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Copyright of Revista de Psicoterapia is the property of Revista de Psiquiatria y Psicologia Humanista, S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

[Background] Although in most countries psychotherapy trainings focus on one treatment orientation, such an approach is associated with systematic shortcomings. The priorities from teaching one theoretical framework should be moved to a more rigorous orientation in science and evidence-based practice, and to the needs of patients, even if strategies of different theoretical approaches need to be combined. [Method] We discuss whether competence-based trainings in psychological treatments offer a better framework to facilitate the progress of psychological treatments to a professional academic discipline with transtheoretical exchange, and we provide an example of a transtheoretical education in the basic competences of psychological treatments. A transtheoretical education program requires an umbrella model for case formulation and a transtheoretical definition of intervention goals. [Results] We provide an adaptation of the traditional model distinguishing vulnerability/resilience, exacerbation, and maintenance of clinical problems for case conceptualization. Dynamic network models offer a further perspective for developing modern, transtheoretical case formulations. Treatment methods should be better classified according to their transtheoretical goals, which offers opportunities to better compare or combine them. We report a case example of how to transform a general competence-based approach in the training of psychological treatments in the academic education system, which found exceptional acceptance from participating students. [Conclusion] Thus, a rigorous competence-based approach to training early clinicians in applying psychological treatments helps to bridge the artificial divide between psychotherapeutic traditions. It also supports the evolution of psychological treatments into an academically robust and highly professional, integrative discipline.

A brief characterization of transtheoretical stances to which existing approaches can be allocated is followed by a description of the "Bernese view", that is, what Klaus Grawe and his colleagues, including the authors of this article have developed: the origins, a model of the multiple constraint satisfaction construction of therapist action, a discussion of psychotherapy integration, the crucial role of supervisors in an integrative multiple constraint satisfaction approach, and a discussion of when and how trainees should be introduced to a transtheoretical stance.

Receiving my doctorate in 1961 just as John F. Kennedy was inaugurated president of the United States, I was inspired by his sentiment that any person can make a difference, and every person should try. In this memoir I review my professional journey of trying to make a difference in researching, teaching, supervising, and practicing clinical psychology and psychotherapy. I began my career by working on an evidence base for projective techniques. Upon joining the Stony Brook faculty, I shifted my efforts to research on and practice of behavior therapy, and then to the incorporation of cognition in developing cognitive behavioral therapy. Further work on integration consisted of closing the gap between research and practice, lowering the barriers that existed across schools of therapy, and incorporating lesbian, gay, bisexual, and transgender issues into mainstream psychology.

The way that people internalize adverse experiences plays an important role in the development of psychopathology. The Pathogenic Belief Scale (PBS) is intended to operationalize a transtheoretical understanding of repetitive patterns of emotion-laden beliefs that develop in childhood and continue to influence people's current experience. Using a cross-sectional survey design, we recruited a large heterogeneous sample of 246 clinic outpatients and 732 adults in the community. Besides the PBS, measures of adverse parenting experiences and common psychopathology were administered. An exploratory factor analysis of the total sample of 978 participants was conducted followed by a convergent validity analysis for the 246 clinic outpatients. The three-factor solution included "cannot rely on others," "undeserving," and "interpersonal guilt," and it showed good psychometric properties, including convergent validity with the measures of adverse parenting experiences and psychopathology. The 34-item PBS offers a promising self-report measure that could help delineate and understand the pathogenic beliefs that heterogeneous samples of patients may hold. Pathogenic beliefs may be relevant to the psychotherapy process, regardless of model or theoretical context. [ABSTRACT FROM AUTHOR]

A brief characterization of transtheoretical stances to which existing approaches can be allocated is followed by a description of the "Bernese view", that is, what Klaus Grawe and his colleagues, including the authors of this article have developed: the origins, a model of the multiple constraint satisfaction construction of therapist action, a discussion of psychotherapy integration, the crucial role of supervisors in an integrative multiple constraint satisfaction approach, and a discussion of when and how trainees should be introduced to a transtheoretical stance., Competing Interests: The authors have declared that no competing interests exist.

