A 63-year-old man comes to the office for follow-up of hypertension. At his last appointment, he revealed that he had increased his intake of 12-oz cans of beer from 3 to 6 cans daily due to stress at work. The physician advised him to seek help for his alcohol use because it could be causing his elevated blood pressure and has many negative health risks. The patient now tells the physician, "I thought about what you said. I know my alcohol use has gotten out of hand and is affecting my health. My wife and daughter also say that I need to quit. I have made an appointment with a counselor to talk about my options." Which of the following best describes this patient's stage of behavioral change?

Question

A 63-year-old man comes to the office for follow-up of hypertension.  At his last appointment, he revealed that he had increased his intake of 12-oz cans of beer from 3 to 6 cans daily due to stress at work.  The physician advised him to seek help for his alcohol use because it could be causing his elevated blood pressure and has many negative health risks.  The patient now tells the physician, "I thought about what you said.  I know my alcohol use has gotten out of hand and is affecting my health.  My wife and daughter also say that I need to quit.  I have made an appointment with a counselor to talk about my options."  Which of the following best describes this patient's stage of behavioral change?

Quizplus · Accepted Answer

11ec160b_35fd_f68e_9249_b1407a523bbd_MD0001_00 The transtheoretical model of behavioral change describes 5 stages that many people progress through when making significant behavioral change. It begins with initial denial of the problem (precontemplation), moving through admitting the problem and the need to change (contemplation), committing to change and planning a change strategy (preparation), and taking concrete steps to implement change (action). Finally, behavioral change requires efforts for long-term maintenance. This patient has acknowledged his drinking problem and is developing plans for behavioral change. Characteristic features of the preparation stage include the following: In the preparation stage, the individual may take initial, preliminary steps to effect behavioral change (eg, contacting a substance abuse counselor) but has not yet taken concrete action with a demonstrable change in the subject behavior. (Choice A) In the action stage, the individual has initiated a specific plan and taken concrete steps to effect change. Demonstrable changes in the subject behavior (eg, reducing the quantity of alcohol consumption) are seen. (Choices B and D) In the precontemplation stage, patients deny the problem or attribute it to external factors (eg, work stress) without acknowledging the need for change. In the contemplation stage, the patient acknowledges the problem but is ambivalent about the need for change and is not yet considering specific strategies for change. (Choices C and F) Intellectualization and rationalization are defense mechanisms rather than stages of change. Intellectualization is the use of intellectual argument to avoid painful feelings. Rationalization is the making of excuses to justify behavior or avoid the truth. Defense mechanisms are often used in the precontemplation or contemplation phases to avoid acknowledging the problem or making behavioral changes. Educational objective: In the transtheoretical stages of change model, the preparation stage represents the stage in which the individual has committed to behavioral change and is considering change strategies but has not determined or instituted a specific course of action. Individuals at this stage may be weighing options and seeking additional support. __________ References: The transtheoretical model and substance dependence: theoretical and practical aspects. (http://www.ncbi.nlm.nih.gov/pubmed/19918675)

A 63-Year-Old Man Comes to the Office for Follow-Up of Hypertension