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A randomized controlled trial was used to guide this study. This study aimed to examine the effect of the Transtheoretical of Change-based intervention (TTM) in bettering collegians’ readiness to adhere to weight control behavior. The study was conducted at the College of Languages, University of Baghdad. The study included 152 students who were randomly selected and assigned into two groups; study and control groups. Each group included 76 students. The study instrument consists of the sociodemographic sheet and the Processes for Change for Weight Control Scale. Data were collected by a self-report questionnaire. Data were analyzed using the statistical package for social science (SPSS) for windows, version 24. The study results demonstrated that there is a statistically significant difference in the Processes of Change for weight control for students in the study group over time with an approximately 73% of variance in the value of the Decisional Balance that could be attributed to the administered TTTM-based intervention. There was a positively significant correlation between students’ BMI and each of Processes of Change over time. The researcher concluded that the TTM-based intervention enabled students to employ more both the cognitive and behavioral Processes of Change for weight control behavior. [ABSTRACT FROM AUTHOR]

The article presents an analysis of 93 essays written in an upper secondary school context. The essays were collected in relation to a larger research project, which went on for 5 years in a Danish upper secondary school (2010–2015). The material represents both genders and the students are 15–17 years old. We deploy a theoretical framework taken from Norbert Elias' notion on established-outsider relations [Elias, N., & Scotson, J. L. (1994 [1965]). The established and the outsiders. London: SAGE] as well as his use of personal pronouns [Elias, N. (1978). What is sociology? London: Hutchinson, Elias, N. (2001). The society of individuals. New York: The Continuum International Publishing Group] in illustrating how people negotiate, position and navigate within figurational contexts [Elias, N. (1994 [1939]). The civilizing proces. Oxford: Blackwell.]. We do this in an effort to interpret how young people negotiate 'we-I-relations' when it comes to their sporting identity. Elias' processual framework provides a tool for a much needed analysis of how young people continually orientate and develop their sense of selves. The web of human interdependencies and processes of change are key words when it comes to understanding the social practices and doings of the students' constructions of self-steering. What social scientists may see as laziness and drop-outs of sports [Seippel, Ø. (2016). Prek, vekker og kjedelig? Trening og mening blant ungdom: 1985–2013. In Ø. Seippel, M. K. Sisjord, & Å Strandbu (Eds.), Ungdom og Idrett. Oslo: Cappelen Damm Akademisk] can in the essays of students be analysed as a struggle for group connectedness and social inclusion in the classroom. The results of our research show that identity is a multiple concept and an ongoing process of emotional work [Elias, N. (1987). On human beings and their emotions: A process-sociological essay. Theory Culture Society, 4, 339–361], but also a power balance of playing and presenting what is imagined as the right performance as not being shamed as outcasts. [ABSTRACT FROM AUTHOR]

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This study explores the efficacy of BEfree, a 12-session group intervention that integrates psychoeducation, mindfulness, compassion and value-based action, in a sample of overweight and obese women with binge eating disorder (N = 31). We used repeated measures analyses of variance and explored processes of change in binge eating and eating psychopathology. At post-intervention, participants decreased in binge eating severity, eating psychopathology, external shame, self-criticism, psychological inflexibility, body image cognitive fusion and increased self-compassion and engagement with valued actions. These results were maintained at 3- and 6-month follow-up. The changes in binge eating were mediated by the changes in the psychological processes promoted by BEfree. [ABSTRACT FROM AUTHOR]

Introduction: The transtheoretical model (TTM) is an integrative model of intentional change consisting of stages of change, processes of change, decisional balance and self-efficacy. This study aimed at validating the TTM questionnaires on physical activity for Malaysian children using confirmatory factor analysis. Methods: The participants were 381 Malay students (188 male; 193 female), aged 10-12 years old, with a mean age of 10.94 (SD = 0.81). The original version of the TTM was translated into the Malay language using forward and backward translation. Certain phrases were adapted based on the local culture and vocabulary suitable for primary school students. Results: The final measurement models and their fit indices were: processes of change (CFI = 0.939, TLI = 0.925, SRMR = 0.040, RMSEA = 0.030); decisional balance (CFI = 0.897, TLI = 0.864, SRMR = 0.045, RMSEA = 0.038); and self-efficacy (CFI = 0.934, TLI = 0.915, SRMR = 0.042, RMSEA = 0.032). Conclusion: Care must be taken when using the TTM with children, as it has been prevalently validated with adults. The final version of the TTM questionnaire for Malay primary school children had 24 items for process of changes, 13 items for self-efficacy and 10 items for decisional balance. [ABSTRACT FROM AUTHOR]