Background: Although in most countries psychotherapy trainings focus on one treatment orientation, such an approach is associated with systematic shortcomings. The priorities from teaching one theoretical framework should be moved to a more rigorous orientation in science and evidence-based practice, and to the needs of patients, even if strategies of different theoretical approaches need to be combined., Method: We discuss whether competence-based trainings in psychological treatments offer a better framework to facilitate the progress of psychological treatments to a professional academic discipline with transtheoretical exchange, and we provide an example of a transtheoretical education in the basic competences of psychological treatments. A transtheoretical education program requires an umbrella model for case formulation and a transtheoretical definition of intervention goals., Results: We provide an adaptation of the traditional model distinguishing vulnerability/resilience, exacerbation, and maintenance of clinical problems for case conceptualization. Dynamic network models offer a further perspective for developing modern, transtheoretical case formulations. Treatment methods should be better classified according to their transtheoretical goals, which offers opportunities to better compare or combine them. We report a case example of how to transform a general competence-based approach in the training of psychological treatments in the academic education system, which found exceptional acceptance from participating students., Conclusion: Thus, a rigorous competence-based approach to training early clinicians in applying psychological treatments helps to bridge the artificial divide between psychotherapeutic traditions. It also supports the evolution of psychological treatments into an academically robust and highly professional, integrative discipline., Competing Interests: Winfried Rief is an Editor-in-Chief for Clinical Psychology in Europe but played no editorial role in this particular article or intervened in any form in the peer review process.

Western culture has historically drawn on many theories to understand and intervene in human behavior. This article will examine the contributions of three theoretical models: Augustine's conceptualization of free will, Albert Bandura's human agency model, and Prochaska, DiClemente, and Norcross' transtheoretical model. Although these perspectives vastly differ in the year of origin and are understood through different fields, they are commonly linked in the role that the individual plays in human behavior. This article is a review of the implications of each theory for the integration of Christian faith and social work practice. [ABSTRACT FROM AUTHOR]

Treatment recommendations for cancer patients are carried out according to clinical assessment, type and stage of cancer and treatment guidelines. However, many patients do not accept the recommendations. This raises obstacles in managing of cancers, which not only affects the patients, but also the family and people around the patients. This problem could increase morbidity, mortality and recurrence rate, which might result in lower quality of life. Since this condition is a complex problem, there is necessity to explore and determine various determinants from different levels. The aim of this systematic review was to explore the acceptances of cancer treatments among cancer patients and its associated determinants. Articles published from 2010 to 2023 were searched in four databases: ScienceDirect, Medline, Google Scholar and PubMed. Articles written in English and focussing on three main cancer treatments (surgery, chemotherapy and radiotherapy) were eligible. A narrative approach was used and the data were analysed into selected themes. Data suggest that several factors influence patient acceptance for cancer therapy including sociodemographic, economic and spiritual cultural backgrounds; patient knowledge and perceptions; community support, as well as policy and availability of health facilities. The determinants consist of individual, interpersonal, institutional, community and public policy level and interaction between levels are contributing to cancer treatment acceptance. In conclusion, cancer treatment acceptance remains a problem in particular in low middle income countries. In addition, the data on radiotherapy referral acceptance were limited and needed further study., Competing Interests: The authors declare that there is no conflict of interest., (© 2023 The Author(s).)

ABSTRACT: Introduction & Objective: Understanding and influencing the determinants of physical activity is an important public health challenge. This study examines the application of key constructs of the transtheoretical model to physical activity behaviors for aged people. Materials & Methods: This study is a field trial with census sampling. Sixty healthy adult men at Kahrizak nursing home in 1386 completed a questionnaire including demographics and self-reported levels of physical activity, constructed from the Transtheoretical Model (TTM), before and after two months of intervention. The interventional program included tailored counseling and focus group. The data were then analyzed with T test, X2, pair T test and Wilcoxon, using SPSS software. Results: Statistical analysis showed a significant difference for the effect of health education program on increasing stage of change, self-efficacy, decisional balance and physical activity behavior in elderly people (p

