Changing for Good

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by James O Prochaska


  revising of, 132–133, 150–151, 172–173, 247–248

  threats to, 130, 172–173

  self-liberation, 29

  self-praise, 31

  self-reevaluation, 26, 29

  in contemplation, 55, 129–136

  decision making in, 133–136, 134, 137–141, 139, 140, 149

  freedom and, 285–286

  goals of, 33

  negative and positive appraisal combined in, 131, 133–136, 134

  in preparation, 146, 147, 149–151

  questions appropriate in, 129–130, 131–132

  self-assessment of, 136

  techniques of, 33, 131–136, 150–151

  thinking process in, 131–132

  serenity prayer, 154

  sex, 24, 37, 40, 141

  safe, 67, 286

  Shakespeare, William, 130

  Siegel, Bernie, 113

  Skinner, B. F., 17, 26, 90, 282

  sleep, 40, 76, 81

  Smokenders, 175

  smoking, 14, 15, 77, 105, 242–251

  adolescent, 16, 242

  cutting down on, 43, 66, 147

  functional analysis of, 124–125, 124

  government warnings vs. industry advertising on, 41, 101–102, 242

  health problems and death associated with, 29, 41, 42, 51, 62, 65, 66, 78–79, 83, 84, 85, 86–88, 113, 116, 117, 133, 152, 153, 202, 242–246, 244

  information about, 41, 88, 152, 153, 244–245

  medical costs and, 51

  statistics on, 36, 83, 86, 242

  studies on, 64–66, 85, 86–88, 153, 207–208

  typical reasons for, 30, 132, 247

  smoking cessation:

  action and, 67, 87–88, 249–250

  changers’ manual for, 242–251

  cold turkey, 43, 48

  commercial aids to, 157, 158

  contemplation and, 246–248

  doctor’s counseling on, 62, 88

  emotional arousal and, 28–29, 117

  external pressure for, 80, 88, 113–114

  groups and programs for, 32–34, 36, 42, 45, 51, 86–88, 113–114, 152, 175

  importance of stages in, 64–66, 65, 87

  maintenance and, 202, 205, 206, 250–251

  oral cravings and, 46, 158

  precontemplation and, 243–246

  preparation and, 248–249

  prior attempts at, 47, 48, 57, 113–114, 175, 208

  resistance to, 41, 42, 47, 83, 87, 113–114

  self-change, 36, 51, 52, 86–88, 157, 206

  techniques of, 116, 117, 157, 206

  weight gain and, 57

  social liberation, 26, 28, 56

  goals of, 33, 100, 103–104

  motivation and, 103–104, 105

  outside influences and, 104–105

  in precontemplation, 82, 100–106, 108, 246

  self-assessment and, 105–106

  techniques of, 33, 100–102, 103–105

  social mores, 31, 37, 74, 80, 81

  social workers, 236–238

  stages of change, 15–16, 17, 27, 37–50, 63, 73–219

  awareness and readiness in, 59, 64–69, 75, 109

  bogging down in, 42–43, 75, 109–112, 147

  knowledge and assessment of, 15, 16, 39, 55, 60, 64–69, 77, 243

  linear vs. spiral progress in, 47–50, 64–66, 226

  matching processes of change with, 15–17, 27, 37–39, 41, 50, 52–60, 54, 56, 61–62, 223, 224

  progress in, 100, 101, 115, 120, 162–171

  relationship of pros and cons to, 162–171, 163

  self-assessment of, 243

  setbacks in, 47–50, 172, 221

  transition between, 45, 47, 55, 68, 79, 81, 108, 115, 133, 166, 274

  see also action; contemplation; maintenance; precontemplation; preparation; termination

