The following experiences can affect the weight of some people. Think of any similar experiences you may have in trying to lose weight or keep from gaining weight. Please rate how FREQUENTLY you use(d) each of these during the past month. There are FIVE possible responses to each of the questionnaire items. Please circle the number that best describes your experience.

1 = Never
2 = Seldom
3 = Occasionally
4 = Often
5 = Repeatedly (always)

Scoring

Consciousness Raising = 1, 13, 25, 37
Countercoditioning = 2, 14, 26, 38
Dramatic Relief = 3, 15, 27, 39
Environmental Reevaluation = 4, 16, 28, 40
Helping Relationships = 5, 17, 29, 41
Interpersonal Systems Control = 6, 18, 30, 42
Reinforcement Management = 7, 19, 31, 43
Self Liberation = 8, 20, 32, 44
Self Reevaluation = 9, 21, 33, 45
Social Liberation = 10, 22, 34, 46
Stimulus Control = 11, 23, 35, 47
Substance Use = 12, 24, 36, 48

Description

Meta-analyses of models of how people change have identified a common set of processes underlying the modification of problem behaviors (Prochaska, 1979; Prochaska & DiClemente, 1982, 1983, 1985, 1986, 1992; Rossi, 1992). These processes of change are overt and covert change strategies and techniques that can be employed by professionals, such as therapists or physicians, or by people changing on their own or with the aid of self-help programs. Ten to twelve processes have been consistently replicated across time, problem behaviors, sex, age, geographical region, and response formats (Prochasks & DiClemente, 1985; Prochaska, Velicer, DiClemente, & Fava, 1988; Rossi, 1992; Rossi & Bellis, 1993). For weight control, 12 processes of change have been identified: consciousness raising, counterconditioning, dramatic relief, environmental reevaluation, helping relationships, interpersonal systems control, reinforcement management (sometimes termed contingency management), self liberation, self reevaluation, social liberation, stimulus control, and substance use (sometimes called medication). Brief definitions of the processes can be found linked to the CPRC Transtheoretical Model page. Brief definitions of the processes are given in Table 1. Structural analyses indicate that the processes are organized into two general second order (hierarchical) constructs, reflecting the tendency of individuals to use more than one process of change at a time (Prochaska et al., 1988; Rossi, 1992). This model has been replicated across nine different problem behaviors, including smoking cessation, alcohol use, cocaine use, exercise adoption, dietary fat reduction, HIV risk reduction, psychological distress, weight control, and heroin use (Marcus, Rossi et al., 1992; Prochaska et al., 1988; Redding & Rossi, 1993a; Rossi, 1992; Rossi et al., 1993a; Rossi, Rossi et al., in press; Snow, Prochaska, & Rossi, in press). The two higher order factors are the experimental and the behavioral processes of change. In general, the experimental processes may be characterized as incorporating the cognitive, evaluative, and affective aspects of change whereas the behavioral processes include more specific, observable change strategies. However, these distinctions are not absolutely clear-cut. Across nine different problem behaviors, the correlation between the experimential and behavioral factors ranged from .51 to .91 (median = .77), indicating a general tendency to use (or not use) all of the processes of change (Rossi, 1992).

The processes of change and the stage of change are integrally related. Transitions between stages are mediated by the use of distinct subsets of change processes (DiClemente et al., 1991; Prochaska & DiClemente, 1983; Prochaska, DiClemente, Velicer, Ginpil, & Norcross, 1985; Prochaska, Velicer et al., 1991). For example, consciousness raising is an experiential process reflecting an individual's attempt to seek out information concerning their problem behavior. Employment of this process predicts successful movement from the precontemplation stage to the contemplation stage. The process of self reevaluation is characteristic of the change from contemplation to action, whereas stimulus contol is most frequently employed by individuals progressing from action to maintenance. In general, use of the experiential processes of change tends to peak in the contemplation or preparation stages, whereas use of the behavioral processes tends to peak in the action or maintenance stages. Precontemplators use the processes least of all. Longitudinal data suggest that when individuals (or treatment programs) mismatch processes to stages, action attempts are likely to fail (Fitzgerald & Prochaska, 1990; Gritz, Berman, Bastani, & Wu, 1992; Ockene et al., 1992; Prochaska et al., 1985). These results suggest that stage-specific interventions may accelerate progress through the stages of change. Interventions tailored to participant's stage of change have been developed for smoking cessation (Prochaska, DiClemente, Velicer, & Rossi, in press), exercise adoption (Marcus, Banspach, Lefebvre, Rossi, & Carleton, 1992), and sun exposure (Rossi, Blais, & Weinstock, in press) and have proved successful. Consideration of the processes of change and their relationship to the stages of change is thus important from the standpoint of providing guidance for the development of successul intervention programs applicable not only for individuals who are ready to change a problem behavior but for the vast majority of people who are neither prepared nor motivated to change.

Stages of Change in which the Processes of Change of Weight Control are most emphasized