Work related musculoskeletal disorders remain an intractable OHS problem. In 2002, Haslam proposed applying the stage of change model to target ergonomics interventions and other health and safety prevention activities. The stage of change model proposes that taking into account an individual's readiness for change in developing intervention strategies is likely to improve uptake and success. This paper revisits Haslam's proposal in the context of interventions to reduce musculoskeletal disorders. Effective MSD interventions require a systematic approach and need to take into account a combination of measures. Research evidence suggests that in practice, those charged with the management of MSDs are not consistently adopting such an approach. Consequently, intervention development may not represent contemporary best practice. We propose a potential method of addressing this gap is the stage of change model, and use a case study to illustrate this argument in tailoring intervention development for managing MSDs. [ABSTRACT FROM AUTHOR]

Background: This study aimed at investigating the impact of an educational intervention based on transtheoretical model to increase physical activity and improve metabolic syndrome indicators in women. Methods: In this quasi-experimental study, 142 women with metabolic syndrome were randomly assigned to the case and control group (each group 71 participants). SECQ (Marcus), processes of change (Marcus), decisional balance (Bandura) and self-efficacy (Nigg) questionnaires and International Physical Activities Standard Questionnaire in preintervention, 3 and 6 months after intervention were completed. Furthermore, abdominal obesity, triglycerides (TG), and high-density lipoprotein (HDL) were measured. Physical activity intervention based on transtheoretical model (TTM) was performed in the case group. Finally, data were analyzed by SPSS (16) (SPSS Inc., Chicago, IL, USA) and repeated measure ANOVA, independent t-test and Freidman was used. A two-tailed P value, lower than 0.05, was considered to be statistically significant. Results: After the intervention, physical activity level increased in the intervention group, and they also progressed in stages of change, but the people in the control group had regressed. All changes in TTM constructs were significant in the intervention group during the time and differences in pros and cons were not significant in the control group. Abdominal obesity and TG has significantly reduced, and HDL has increased in the intervention group. In the control group, there was a significant increase in TGs and a decrease in HDL. Conclusions: Physical activity training based on TTM can improve physical activity and metabolic syndrome indicators in women. [ABSTRACT FROM AUTHOR]

There are almost 9,500 full-time employees in Australia's thoroughbred horse breeding industry. During foaling, they can be exposed to bodily fluids and mucous membranes which may present risks for zoonotic disease. These risks can be mitigated through personal biosecurity strategies. The aim of this study was to identify which personal biosecurity strategies were more or less likely to be adopted by workers. Seventeen participants representing 14 thoroughbred breeding farms and three equine veterinary practices in Australia's largest thoroughbred breeding region trialed up to 16 stakeholder-nominated personal biosecurity strategies over the 2021 foaling season. The strategies encompassed personal protective equipment (PPE), zoonotic disease awareness, policies and protocols, supportive environments, and leadership. Strategy adoption was monitored through three repeated self-audit surveys designed around the Transtheoretical Model of change (TTM) and findings were reviewed in exit interviews. For all survey waves in aggregate, 13 strategies were practiced by at least 50.0% of participants. Participants were most likely to use a ready-made foaling box (98.0%), communicate the message that PPE usage is a personal responsibility (94.1%) and use ready-made PPE kits (88.2%). However, 31.4% had no intention of doing practice sessions and/or dummy runs for PPE use and 27.5% had no intention of using a buddy system on farm/practice to check use of PPE. Whilst these rates indicate workers' willingness to adopt and maintain personal biosecurity strategies, they also indicate capacity for more practices to be implemented more often. Overall, the findings highlight the need for personal biosecurity interventions to be sensitive to the demands of the annual thoroughbred breeding calendar, the size of the breeding operation and the availability of skilled staff., Competing Interests: Author JC is the owner-operator of Equine Specialist Consulting. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Thompson, Taylor, Mendez, Chicken, Carrick and Durrheim.)

