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Psychotherapy Relationships That WorkEvidence-Based Responsiveness$
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John C. Norcross

Print publication date: 2011

Print ISBN-13: 9780199737208

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780199737208.001.0001

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Stages of Change

Stages of Change

(p.279) Chapter 14 Stages of Change
Psychotherapy Relationships That Work

John C. Norcross (Contributor Webpage)

Paul M. Krebs

James O. Prochaska

Oxford University Press

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

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