Applications to Addictive Behaviors
James O. Prochaska
Cancer Prevention Research Consortium,
University of Rhode Island
Carlo C. DiClemente
University of Houston
John C. Norcross
University of Scranton
How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-ini-tiated and professionally facilitated change of addictive behaviors using the key transtheoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages—pre-contemplation, contemplation, preparation, action, and maintenance-and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a transtheoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
Hundreds of psychotherapy outcome studies have demonstrated that people successfully change with the help of professional treatment (Lambert, Shapiro, & Bergin, 1986; Smith, Glass, & Miller, 1980). These outcome studies have taught us relatively little, however, about how people change with psychotherapy (Rice & Greenberg, 1984). Numerous studies also have demonstrated that many people can modify problem behaviors without the benefit of formal psychotherapy (Marlatt, Baer, Donovan, & Divlahan, 1988; Schachter, 1982; Shapiro et al., 1984; Veroff, Douvan, & Kulka, 198la, 1981b). These studies have taught us relatively little, however, about how people change on their own.
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