Background: This study aimed at investigating the impact of an educational intervention based on transtheoretical model to increase physical activity and improve metabolic syndrome indicators in women. Methods: In this quasi-experimental study, 142 women with metabolic syndrome were randomly assigned to the case and control group (each group 71 participants). SECQ (Marcus), processes of change (Marcus), decisional balance (Bandura) and self-efficacy (Nigg) questionnaires and International Physical Activities Standard Questionnaire in preintervention, 3 and 6 months after intervention were completed. Furthermore, abdominal obesity, triglycerides (TG), and high-density lipoprotein (HDL) were measured. Physical activity intervention based on transtheoretical model (TTM) was performed in the case group. Finally, data were analyzed by SPSS (16) (SPSS Inc., Chicago, IL, USA) and repeated measure ANOVA, independent t-test and Freidman was used. A two-tailed P value, lower than 0.05, was considered to be statistically significant. Results: After the intervention, physical activity level increased in the intervention group, and they also progressed in stages of change, but the people in the control group had regressed. All changes in TTM constructs were significant in the intervention group during the time and differences in pros and cons were not significant in the control group. Abdominal obesity and TG has significantly reduced, and HDL has increased in the intervention group. In the control group, there was a significant increase in TGs and a decrease in HDL. Conclusions: Physical activity training based on TTM can improve physical activity and metabolic syndrome indicators in women.

Like many others seeking to make room for alternative voices in the narrow canon of CYC theory and practice, our work is steeped in theoretical and activist perspectives on colonialism, neoliberalism, normativity, social power, and social change. This critical, multidisciplinary lens is too often cast outside the realm of authentic CYC. In this article, we share our simultaneous struggles with and passion for our work and the CYC field and consider what can be gained from a critical ethic of practice, research, and activism. Our transtheoretical framework, drawn from Indigenous, postcolonial, queer, feminist, and poststructural perspectives, helps us unpack how coming together critically, hopefully, productively enables us to trouble exclusionary notions of CYC. We present vignettes from our practice and research that explicitly challenge the assumption that critical practice is somehow less effective and less responsive to the realities of the diverse children, youth, families, and communities with whom we work. [ABSTRACT FROM PUBLISHER]

Copyright of International Journal for Educational & Vocational Guidance is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article will examine a therapeutic methodology that may have some promise for use with an Asian clinical population. The model presented is a transtheoretical model that uses a particular atheoretical method of case conceptualizing. Client change is the ultimate goal of therapeutic intervention, so clients' readiness to change is incorporated into the treatment planning. Finally, interventions are examined by way of examples. [ABSTRACT FROM AUTHOR]

Direct practice social workers today are challenged to address the requirements of the complex array of professional, organizational, institutional, and regulatory demands placed on them in the broader socioeconomic context of fewer resources and diminished public support for social welfare services in the United States. The common factors model provides an accessible, transtheoretical, empirically supported conceptual foundation for practice that may help to resolve this conundrum and support effective practice. Common factors are conditions and processes activated and facilitated by strategies and skills that positively influence practice outcomes across a range of practice theories. The model provides an expanded conceptualization of the "active ingredients" required for change to include a focus on conditions and processes as well as practice strategies and to focus on all who are involved in the work. The model is described and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Showcased in this article is an interview with Carlo C. DiClemente, PhD, an internationally renowned health behavior researcher and codeveloper of the Transtheoretical or Stages of Change Model. In this verbatim interview transcript, later edited by the authors and interviewee, Dr. DiClemente, he provides practical information and frank commentary on the steps to follow and pitfalls to avoid in developing, implementing, evaluating, and disseminating efficacious programs for affecting the health and well-being of individuals and populations. A concluding section summarizes key lessons learned from the professional experiences of Dr. DiClemente and discusses implications for advancing health behavior intervention practice and research. [ABSTRACT FROM AUTHOR]

Trends in adolescent drug use are encouraging and suggest the importance of preventative programs for youth. Yet, among those who become involved with illicit substances and seek treatment, only a fraction report positive outcomes. This article describes an approach to enhance adolescent participation in substance abuse treatment. Aspects of the transtheoretical model are integrated into a treatment program designed to meet the unique developmental needs of adolescent alcohol and marijuana abusers. The result is a treatment that better engages adolescents in participation, thereby increasing the likelihood for treatment success. [ABSTRACT FROM AUTHOR]

