change while Lewin and Ajzen are more specific. Linear progression is used while passing from one stage to another in all theories except Prochaska and DiClemente’s one, which is based on a cyclical one. The theories try to examine what influences change and how. Prochaska and DiClemente’s Change Theory is the only one that allows people to leave it, encourages their revaluation of the issue and return to the program. All theories make people take a part of the responsibility by offering self-evaluation, self-report, and self-efficacy.
The Most Effective Change Model/Theory
I believe that the Lewin’s change theory would be most effective for the healthcare organization, as it is the most rational, substantial and plan oriented theory. Many people are engaged in the work of such an organization, and the change needed might influence both employees and patients. That is why a group approach would be of advantage. It allows people to understand what benefit they would get when the change is successfully achieved, which makes them try harder. The model has a simple structure and is easy to comprehend and maintain.
Works Cited
Darnton, Andrew. Practical Guide: An Overview of Behaviour Change Models and Their Uses, London: Government Social Research Unit, 2008. Print.
Knabe, Ann 2012, Applying Ajzen’s Theory of Planned Behavior to a Study of Online Course Adoption in Public Relations Education. Web.
Kritsonis, Alicia. “Comparison of Change Theories.” International Journal of Scholarly Academic Intellectual Diversity 8.1 (2005), 1-7. Print.
Lenio, James. “Analysis of the Transtheoretical Model of Behavior Change”. Journal of Student Research 32.3 (2006): 73-86. Print.
Miner, John. Organizational Behavior Three: Historical Origins, Theoretical Foundations, and the Future, New York: M.E. Sharpe, 2006. Print.
Summary of the TPB by Ajzen. Abstract. 2014. Web.