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Scenes from the Cancer Prevention Research Center

Transtheoretical Model: Processes of Change


Processes of change is a major dimension of the Transtheoretical model that enables us to understand how shifts in behavior occur. Change processes are covert and overt activities and experiences that individuals engage in when they attempt to modify problem behaviors. Each process is a broad category encompassing multiple techniques, methods, and interventions traditionally associated with disparate theoretical orientations. Numerous studies have shown that successful self-changers employ different processes at each particular stage of change.

The ten processes of change are consciousness raising, counterconditioning, dramatic relief, environmental reevaluation, helping relationships, reinforcement management, self-liberation, self-reevaluation, social-liberation, and stimulus control. The processes of change are defined in the table below.

Processes of Change 

Definition / Interventions 

Consciousness Raising 

Efforts by the individual to seek new information and to gain understanding and feed-back about the problem behavior / observations, confrontations, interpretations, bibliotherapy. 


Substitution of alternatives for the problem behavior / relaxation, desensitization, assertion, positive self-statements. 

Dramatic Relief 

Experiencing and expressing feelings about the problem behavior and potential solutions / psychodrama, grieving losses, role playing. 

Environmental Reevaluation 

Consideration and assessment of how the problem behavior affects the physical and social environment / empathy training, documentaries. 

Helping Relationships 

Trusting, accepting, and utilizing the support of caring others during attempts to change the problem behavior. 

Reinforcement Management 

Rewarding oneself or being rewarded by others for making changes / contingency contracts, overt and covert reinforcement, self-reward. 


Choice and commitment to change the problem behavior, including belief in the ability to change / decision-making therapy, New Year's resolutions, logotherapy techniques, commitment enhancing techniques. 


Emotional and cognitive reappraisal of values by the individual with respect to the problem behavior / value clarification, imagery, corrective emotional experience. 

Social Liberation 

Awareness, availability, and acceptance by the individual of alternative, problem-free lifestyles in society / empowering, policy interventions. 

Stimulus Control 

Control of situations and other causes which trigger the problem behavior / adding stimuli that encourage alternative behaviors, restructuring the environment, avoiding high risk cues, fading techniques.