Smokers report pleasant reactions to viewing cigarettes, suggesting that smoking cues may be appetitive in nature. Two studies have investigated this hypothesis through physiological assessment. The first study found that smoking cues were physiologically appetitive in nature, with dampened startle response to smoking pictures in comparison to neutral pictures. The second found that smoking pictures did not modulate the startle response, suggesting such cues may not be physiologically appetitive. The goal of the present study was to further investigate how participants’ motivation to quit smoking might modulate responses to smoking cues. Twenty-two nicotine-dependent smokers viewed standardized pleasant, unpleasant, neutral, and smoking pictures. Eleven of the subjects reported no intent to quit (precontemplators) and 11 reported planning to quit within the next 6 months (contemplators). Acoustic startle probes were randomly administered while subjects viewed the pictures, and eyeblink startle magnitude was measured with electromyography (EMG). As a whole, participants exhibited dampened startle responses during smoking pictures, relative to unpleasant pictures. Precontemplators showed robust startle inhibition to smoking pictures, in comparison to both neutral and unpleasant pictures. Contemplators, however, showed blunted unpleasant picture augmentation and a lack of startle inhibition for pleasant pictures. These findings are consistent with the idea that smoking pictures are appetitive in nature. Furthermore, they suggest that smokers at a later stage of change may exhibit a lesser response. [ABSTRACT FROM AUTHOR]

Abstract: Addiction is important to account for when designing smoking cessation interventions as withdrawal symptoms impede quitting. Ameliorating symptoms may increase those successfully quitting. A two‐group, two‐time, five‐week, multi‐site experimental design using the Transtheoretical Model examined whether addiction predicted post‐intervention smoking behavior (point prevalence and stage of change), controlling for NRT (nicotine replacement therapy use) in adult FreshStart participants (N =109). The intervention group self‐designated an Indigenous Helper (IH) Inde from their social network; the control group did not. The Fagerstrom Test for Nicotine Dependence (FTND) and the Stage of Change questionnaire were completed at baseline and 4 weeks. NRT use, but not the FTND, predicted smoking behavior. There is a need for an accurate nicotine addiction measure. Future smoking cessation studies should include NRT as a covariate. [Copyright &y& Elsevier]

Purpose: To identify the transtheoretical model and the five stages of change that assist to bring about behavioral change. A case study is presented to illustrate how the model can be applied by primary care nurse practitioners (NPs) to assist patients toward a healthier lifestyle. Data sources: Scientific literature, theoretical framework, and case study. Conclusions: The transtheoretical model has implications in primary care to assist NPs in assessing what stage a patient may be in, offering encouragement to promote a healthier lifestyle change, and reassessing the patient to maintain the desired healthy behavior. Implications for practice: Primary care NPs can use the transtheoretical model to better advance patients into a healthy behavioral change. Documentation of the current stage a patient is in can promote continuity of care among providers, outline specific health promotion initiatives to enhance patient care, and provide documentation during regulatory inspections. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To test the theoretical predictions of the Transtheoretical Model regarding process-use and progressive stage-transition in relation to smoking behavior. Design and Setting: Secondary data analyses of a 2-year longitudinal worksite-based smoking-cessation study [Working Well Trial (Abrams, D., Boutwell, W., Grizzle, J., Heimendinger, J., Sorensen, G., & Varnes, J. (1994). Cancer control at the workplace: The Working Well trial. Preventative Medicine, 23, 15–27)]. Findings: The results demonstrated some support for the predictions generated from the Model: those making the transition from the Precontemplation stage to the Contemplation stage showed a heightened use of experiential processes-of-change from the baseline measurement to the 2-year follow-up, while those remaining in the Precontemplation stage reported no differences across time in their ratings of experiential and behavioral processes-of-change. Contrary to Transtheoretical Model''s claims, however, smokers moving from the Contemplation stage to the Preparation stage over the 2-year period did not manifest an increasing use of experiential or behavioral processes over time in comparison to their counterparts remaining in the Contemplation stage. Conclusions: Given the lack of longitudinal relation between process-use and the Contemplation-to-Preparation transition, the findings in this paper undermine the Transtheoretical Model''s central tenet that stage-matched processes-of-change serve as the primary mechanisms of stage progression from the Contemplation stage to the Preparation stage. [Copyright &y& Elsevier]

