Stages of Change

John C. Norcross, Paul M. Krebs and James O. Prochaska

in Psychotherapy Relationships That Work

Second edition

Published in print April 2011 | ISBN: 9780199737208
Published online May 2011 | e-ISBN: 9780199894635 | DOI:
Stages of Change

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The transtheoretical model in general and the stages of change in particular have proven useful in adapting or tailoring treatment to the individual. This chapter defines the stages and processes of change and then review previous meta-analyses on their interrelationship. This chapter reports an original meta-analysis of 39 studies, encompassing 8,238 psychotherapy patients, to assess the ability of stages of change and related readiness measures to predict psychotherapy outcomes. Clinically significant effect sizes were found for the association between stage of change and psychotherapy outcomes (d = .46); the amount of progress clients make during treatment tends to be a function of their pretreatment stage of change. We examine potential moderators in effect size by study outcome, patient characteristics, treatment features, and diagnosis. We also review the large volume of behavioral health research, but scant psychotherapy research, that demonstrates the efficacy of matching treatment to the patient’s stage of change. Limitations of the extant research are noted, and practice recommendations are advanced.

Keywords: stage of change; transtheoretical model; therapy relationship; tailoring treatment; meta-analysis; treatment adaptation

Chapter.  11348 words. 

Subjects: Clinical Psychology

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