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Since I began documenting my health behaviours over the past few months,
I have noticed that the amount of sleep I obtain was declining. This was mainly
due to needing to check my phone before bed and contacting my friends and
family back in Canada. Since there is a six-hour time change, the time I have
to speak to them is limited, resulting in me staying up much later than I
should be. I found myself drained and unproductive the following day and this
behaviour was cyclical. Although, I am informed of the benefits of adequate
sleep, communicating back home at night is imperative.

            According to my
research, I would adopt the Stages of Change/Transtheoretical Model (SOC/TTM
model) to modify my harmful behaviour. This model can be defined as “an intentional process that unfolds over time and involves
progress through a series of six stages of change” (Prochaska, DiClemente,
& Norcross,
1992). These steps are named, precontemplation,
contemplation, preparation, action, maintenance, and termination (Prochaska et
al., 1992; Lennox, 2017). Unlike other models of change, the SOC/TTM model
encompasses an integrative, biopsychosocial approach from a wide range of
paradigms to create one unified theory of change (Prochaska et al., 1992).
Moreover, certain principles are better expressed at different stages of the
model and they aim to prevent relapse and facilitate progress. These principles
are named, decisional balance, self-efficacy and progress of change (Alzate Sáez de Heredia, Arocena, & Gárate, 2004; Bandura, 1977).

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Based on my diary
logging, I have gone through the precontemplation and contemplation stages and
currently reside in the preparation stage (Figure 1). At first, I never truly
acknowledged what the effect of sleep deprivation was on me and had no
intention of changing my behaviour; however, as the medical school program
became more vigorous, I realized the significance of maintaining a proper
sleeping pattern. It was then I intended to make a change to my sleeping habits
to ensure I obtained adequate sleep. Currently, I am preparing to alter my
behaviour in the next month by adopting certain small measures like talking to
my friends and family throughout the day and turning my phone off at night to
reduce temptation (Lennox, 2017). My goal is to enter the action stage in the
next month by implementing more drastic measures of altering my negative
behaviour and eventually maintaining a healthier alternative (Lennox, 2017). I
am aware that relapse is more plausible in the latter stages of change (six
months to five years in the maintenance stage), but I am determined to stick to
my goal and ultimately reach the termination stage where relapse is impossible
to occur regardless of external factors (Lennox 2017).

Though this model
proves useful, it does pose restrictions to its effectiveness. One restriction
is that the SOC/TTM is cognitively based. In turn, this may have limiting
application to some strong addictions where self-control or reason is offset by
the addiction itself increasing the possibility of relapse (Rosen, 2000). Next,
it assumes that people make rational and intelligible strategies when making
decisions, which is not always apparent as many individuals will make decisions
out of impulse or desire. Third, there is an indistinct criterion for how long
an individual can stay in a stage or how much time is required before they can
progress to the next stage. Some individuals may be more inclined to change
quicker than six months of precontemplation and contemplation for example.
Therefore, when analyzing data from this model, it is important not to overlook
the severity of the individual’s behaviour, the individual’s control of their
actions as well as the fact that each individual may progress at their own
speed. 

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