construct is based on Bandura's self-efficacy theory and conceptualizes a person's perceived ability to perform on a task as a mediator of performance on future tasks. In his research Bandura already established that greater levels of perceived self-efficacy leads to greater changes in behavior. Similarly, Ajzen mentions the similarity between the concepts of self-efficacy and perceived behavioral control. This underlines the integrative nature of the transtheoretical model which combines various behavior theories. A change in the level of self-efficacy can predict a lasting change in behavior if there are adequate incentives and skills. The transtheoretical model employs an overall confidence score to assess an individual's self-efficacy. Situational temptations assess how tempted people are to engage in a problem behavior in a certain situation. Levels of change This core construct identifies the depth or complexity of presenting problems according to five levels of increasing complexity. Different therapeutic approaches have been recommended for each level as well as for each stage of change. The levels are: Symptom/situational problems: e.g., motivational interviewing, behavior therapy, exposure therapy Current maladaptive cognitions: e.g., Adlerian therapy, cognitive therapy, rational emotive therapy Current interpersonal conflicts: e.g., Sullivanian therapy, interpersonal therapy Family/systems conflicts: e.g., strategic therapy, Bowenian therapy, structural family therapy Long-term intrapersonal conflicts: e.g., psychoanalytic therapies, existential therapy, Gestalt therapy In one empirical study of psychotherapy discontinuation published in 1999, measures of levels of change did not predict premature discontinuation of therapy. Nevertheless, in 2005 the creators of the TTM stated that it is important "that both therapists and clients agree as to which level they attribute the problem and at which level or levels they are willing to target as they work to change the problem behavior". Psychologist Donald Fromme, in his book Systems of Psychotherapy, adopted many ideas from the TTM, but in place of the levels of change construct, Fromme proposed a construct called contextual focus, a spectrum from physiological microcontext to environmental macrocontext: "The horizontal, contextual focus dimension resembles TTM's Levels of Change, but emphasizes the breadth of an intervention, rather than the latter's focus on intervention depth." Outcomes of programs The outcomes of the TTM computerized tailored interventions administered to participants in pre-Action stages are outlined below. Stress management A national sample of pre-Action adults was provided a stress management intervention. At the 18-month follow-up, a significantly larger proportion of the treatment group (62%) was effectively managing their stress when compared to the