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Processes and Stages of Change: Counseling With the Transtheoretical Model of Change

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Abstract

Technical eclecticism and theoretical integration literature has typically examined how multiple approaches to counseling practice may lead to more comprehensive and functional outcomes. Few have proposed an integration of approaches from a scientist‐practitioner perspective; many others have neglected the richness found in the body of existing theory. The purpose of this synthesis is to highlight the contributions that the Transtheoretical Model of Change (J. O. Prochaska & C. C. DiClemente, 1984; J. O. Prochaska & J. C. Norcross, 1994) has for technical eclecticism and theoretical integration. The intervention implications of processes and stages of change are discussed.
... Many researchers worked on the definition and analysis of the processes and stages of change. In Table 3 I display the processes of changes and their description according to [11]. ...
... Processes of change and their description[11] moments, with sensations and insights. I really felt as if something about me was unveiled. ...
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Thesis
This thesis explores some of the techniques used in the professional guidance offered by transformative and expressive counselors and deals with the change process they trigger in the clients. In the first part of the thesis (Chapters 2 and 3), I introduce the methods and I describe the expressive and transformation actions, showing the techniques, their steps to integrate the emotional and cognitive dimensions and their application in counseling actions. In the second part (Chapter 4), I focus on the experience of change, including records from clients.
... According to Transtheoretical Model (TTM), there are ve relatively independent but interrelated stages, including precontemplation, contemplation, preparation, action, and maintenance, of healthy-related behaviors through the process of behavior change 11 . Thus, our study aimed to investigate willingness to adopt healthy dietary habits in a short time of the COVID-19 pandemic. ...
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Preprint
Background: To investigate impact of the 2019 novel coronavirus disease (COVID-19) pandemic on willingness to adopt healthy dietary habits in China. Methods: A survey was carried out, and subjective perception of impact due to COVID-19 and willingness to change dietary habits were obtained. Results: A total of 22,459 subjects were derived from China, with an average age of 27.9±7.8 years old. Of them, the mean score of willingness to adopt healthy dietary habits was 2.2 (ranges from -9 to 9). Multivariate regression analysis showed that the impact of the COVID-19 pandemic (epidemic concern, impact of psychology, impact of work or study) are associated with a higher score of willingness to adopt healthy dietary habits among female, the older, on-medical worker, and individuals married or with higher education level, normal BMI. Conclusions: There was a positive improvement to a proper diet, so the changing features of diets should be considered in nutritional interventions for maintaining health, and prevention and control COVID-19 during the pandemic period.
... The results were similar to the results of the study by Fallon et al. in which people reported greater use of the cognitive and behavioral level of change [40]. The early stages of SOC (precontemplation, contemplation, and preparation) mainly reflect changes at the cognitive level, which increases the willingness of patients to engage in the behavioral change, the later stages (preparation, action, and maintenance) indicate changes at the behavioral level and reflect the aim to undertake observable and maintainable efforts [41], and the transition from the cognitive level to behavioral level indicates the progress across the SOC [42]. In this study, we designed the corresponding intervention strategies according to the influencing factors at all levels of the change process and adopted different psychological intervention measures for patients at different stages according to the relationship between the SOC and POC. ...
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Article
Background: Depression is a major risk factor for the morbidity and mortality of cardiovascular disease. A transtheoretical model-based intervention and motivational interviewing have been used to change health risk behaviors and have demonstrated positive effects. To our knowledge, no studies of patients with coronary heart disease (CHD) have used a transtheoretical model-based intervention and motivational interviewing as an intervention to provide dynamic education. Therefore, this study aimed to determine the effects of the transtheoretical model-based intervention and motivational interviewing on the management of depression in hospitalized patients with CHD. Method: A randomized controlled trial was designed. A total of 110 participants were randomly divided into an intervention group (n = 55) and a control group (n = 55). The Hamilton Rating Scale for Depression and the Depression Prevention & Management Survey items (stages of change, perceived benefits, perceived barriers, process of change and self-efficacy) were used to collect data at all time points. Analysis of covariance, chi-square test and repeated measures analysis of variance were used to analyze the data. Results: After the intervention, there were more positive changes in stages of change, higher scores for the cognitive and behavioral levels, the perceived benefits, and self-efficacy, and lower perceived barriers and depression in the intervention group than in the control group. Finally, there were statistically significant differences in the depression scores at different time points in the intervention group (F = 17.814, p = 0.000 < 0.01). Conclusions: The study showed that a transtheoretical model-based intervention and motivational interviewing exert positive effects on the management of depression in hospitalized patients with CHD. Trial registration: Clinicaltrials.gov, NCT03953924 (Date assigned: 16/5/2019). Retrospectively registered.
