The Change Companies

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Stages of Change

Norcross, J.C., Krebs, P.M., & Prochaska, J.O. (2011). Stages of Change. Journal of Clinical Psychology , 67(2), 143-154

The transtheoretical model, in general, and the stages of change, in particular, have proven useful in adapting or tailoring treatment to the individual. The authors define the stages and processes of change and then review previous meta-analyses on their interrelationship. They 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. They examine potential moderators in effect size by study outcome, patient characteristics, treatment features, and diagnosis. They 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.