Transtheoretical therapy: Toward a more integrative model of change.
Open accessAbstract
Transtheoretical therapy is presented as one alternative within the Zeitgeist seeking a synthesis for the increasing proliferation of therapeutic systems. From a comparative analysis of 18 leading systems, five basic processes of change were identified. Each process can be applied at either the level of the individual's experience or environment. In studying how individuals change on their own compared with change in formalized treatments, four stages of change have been identified. Individuals changing within and without therapy appear to apply three verbal processes of change in the contemplation and determination stages and then apply two behavioral processes in the action and maintenance stages. Rather than being theoretically incompatible, the verbal processes are most important in preparing clients for action, while the behavioral processes become most important once clients have committed themselves to act. Psychotherapy appears to be approaching a crisis or a new wave of creativity. The potential for crisis comes in part from the unprecedented pace at which new therapies are being placed on the market (Prochaska, 1979). In 1975 Parloff reported that there were 130 therapies on the therapeutic marketplace (or jungleplace as he more aptly described it). By 1979 Time magazine was reporting that there were over 200 therapies, and that the confusion of over-choice was adding to the depression of psychiatry. Divergence has dominated the past decade of development within the field of psychotherapy (Prochaska, 1979). Yet divergent 1 This work was partially supported by Grant CA27821 from the National Cancer Institute. * Requests for reprints should be sent to James O. Prochaska, Dept. of Psychology, University of Rhode Island, Kingston, RI 02881. CARLO C. DI CLEMENTE Texas Research Institute of Mental Sciences thinking has been characterized by Guilford (1956), among others, as a necessary part of creativity. The increased divergence in psychotherapy thus provides the potential for a new wave of creativity. What is needed to prevent the increasing divergence from leading to fragmentation, confusion and chaos and allow it to be the foundation for a more fertile future? Heinz Werner's (1948) theory of development may serve as a guide in this regard. Development, as opposed to other forms of change, such as regression or chaos, is characterized by a combination of increasing differentiation and hierarchic integration. The increasing production of new forms of psychotherapy may indeed be an expression of the increasing differentiation of a growing discipline like psychotherapy. Increasing differentiation alone, however, can become like a cancer of uncontrolled growth that threatens to destroy the very body of knowledge in which it is growing. Unless increasing differentiation is matched by more effective forms of integration, then crisis rather than creativity will be the result. In Guilford's (1956) terms an increase in divergent thinking needs to be followed by higher levels of convergent thinking. What have been some of the professional responses to the increasing divergence in psychotherapy? Psychiatry's depression over the increased confusion is being treated in part by an increased reliance on chemotherapy. The emphasis on medication has the advantage of reaffirming psychiatry's medical identity and of relying on treatments that have perhaps the most consistent empirical support {Time, 1979; Luborsky, 1975). Clinical social workers have mounted a se-
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Central to the stages of change model is the concept of readiness for change, which influences engagement with support resources and movement across stages.
“Central to the SOC is the concept of readiness for change , which in fl uences engagement with support resources and movement across stages (Cluss et al., 2006; Miller & Rollnick, 2012; Prochaska & DiClemente, 1982).”
From ‘Reconnecting With All the Things That You Lost Because of Control’: What Helps Women in the Process of Leaving a Psychologically Abusive Intimate Partner? (2026) · cites this paper as Prochaska & DiClemente, 1982
The impact of the intervention was greatest among participants who intended to seek treatment before taking part in the study.
“The impact of the intervention was greatest among participants who intended to seek treatment before taking part in the study, consistent with the Transtheoretical Model of Change (Prochaska and DiClemente, 1982).”
From Translating the Intention to Seek Treatment into Action: Does Symptom Monitoring Make a Difference? Results from a Randomized Controlled Trial (2019) · cites this paper as Prochaska and DiClemente, 1982
The transtheoretical model dictates that interventions based on action should only be implemented by those who are ready to engage in that action.
“The model dictates that interventions based on action should only be implemented by those who are ready to engage in that action.”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as Prochaska & DiClemente, 1982
Self-monitoring is one of the most important components of psychotherapy for anxiety and other mental illnesses, and is a key step in helping individuals to change unhelpful cognitions, beliefs, and behaviors.
“In one respect, this is unsurprising, as self-monitoring is one of the most important components of psychotherapy for anxiety and other mental illnesses [29], and is a key step in helping individuals to change unhelpful cognitions, beliefs, and behaviors [30].”
From Breaking open the black box: isolating the most potent features of a web and mobile phone-based intervention for depression, anxiety, and stress (2015) · cites this paper as [29]
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- Authors
- Prochaska, J. O., & DiClemente, C. C.
- Affiliations
- University of Rhode Island (US)
- Venue
- Psychotherapy: Theory, Research & Practice
- Published
- 1982
- Volume
- 19
- Issue
- 3
- Pages
- 276-288
- ISSN
- 0033-3204 (ISSN-L)
- OpenAlex
- W2134646220
- Cited by
- 3,922
- References
- 20
- Citations by year
- 2026: 101 · 2025: 132 · 2024: 158 · 2023: 128 · 2022: 136 · 2021: 209 · 2020: 247 · 2019: 174 · 2018: 158 · 2017: 175 · 2016: 153 · 2015: 152 · 2014: 160 · 2013: 170 · 2012: 146
- FWCI
- 21.03
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by
- Locations
- Psychotherapy (publishedVersion)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- transtheoretical model, stages of change, change processes, integrative psychotherapy, differentiation and integration, medical pluralism, self-directed change
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