... The concept of negotiation strategies is developed also for the Transtheoretical Model that is designed to explain, predict and identify the processes of behavioural change (Prochaska 7 & DiClemente, 1986;Prochaska, DiClemente & Norcross, 1992). This model examines the sequential behavior change, which is completed through a series of interrelated stages and dimensions (Marcus, Rakowski & Rossi, 1992b;Petrocelli, 2002). It consists of three levels, which explain thoroughly the change in behavior (Prochaska et al., 1992). ...
Conference Paper
According to the theory of self-determination, the individuals' behavior regarding their decision to participate in an activity could be affected by internal or external motivation. All individuals, whether participants or not, experience constraints in any athletic activity, but participation «depends not on the absence of constraints factors but on be negotiated. This negotiation is likely to vary in participation and not to be excluded». The present paper aims to test the relationship between motivation and negotiation strategies. The results of the confirmatory factor analysis showed the construct validity of this model for the first time in Greek population and in the context of the participants at the programmes. High Motivation team noted high averages on both internal and external motivation and also high averages were recorded in all negotiation strategies because the participants employed all the strategies to participate.
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Adherence to lifestyle changes is a major challenge for healthcare professionals. The transtheoretical model (TTM) was proposed to promote behavioral changes, used in different health conditions (smoking, alcoholism, drug addiction, and obesity) and age groups. However, the effectiveness of the model in older persons is not yet known. This systematic review protocol follows the PRISMA‐P guidance. The question the review will address is, Are interventions based on the TTM, compared with conventional interventions, associated with lifestyle changes in older adults? Databases MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, WoS, and PsycINFO will be searched. Randomized clinical controlled trials and quasi‐experimental studies describing the effectiveness of TTM‐based interventions in changing the lifestyle of individuals aged 65 and over, compared with conventional interventions for lifestyle changes, will be included. Studies that do not address the stages of change characteristic of TTM or that use pharmacological interventions as a comparator will be excluded. Reviewers independently will screen papers for eligibility criteria, and, extracting data, assess the risk of bias for included studies and will evaluate the overall quality of evidence (GRADE system). If possible, a meta‐analysis will be conducted. Otherwise, a narrative synthesis will be prepared according to the SWiM guideline.
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Counseling theory offers direction for counselors regarding a view of maladaptive behaviors and what role the counselor should take to move the client toward adaptive lifestyle change. The transtheoretical model (TTM) of behavior change is a developmental model that can be considered as the counselor tailors interventions based on a client’s readiness to accept change. This article aims to illustrate how sandtray work can be implemented using the TTM. Specifically, we will use one case example and exemplify sandtray directives or prompts designed to meet the client at each stage of change in the TTM.
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Preprint
Background: To investigate impact of the 2019 novel coronavirus disease (COVID-19) pandemic on willingness to adopt healthy dietary habits in China. Methods: A survey was carried out, and subjective perception of impact due to COVID-19 and willingness to change dietary habits were obtained. Results: A total of 22,459 subjects were derived from China, with an average age of 27.9±7.8 years old. Of them, the mean score of willingness to adopt healthy dietary habits was 2.2 (ranges from -9 to 9). Multivariate regression analysis showed that the impact of the COVID-19 pandemic (epidemic concern, impact of psychology, impact of work or study) are associated with a higher score of willingness to adopt healthy dietary habits among female, the older, on-medical worker, and individuals married or with higher education level, normal BMI. Conclusions: There was a positive improvement to a proper diet, so the changing features of diets should be considered in nutritional interventions for maintaining health, and prevention and control COVID-19 during the pandemic period.
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Objective: Most sexual assault prevention approaches are universal in nature. The present study evaluated a Transtheoretical Model (TTM)–based Stages of Change (SOC) measure assessing readiness to utilize sexual assault risk reduction skills. The measure was evaluated with regard to Decisional Balance and Self-Efficacy. Participants: Survey data were collected from 300 college women (Mage=18.5, SD = 0.79). Methods: Three SOC measures were developed and evaluated for using: 1) assertive responding; 2) self-protective dating behaviors; and 3) open sexual communication. Item development was followed by exploratory, confirmatory, and external validation analyses. Results: Exploratory Factor Analysis (EFA) indicated two, six-item factors (Positive Outcomes α=.91; Negative Outcomes α=.85) for Decisional Balance. Confirmatory Factor Analyses (CFA) supported a two-factor correlated model, χ²(66)=2101.70, p<.001, CFI=.946, RMSEA=.083. For Self-Efficacy, EFA indicated one, six-item factor (α=.81). Conclusions: These readiness assessments may guide understanding of factors influencing sexual assault risk reduction program outcomes and aid in tailoring program content.
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