Abstract: The present report describes an investigation of differences in transtheoretical model constructs between 275 smokers with any medical illness, smokers with chronic illness specifically, and smokers who are medically healthy. In contrast to a previous report by Kristeller et al., we did not find higher process scores among medically ill smokers, instead finding more relapses and higher temptation scores among the medically ill smokers. Chronically ill smokers in particular reported high temptation to smoke in negative affect and habit/craving situations. Moreover, greater number of chronic illnesses was associated with increasing temptation and pros of smoking. We conclude that while medical smokers may report more quit attempts, they may have more difficulty staying quit than their healthy counterparts. Helping medically ill smoking patients to cope more effectively with highly tempting situations, to decrease perceived benefits of smoking, and to increase their use of the processes of change may lead to greater cessation success. [Copyright &y& Elsevier]

Abstract: Little is known about what type of drinking related consequences may enhance motivation to change or may hinder behavior change over time. In order to examine this research question, 120 adult participants abusing alcohol were administered the Drinker Inventory of Consequences-Recent (DrInC-R), the Brief Readiness to Change Questionnaire (BRTC), and the Steady Pattern Chart (SP). Subscale scores from the DrInC-R and the BRTC; and alcohol consumption as assessed by the SP at baseline and three month follow-up were retained for data analyses. Greater intrapersonal DrInC-R consequences scores significantly predicted greater contemplation stage scores (R 2 =.37, p <.001), and lower precontemplation stage scores (R 2 =.32, p <.001), and DrInC-R impulse control and interpersonal consequences scores significantly predicted alcohol consumption at three month follow-up after controlling for baseline consumption (R 2 =.50, p <.001). Increased awareness of intrapersonal drinking related consequences may motivate change, whereas numbers of impulse control and interpersonal consequences may predict changes in drinking behavior over the short-term. [Copyright &y& Elsevier]

The transtheoretical model of Prochaska and DiClemente [Psychother. Theory Res. Prac. 19 (1982) 276] postulates that cognitive skills are critical for drinking behavior change. Memory and executive cognitive function likely influence the execution of skills that are implicated for both motivating and sustaining drinking behavior change. Participants who met criteria for alcohol abuse or dependence (N=117) were administered a battery of standardized memory and executive cognitive function tests that included the Wechsler Memory Scale-Revised (WMS-R), Controlled Oral Word Association Test (COWAT), Ruff Figural Fluency Test (RFFT), and Wisconsin Card Sort Test (WCST). Lower verbal and higher delayed recall memory score at baseline significantly predicted precontemplation, higher verbal memory scores predicted contemplation, and better attention–concentration at baseline significantly predicted reduced drinking at 3-month follow-up, after controlling for baseline alcohol consumption. The study findings indicate that explicit memory processes may have utility for predicting readiness to change drinking behavior. [Copyright &y& Elsevier]

The aim of this research was to assess the impact of a cognitive-behavioural intervention on the short-term adherence to exercise of previous sedentary women living in a rural area in Spain. A sample of 30 sedentary women, 49-69 years old, with normal bone mineral density (BMD) or osteopenia were randomly assigned to one of two groups. The control group received four monitored sessions of exercise once a week, while the experimental group attended four additional sessions where strategies to improve adherence to exercise were implemented. The short-term adherence of participants was self-reported in two periods. The first period of 4 weeks consisted of independent walking sessions twice per week, and the second period included attendance at unsupervised group sessions twice per week during the following 5 weeks. Data from 27 subjects attending at least three out of four monitored sessions were analysed. The short-term adherence of the experimental group to the independent walking sessions was significantly higher than the adherence of the control group; however, no significant between group difference was found in adherence to the unsupervised group sessions. In conclusion, the intervention based on the Transtheoretical Model (TTM) improved adherence to walking exercise sessions only during the intervention implementation period. [ABSTRACT FROM AUTHOR]

