This article is adapted, by special permission of Oxford University Press, from a chapter of the same title by the same authors in J.C. Norcross (Ed.), 2011, Psychotherapy Relationships That Work (2nd ed.). New York: Oxford University Press. The book project was cosponsored by the APA Division of Clinical Psychology and the APA Division of Psychotherapy.
Stages of change†
Version of Record online: 14 DEC 2010
© 2010 Wiley Periodicals, Inc.
Journal of Clinical Psychology
Special Issue: ADAPTING PSYCHOTHERAPY TO THE INDIVIDUAL PATIENT
Volume 67, Issue 2, pages 143–154, February 2011
How to Cite
Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011), Stages of change. J. Clin. Psychol., 67: 143–154. doi: 10.1002/jclp.20758
- Issue online: 7 JAN 2011
- Version of Record online: 14 DEC 2010
- stage of change;
- transtheoretical model;
- therapy relationship;
- tailoring treatment;
- treatment adaptation
The transtheoretical model, in general, and the stages of change, in particular, have proven useful in adapting or tailoring treatment to the individual. We define the stages and processes of change and then review previous meta-analyses on their interrelationship. We report 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. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:143–154, 2011.