Doing the right thing at the right time? The interaction of stages and processes of change in successful smoking cessation.

Abstract

Research on the transtheoretical model has provided substantial support for both stages of change and processes of change (coping strategies influencing successful behavior change). This study examined whether timing of process use (using particular change processes during one stage and not during others) influences quit success. Hypothesized patterns of optimal process use were those marked by more use of experiential processes and less use of behavioral processes during contemplation and preparation and by the reverse pattern during action. Participants (N = 388) began in contemplation or preparation and took action during a 4-6 week period. Multivariate analyses of covariance examined the relationship between patterns of process use and success in staying quit both at 1-month follow-up and 5-6 months later. For the most part, results supported the hypothesis that successful stage transitions involve doing the right thing at the right time: engaging in experiential process activities during contemplation and preparation stages and shifting to behavioral process activities during action.

Application of the Transtheoretical Model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness

“…While the affective disorder/remission participants in the present study were not necessarily in treatment, they were in early full remission from cocaine and therefore might be experiencing a similar process as individuals in treatment. Further research is needed to provide a fuller understanding of these differences.The pattern of relationships that emerged among the measures is consistent with previous research (Carbonari & DiClemente, 2000; DiClemente, Prochaska, Fairhurst, Velicer, Valasquez & Rossi, 1991;Perz, DiClemente, Carbonari, 1996) and supports the validity of the TTM measures in people with co-occurring SMI and SUDs. Participants in the earliest stage of change (URICA-M Precontemplation) did not endorse other dimensions of change (e.g., pros, cons, self-efficacy), whereas those in later stages of change (Contemplation, Action, Maintenance) did.…”

“…These relationships have been seen in other samples of substance abusers (Freyer et al, 2006;Perz, DiClemente, & Carbonari, 1996;Prochaska, Velicer, DiClemente, & Fava, 1988Schumann et al, 2005. The greater use of experiential process of change in the early stages of change, and the greater use of behavioral processes in later stages, replicates findings from other studies with non-SMI samples (Perz, DiClemente, & Carbonari, 1996). Analyses involving the Maintenance scale of the URICA-M were also consistent with past research that shows this scale as an indicator of "struggling to maintain abstinence" as opposed to total remission (DiClemente, 2003;DiClemente, Schlundt & Gemmell, 2004 scores were related to greater temptation to use, seeing both the pros and cons of drug use, lower self-efficacy to stay abstinent, and coping skills commonly used among those just beginning behavior change.…”

Life Span Theory in Developmental Psychology

“…To outline one example-findings suggest that the critical factors in success at quitting cigarette smoking involve being reflective and thoughtful (e.g., emotion /self-focused) at a planning stage and then problem-focused and behavioral during the actual quitting process (Perz, DiClemente, & Carbonari, 1996). As in the case of self-evaluative cognitions, it is also crucial to focus on the timing of coping.…”

Ascertaining the relationships between the trajectories of specific categories of alcohol-related negative consequences and subsequent drinking behavior.

“…An awareness of how one's current behavior impacts his/her important personal goals and values is requisite for developing a discrepancy between actual behavior and desired goals, which, according to the principles of MI and SRT, is necessary to motivate the individual toward behavior change. Similarly, the Transtheoretical Stages of Change Model (Perz, DiClemente, & Carbonari, 1996;Prochaska & DiClemente, 1982;Prochaska, DiClemente, & Norcross, 1992) implies that the exploration of the consequences of behaviors can be an effective strategy for enhancing motivation and promoting actual behavior change. Specifically, individuals in the precontemplation stage (i.e., change is not being considered) may move to the contemplation stage (i.e., change is being considered) by having his/her awareness raised in regard to potential problems and negative consequences that might result from their current behavior.…”