  stress reduction, 80, 83, 124–126, 128, 148, 205, 249

  sublimation, 93

  substance abuse, 17, 31, 36, 57–58, 85, 101–102

  see also specific substance abuses

  sun, overexposure to, 16, 67

  support groups, 32–34, 101, 102, 147, 157, 198, 249

  Systems of Psychotherapy (Prochaska), 25

  Tale of Two Cities, A (Dickens), 208

  temptations, 46, 192

  avoidance of, 44, 45, 68, 150, 160, 177, 187–188

  early stages of change and, 161–162

  maintenance and, 202–205, 206–209

  termination and, 277–278

  termination, 15, 39, 43, 46, 66, 274–280

  criteria for, 276–279

  healthier lifestyle in, 279–280

  maintenance vs., 46, 276–279

  self-efficacy in, 278–279

  self-image in, 276–277

  zero temptation in, 277–278

  tobacco industry, 102, 104, 132, 133, 244, 246

  unconscious, 126–127

  Velicer, Wayne, 162

  Waiting for Godot (Beckett), 110

  Watzlawick, Paul, 24, 175n

  weight control, 14, 15, 17, 66, 105, 275–276

  basal metabolism and, 27

  calorie counting and, 43, 121, 122, 123, 138–139, 200

  consciousness-raising and, 89, 91–92, 138–139

  eating habits and, 58, 61, 121, 160

  emotional arousal and, 117–118

  exercise and, 121, 140, 141, 159–160, 199–201

  fasting and, 138, 139

  health benefits of, 140, 141, 199

  helping relationships and, 160, 198

  nutrition and, 121, 199–200

  programs for, 46, 52, 137, 224

  pros and cons of, 137–141, 139, 140

  relapse and, 45–46, 73, 75, 76, 137

  rewards and, 193

  self-image and, 130, 137, 138, 140

  sexuality and, 151, 201

  smoking and, 57

  social attitudes and, 80, 138

  see also diets

  weight tables, 67

  willpower, 175

  emphasis on, 60, 61, 76, 223–224

  misuse of, 225

  strengthening of, 152–153

  testing of, 45, 209

  wishful thinking, 112–114, 119, 130, 138, 147, 156, 234

  Wolpe, Joseph, 26

  women’s rights groups, 28

  Acknowledgments

  OUR COLLECTIVE fifty years of clinical and research experience behind Changing for Good have indebted us to our funding sources, students, clients, and colleagues. We gratefully acknowledge the financial support over the years of the National Institutes of Health, the University of Rhode Island, the University of Scranton, the University of Texas Medical School, and the University of Houston. We appreciate our students, too numerous to thank individually here, for their persistent inquisitiveness and research contributions. We cherish the courage and sharing of our research participants and psychotherapy clients, who have proven to be the ultimate teachers of self-change.

  The development of the transtheoretical approach has been a collaborative effort involving many dedicated individuals who have made invaluable contributions. These include Drs. Wayne Velicer, Joseph Rossi, David Abrams, Ellie McConnaughy, Diane Grimley, Unto Pallonen, Joseph Fava, Colleen Redding, Michael Goldstein, William Rakowski, Raymond Niaura, Bess Marcus, Geoff Greene, Robert Laforge, Laurie Ruggiero, Susan Rossi, Karen Emmons, Gabrielle Reed, and many more. Others making special contributions include Elaine Taylor, Gabrielle Riley, Guy Natelli, and the entire staff of the Cancer Prevention Research Consortium. Collaborating investigators in Houston included Drs. Jack Gordon, Joseph Carbonari, Michael Gibertini, Nancy Brandenburg, Sheryl Hughes, Chris Lovato, Michael Eriksen, Patricia Mullen, and Mary Velasquez.

  Maria Guarnaschelli, our editor, committed her creativity and vitality to help transform our vision into a reality. We treasure her mission of reducing the distance between professionals and the public. The assistance of the William Morrow staff was particularly appreciated by the thre
e of us—all novices in the process of publishing a book for the public.

  Our families are the foundation for creative inspiration and personal support. Each of our spouses, Jan Prochaska, ACSW, Nancy Caldwell-Norcross, ACSW, and Lynn Dahlquist, Ph.D., are dedicated professionals, parents, and partners. Experiencing unconditional caring is a hallmark of successful self-change, and our spouses are remarkably good models of such consummate care. We dedicate Changing for Good to our children, who have changed our lives in so many good ways.

  About the Authors

  JAMES O. PROCHASKA, Ph.D., is a professor of psychology and director of the Cancer Prevention Research Center at the University of Rhode Island. JOHN C. NORCROSS, Ph.D., is professor and former chair of psychology at the University of Scranton. CARLO C. DICLEMENTE, Ph.D., is professor and chair of the department of psychology at the University of Maryland, Baltimore County. Their model for self-change has atttracted attention worldwide and has been applied in programs sponsored by such organizations as the National Cancer Institute and the National Institute of Drug Abuse.

  Visit www.AuthorTracker.com for exclusive information on your favorite HarperCollins author.

  Copyright

  Writing contributions from Mark Beitman and Brian Crawleey.

  CHANGING FOR GOOD. Copyright © 1994 by James O. Prochaska, John C. Norcross, and Carlo C. DiClemente. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins e-books.

  The Library of Congress has catalogued the hardcover edition as follows:

  Prochaska, James O.

  Changing for good / James O. Prochaska, John C. Norcross, Carlo C. DiClemente.

  p. cm.

  1. Behavior modification. 2. Change (Psychology). I. DiClemente, Carlo C. II. Norcross, John C., 1957. III. Title.

  BF637.B4P65 1994 93-44897

  158’.1—dc20 CIP

  EPub Edition © March 2010 ISBN: 978-0-06-201038-4

  10 9 8 7 6 5 4 3 2 1

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  * Each theory of psychotherapy has its own sphere of excellence. Psychoanalysis, for example, is the preferred approach for raising awareness of both conscious and unconscious motivations, or consciousness-raising. Behaviorism, on the other hand, is demonstrably the most effective approach for modifying discrete problem behaviors.

  As you can see, each system is especially useful at one or two stages of change. The transtheoretical model, which builds on the respective strengths of these systems, integrates the best of each into a coherent whole.

  † These techniques are included here for the informed reader, although they are not explored in the text.

  † These techniques are included here for the informed reader, although they are not explored in the text.

  † These techniques are included here for the informed reader, although they are not explored in the text.

  † These techniques are included here for the informed reader, although they are not explored in the text.

  † These techniques are included here for the informed reader, although they are not explored in the text.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * These are primarily professional techniques used by psychotherapists. Throughout Part II you will learn the most creative and effective techniques that self-changers use to apply each process.

  * Adapted from the Defense Mechanism Inventory (Gleser & Ihilevich, 1969).

  * The notion of decisional balance is discussed at length in the book Decision Making, by Irving Janis and Leon Mann (New York: Free Press, 1977).

  * Mechanic, 1962.

  * A T point is a certain statistical unit of measure; you need not understand the unit it represents to understand these principles of progress.

 

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