A brief description of key concepts drawn from Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual, 2nd edition (Velasquez, M.M., Crouch, C., Stephens, N.S., & DiClemente, C.C., 2015), selected resources for clinicians, and other useful links are provided below.
Transtheoretical Model of Change
The transtheoretical model (TTM) of behavior change draws from a wide range of major psychological theories and approaches—hence “transtheoretical”— and offers a well-established and research-based framework for understanding, measuring, evaluating, and intervening in behavior change. According to the TTM, the stages of change that a person goes through when changing a behavior range from an initial “precontemplation” stage to contemplation, preparation, action, and to a “maintenance” stage in which the client works to sustain long-term change. Each stage represents important tasks that facilitate change, and progress through these stages is often cyclical rather than linear. Current work on the TTM supports the strategic use of the TTM’s experiential and behavioral processes of change for both individuals and groups, and the application of the model to numerous populations and behaviors.
Books
- Connors, G. J., DiClemente, C. C., Velasquez, M. M., & Donovan, D. M. (2013). Substance abuse treatment and the stages of change: Selecting and planning interventions. (2nd ed.). New York, NY: Guilford Press.
- DiClemente, C. C. (2003). Addiction and change: How addictions develop and addicted people recover. New York, NY: Guilford Press.
- Velasquez, M. M., Ingersoll, K., Sobell, M., & Sobell, L.C. (2015). Women and Drinking: Preventing Alcohol-Exposed Pregnancies. Series: Advances in Psychotherapy – Evidence-based Practices, vol. 34. New York, NY: Hogrefe Press.
- Velasquez, M. M., Crouch, C., Stephens, N. S., & DiClemente, C. C. (2015). Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual. (2nd ed.) New York, NY: Guilford Press.
- Velasquez, M.M., Gaddy-Maurer, G., Crouch, C., & DiClemente, C.C. Group Treatment for Substance Abuse: A Stages of Change Therapy Manual 1st edition. New York, NY: The Guilford Press. 2001. (Published in English, Dutch, Greek, Korean, Chinese, Japanese, Portuguese and Arabic).
Suggested Articles and Book Chapters on the TTM
- von Sternberg, K., DiClemente, C.C., & Velasquez, M.M. (2019). Profiles of behavior change constructs for reducing alcohol use in women at risk of an alcohol-exposed pregnancy. Psychology of Addictive Behaviors.
- Carbonari, J. P., & DiClemente, C. C. (2000). Using transtheoretical model profiles to differentiate levels of alcohol abstinence success. Journal of Consulting and Clinical Psychology, 68(5), 810-817. doi: 10.1037/0022-006X.68.5.810
- DiClemente, C. C. (2007). Mechanisms, determinants and process of change in the modification of drinking behavior. Alcoholism: Clinical and Experimental Research, 31(S3), 13S-20S. doi:10.1111/j.1530-0277.2007.00489.x
- DiClemente, C. C. & Velasquez, M. M. (2002). Motivational Interviewing and the Stages of Change. In W. R. Miller & S. Rollnick (Eds.) Motivational Interviewing (2nd Edition). (pp. 201-216). New York: Guilford Press.
- Velasquez, M. M., von Sternberg, K., Dodrill, C., Kan., Y., & Parsons, J. (2005). The Transtheoretical Model as a framework for developing substance abuse interventions. Journal of Addictions Nursing, 16(1-2), 31-40.
- Heesch, K. C., Velasquez, M. M., & von Sternberg, K. (2005). Readiness for mental health treatment and for changing alcohol use in patients with comorbid psychiatric and alcohol disorders: Are they congruent? Addictive Behaviors, 30(3), 531-543.
- Velasquez, M. M., Carbonari, J. P., & DiClemente, C. C. (1999). Psychiatric severity and behavior change in alcoholism treatment: The relation of the transtheoretical model variables to psychiatric distress in dually diagnosed patients. Addictive Behaviors, 24(4), 481-496.
- Velasquez, M. M., Stephens, N., & Drenner, K. (2013). The transtheoretical model and motivational interviewing: Experiences with a cocaine treatment group. In C. C. Wagner & K. S. Ingersoll (Eds.), Motivational interviewing in groups. New York, NY: Guilford Press.
Motivational Interviewing
A critical aspect of the TTM is the recognition that client motivation can be influenced. Counseling approaches such as motivational interviewing (MI) complement the TTM and provide strategies for engaging important change processes. They also offer a method of facilitating change in the early stages, even with clients who are not yet ready to change. Using an MI approach, clients are seen as being responsible for their own change and as having an inherent potential to change for the better. Providers are viewed more as guides who walk alongside clients while they use their own resources to plan, execute and sustain change. Although these guides may respectfully offer helpful suggestions and give advice from time to time, the responsibility for change is explicitly left up to the client.
Books
- Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. (3rd ed.) New York, NY: Guilford Press.
- Wagner, C.C. & Ingersoll, K. S., Eds. (2012), Motivational Interviewing in Groups. New York, NY: Guilford Press.
Suggested Articles and Book Chapters on MI
- DiClemente, C. C. & Velasquez, M. M. (2002). Motivational Interviewing and the Stages of Change. In W. R. Miller & S. Rollnick (Eds.) Motivational Interviewing (2nd Edition). (pp. 201-216). New York: Guilford Press.
- Velasquez, M. M., Stephens, N. & Drenner, K. (2012). Motivational Interviewing – Transtheoretical Model Groups for Addictions. In K. Ingersoll & C. Wagner (Eds). Motivational Interviewing in Groups. Guilford Press.
- Velasquez, M. M., Stephens, N. & Ingersoll, K. (2006). Motivational Interviewing in groups. Journal of Groups in Addiction and Recovery, 1(1), 27-50.
- Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions, 5, 3-17.
Additional Resources
- HABITS Lab at UMBC Health and Addictive Behaviors: Investigating Transtheoretical Solutions (website)
- MINT: Motivational Interviewing Network of Trainers (website)
- MITRIP: Motivational Interviewing Training, Research, Implementation, Practice (MINT’s electronic journal; ISSN 2160-584x)