A theoretical model for a prison-based rehabilitation programme is described. It was developed from a theory manual, written for a prison-centred programme in Oxfordshire run by the Ley Community, a concept-based therapeutic community. It draws on two theoretical models that are historically separate and distinct, reviews their key theoretical components and explores integrative links. Concept-based therapeutic communities, their origins, aims, values and methods are discussed. Cognitive behavioural group work approaches are explored and the features crucial to their effectiveness are identified. Two types of prison-based drug treatment programmes, based on therapeutic community and cognitive behavioural approaches are described and discussed. This includes consideration of research findings into their effectiveness and identifies features that are considered crucial to a programme's success. It is suggested that the adoption of a transtheoretical model would enable an integration of concepts and components that underpin both cognitive behavioural and structured therapeutic community approaches, and may provide a pragmatic solution to any inherent theoretical tensions. [ABSTRACT FROM AUTHOR]

Purpose. To assess the effectiveness of applying behavior change theory to a physical activity intervention for obese, sedentary women. Design. A 48-week randomized controlled trial. Subjects were randomized to one of two intervention groups. Setting. A university classroom and a local health club. Subjects. Fifty-eight sedentary, obese women. Interventions. A 24-week theory-based physical activity program that aims to change the way subjects think and behave in relation to physical activity (treatment group, n = 29) and a traditionally structured exercise program (control group, n = 29). Measures. Questionnaires on physical activity, stage of change, processes of change, and self-efficacy were completed at baseline, 24 weeks, and 48 weeks. Results. Twenty-seven of the 29 participants in the treatment group and 17 participants in the control group completed the study. Analysis of variance revealed significant and positive changes in measures of eight processes of change, self-efficacy, physical activity, and cardiorespiratory fitness in the treatment group at 24 weeks. All but one of these changes were maintained at 48 weeks. In the control group, significant changes occurred in only two processes of change, and no change occurred in self-efficacy, physical activity, or cardiorespiratory fitness at 24 or 48 weeks. Conclusion. A theory-based intervention is more likely to change the ajay obese women think and behave in relation to physical activity than a traditional exercise program that does not incorporate behavior change theory. [ABSTRACT FROM AUTHOR]

Background: The high prevalence of behavioral risk factors for cardiovascular diseases demands innovative approaches to achieving behavior change. Primary care physicians are in an ideal position for offering such interventions. Purpose: To evaluate whether training of primary care physicians in counseling skills based on the Transtheoretical Model (TTM) leads to motivational and behavioral changes in their patients. Method: Seventy-four primary care physicians in Germany were randomly assigned to either an intervention condition (one day of training in TTM-based counseling plus brochures matched to their patients' ''stages of change'') or a control condition (usual care). Baseline and 12-month follow-up data were collected from 305 of their patients who signed up for a health check-up. Outcome measure: Patients' movements across the stages of change for smoking, diet, exercise and stress management. Results: After 12 months, patients of physicians in the intervention group did not show more movement through the stages of change for any of the behaviors than did patients of control physicians. Additionally, there were no differences between groups in counseling frequency, counseling intensity, or patient satisfaction with counseling. Conclusions: A high dropout rate at follow-up and resulting ''power'' problems limit the possible conclusions. The high numbers of patients in early stages of change and the minimal improvement over time underline the need for improving motivational counseling skills of primary care physicians in Germany. In our study the dissemination of these strategies failed. We offer lessons we feel can be learned from this outcome. Further studies should focus on ways to enhance the process of educating physicians for implementing counseling strategies in primary care settings. [ABSTRACT FROM AUTHOR]

Objectives: The study was conducted in Western Australia, focusing on the attitudes of older, rural, non-hospitalised people towards newly legislated advance care planning (ACP) documents. This study explored baseline awareness and perception of advance directive (AD) forms and factors relevant to their utilisation, using the transtheoretical model as a theoretical framework., Methods: Sixty-two adults were recruited from residential aged care facilities, community care organisations, general practice, an oncology service and a law firm. Semi-structured interviews were undertaken. These were transcribed and thematically analysed by the authors., Results: Participants gave responses that were consistent with different stages of the transtheoretical model. Perceived susceptibility to the negative consequences of not engaging in AD form utilisation was a trigger for further contemplation. The presence of adequate personal empowerment was important for successful completion of AD forms. There was also qualitative evidence of a negative relationship between perceived susceptibility and empowerment regarding AD form utilisation., Conclusions: Promoting balance between a person's perceived susceptibility and empowerment may be an effective method of increasing engagement with AD forms.