In Search of How People Change: Applications to Addictive Behaviors

The University of Scranton, Scranton, Pennsylvania, United States
American Psychologist (Impact Factor: 6.87). 10/1992; 47(9):1102-14. DOI: 10.3109/10884609309149692
Source: PubMed


How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.

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    • "Three theoretical perspectives on communication campaigns are found in the literature; viz., stage-based psychological perspectives; diffusion of innovation; and social marketing perspectives (McGuire, 1989; Prochaska, DiClemente, & Norcross, 1992; Maiback, Kreps, & Bonaguro, 1993;Rogers, 1995). Prochaska et al. (1992) note that change happens in stages that run from pre-contemplation stage (the target person is unaware of a risky behavior to be changed) to contemplation (the person begins considering how to make a change in behavior) to actionstages (the person modifies a risky behavior). Persuasive communications are tailored to the needs of the person at a particular stage. "
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    ABSTRACT: Based on an overview of over half a century of research on persuasive communication and information campaigns in the West and the assumptions and challenges of a successful communication and information campaign, the present paper basically outlines a holistic communication intervention strategy in the service of crowd management in the Islamic Holy places (Masha'er). The objectives and characteristic of the strategy in general are described. Theoretical rationale and a prototype of a set of on-site messages for creating a communication ambience in the Arafaat area are also given. These particular messages aim at preventing crowd congestion around the mount al-Rahmah (Jabal al-Rahmah).
    • "Housing First (HF) is a recovery-oriented model that focuses on providing independent living options and promoting empowerment and self-determination to create a more seamless, client-centered approach to community integration and service provision (Tsemberis 2010). An important element of HF is the expectation that programs embrace principles of harm reduction, delivering interventions that are tailored to individuals' readiness to change (Prochaska et al. 1992). Because co-occurring mental illness and substance abuse is common and challenging (Drake et al. 1998), an array of individualized consumer-driven strategies are employed to assist clients to manage, reduce, or stop substance use. "
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    ABSTRACT: This mixed-method study used administrative data from 68 supportive housing programs and evaluative and qualitative site visit data from a subset of four forensic programs to (a) compare fidelity to the Housing First model and residential client outcomes between forensic and nonforensic programs and (b) investigate whether and how providers working in forensic programs can navigate competing Housing First principles and criminal justice mandates. Quantitative findings suggested that forensic programs were less likely to follow a harm reduction approach to substance use and clients in those programs were more likely to live in congregate settings. Qualitative findings suggested that an interplay of court involvement, limited resources, and risk environments influenced staff decisions regarding housing and treatment. Existing mental health and criminal justice collaborations necessitate adaptation to the Housing First model to accommodate client needs.
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    • "These negative associations between RTC and subsequent alcohol use and problems also imply that weeks when a student was relatively low on RTC tended to be followed by weeks characterized by higher levels of drinking and consequences. The fi nding that changes in RTC were related in the expected direction to short-term changes in alcohol outcomes is consistent with the theoretical conceptualization of RTC as a dynamic construct (Prochaska et al., 1992) and supports the notion that natural ups and downs in RTC among young adult drinkers are proximally related to ups and downs in alcohol use and consequences. Although as noted, the literature on RTC and alcohol outcomes has yielded mixed fi ndings, the present results are consistent with at least one past study that examined the association between intraindividual-level RTC and alcohol use over short intervals (i.e., 1 week) (Kaysen et al., 2009). "
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    ABSTRACT: Objective: The literature on whether readiness to change (RTC) alcohol use translates into actual change among college students is both limited and mixed, despite the importance of understanding naturalistic change processes. Few studies have used fine-grained, prospective data to examine the link between RTC and subsequent drinking behavior, and alcohol consequences in particular. The present study involves tests of whether (a) intraindividual changes in RTC are negatively associated with alcohol use and alcohol-related consequences from week to week, (b) the effect of RTC on use and consequences is direct versus mediated by change in alcohol use, and (c) the association between RTC and drinking behavior is moderated by gender. Method: Participants were 96 college student drinkers who completed a baseline survey and 10 weekly web-based assessments of RTC, alcohol use, and consequences. Results: Hierarchical linear models indicated that, as hypothesized, reporting greater RTC on a given week (relative to one's average level of RTC) was negatively associated with alcohol use (measured by either drinks per week or frequency of heavy episodic drinking) and alcohol consequences the following week. Changes in use fully mediated the relationship between RTC and consequences. The prospective association between RTC and both alcohol use and consequences did not differ by gender. Conclusions: Findings suggest that higher RTC translates into short-term reductions in alcohol use and in turn alcohol consequences, and highlight important avenues for future research.
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