The Transtheoretical Model of Intentional Behavior Change was originated by James O. Prochaska, Ph.D. and Carlo C. DiClemente, Ph.D. In May and June 2003, I had the honor of presenting two programs on the Stages of Change, broadcasted by the Veterans Administration (VA) Knowledge Network. This program was developed to educate clinicians working with Veterans to “help them change one stage at a time.”

You will have the opportunity to hear about the Transtheoretical Model directly from Dr. Prochaska. In the first program he discusses the stages of change, decisional balance, and processes of change. A summary of the model is provided with questions posed to Dr. Prochaska and myself by VA employees across the United States.

I hope you will be stimulated to learn more about this model. There is a vast body of literature related to the Transtheoretical Model and its application to a wide variety of health problems.

Promoting Adherence to Medications – One Stage at a Time

Pharmacological treatment is an important aspect of treatment, yet not all clients are ready to take them. It is useful to assess a client’s stage of change for medication adherence so stage-matched interventions can be provided.

This set of video clips is from the VA program televised in June 2003. You will be able to observe how I work with a client who has agreed to take medications for his depression. In each session, stage-matched interventions are provided to promote adherence to antidepressant medication. Over time and utilizing various written tools, you will see how he moves through the stages of change from precontemplation to maintenance.

Deborah S. Finnell, DNS

Health Behavior Change and the Transtheoretical Model Contibutors

Originators:

James O. Prochaska, PhD
University of Rhode Island
http://www.uri.edu/research/cprc/Faculty/JProchaska.htm

Carlo C. DiClemente, PhD
University of Maryland, Baltimore County
http://www.umbc.edu/psyc/personal/diclemente/index.htm

Web sites:

University of Rhode Island Cancer Prevention Research Center

University of Maryland, Baltimore County
HABITS: Health and Addictive Behaviors: Investigating Transtheoretical Solutions

Boston University, Center for Psychiatric Rehabilitation Internet Webcasts “Helping Populations Progress Through Stages of Change” by James O. Prochaska

University of Connecticut Health Center
Matching Alcoholism Treatments to Client Heterogeneity A Multisite Clinical Trial (Project MATCH)

Researchers:

Mary Marden Velasquez, PhD

Deborah S. Finnell, DNS
VA Healthcare Network Upstate New York
The State University of New York, University at Buffalo, School of Nursing

Gerard Connors, PhD
The State University of New York, University at Buffalo
Research Institute on Addictions

Mary Ann Jezewski, PhD
The State University of New York, University at Buffalo

Mary Ann Meeker, DNS
The State University of New York, University at Buffalo

Sherry Pomeroy, PhD
The State University of New York, University at Buffalo

Bill Wu, PhD
The State University of New York, University at Buffalo

PTSD and Readiness to Change, The Center for Motivation Intervention Studies
Director: Ronald T. Murphy, Ph.D.
Department of Psychology
Dillard University, New Orleans, LA

Instruments and Measures:

http://www.uri.edu/research/cprc/measures.htm

Selected References:

CSAT Treatment Improvement Protocol Number 35. (1999). Enhancing motivation for change in substance abuse treatment. DHHS Publication No. (SMA) 99-3354.

Connors, G., Donovan, D. & DiClemente, CC. (2001). Substance abuse treatment and the stages of change. New York: Guilford Press.

DiClemente, C. C. (2003). Addiction and change: How addictions develop and addicted people recover. New York: Guilford Press.

DiClemente, C. C., & Prochaska, J. O. (1998). Toward a comprehensive, transtheoretical model of change: Stages of change and addictive behaviors. In: Miller, W. R. and Heather, N., (Eds). Treating addictive behaviors. 2nd ed. New York: Plenum.

DiClemente, Schlundt, & Gemmell (2004). Readiness and stages of change in addiction treatment. The American Journal on Addictions, 13, 103-119.

DiClemente, C. C., & Scott, C. W. (1997). Stages of change: Interaction with treatment compliance and involvement. In: Onken, L. S., Blaine, J. D., and Boren, J. J., (Eds). Beyond the therapeutic alliance: Keeping the drug-dependent individual in treatment. NIDA MONOGRAPH #165. Rockville, MD: National Institute on Drug Abuse.

Finnell, D.S. (in press). Promoting medication adherence one stage at a time. Clinical Psychiatry.

Finnell, D.S. (2005). Building a program of research based on the transtheoretical model. Journal of Addictions Nursing, 16(1), 1-9.

Finnell, D.S. (1998). Suitability of the Transtheoretical Model for individuals with co-occurring disorders. Dissertation Abstracts International, 59 (1-B), (UMI No. 95014-89).

Prochaska, J. O., Norcross, J. C., & DiClemente, C. C. (1994). Changing for Good. New York: Avon books.

Prochaska, J. O. & DiClemente, C. C. (1984). The transtheoretical approach: Crossing traditional boundaries of treatment. Melbourne, Florida: Krieger Publishing Company.

Prochaska, J. O. & Norcross, J. C. (2002). Systems of psychotherapy: A transtheoretical analysis (Fifth Edition) Pacific Grove, CA: Brooks-Cole.

Velasquez, M. M., Maurer, G. G., Crouch, C., DiClemente, C. C. (2001). Group treatment for substance abuse: A stages-of-change therapy manual. NY: Guilford Press.

Special Issue of the Journal of Addictions Nursing, Volume 16, Number 1-2 / Spring-Summer 2005.