This study’s purpose was to examine the structural relationship of the transtheoretical model (TTM) and the amount of physical activity (PA) among undergraduate students in health and medicine at Universiti Sains Malaysia. A cross-sectional study was carried out among students who took part in the co-curricular program. Co-curricular program includes activities that take place outside of the regular lectures or tutorials in the University. Students recruited through purposive sampling were informed that their participation was entirely voluntarily. Those interested completed the self-administered questionnaire, which consisted of the decisional balance, processes of change, self-efficacy, stages of change scales, and Godin leisure-time exercise questionnaire. Data were analyzed using Mplus version 8 for descriptive statistics and structural equation modeling analysis for inferential statistics. A total of 562 students participated in the study. The majority of the students was female (79.0%) and Malay (73.3%) and average of exercise sessions per week was 2.62, with a mean of 43.37 min per exercise session. The final structural model fit the data well based on several fit indices (SRMR = 0.046, RMSEA (CI: 90%) = 0.061 (0.045, 0.078), RMSEA p = 0.130). The model showed that stages of change significantly affected self-efficacy (p < 0.001), pros (benefits of exercise; p < 0.001), cons (barriers to exercise; p = 0.022), and processes of change (p < 0.001). The model also showed significant inter-relationships among the TTM constructs and supported seven hypotheses. Among all the variables examined, only processes of change significantly affected PA (p < 0.001). However, stages of change (p < 0.001) and pros (p =< 0.001) had significant indirect effects on PA via processes of change. The findings support that individuals’ stages of change affect their self-efficacy level, or the ability to make positive and negative decisions and perform behavior accordingly. The study confirms that making correct decisions and taking action accordingly can increase PA levels.

In the context of the popular uprisings in the Middle East and North Africa known as the Arab Spring, Jordan has remained at the second level both on the international scene and in the analyses made of this movement. The Hashemite Kingdom, characterised by its political stability and neutral position in the various confrontations that shape regional politics, has made changes in order to avoid the political processes being experienced by some of its neighbours. In this way, from a political science point of view and with an analysis that traces the processes, the developments that have taken place in Jordan are examined, putting particular emphasis on the central role of the tribal organisation within the monarchy.

Reducing or quitting problematic gambling often requires implementing a variety of behaviour change strategies, but there is limited evidence regarding the breadth of specific strategies that gamblers use to control or limit gambling behaviours. This study aimed to identify the range of change strategies reported by gamblers in a naturalistic setting (i.e. two online forums for problem gambling). A total of 2937 change strategies were extracted from online posts (N = 1370). Content analysis identified 27 discrete change strategies that were pre-decisional (i.e. barriers - behavioural and psychological, decisional balance, realization - behaviour and cognitions, set reasons to change, seek knowledge and information, self-assessment), pre-actional (i.e. action planning, commitment, goal setting), actional (i.e. alternative activity, behavioural substitution, avoidance - abstinence, environment and financial, consumption control, maintain readiness, reinforcement, urge management, cognitive restructuring, seek inspiration, self-monitoring and spiritual) and multi-phased (i.e. external support, social support and well-being). This study suggests the breadth and depth of change strategies are far more complex than previously reported. Future research with a broader population needs to determine which change strategies are most effective for those experiencing different levels of gambling problems. [ABSTRACT FROM AUTHOR]

Objective: Sudden gains are robust predictors of outcome in psychotherapy. However, previous attempts at predicting sudden gains have yielded inconclusive findings. The aim of the present study was to examine a novel, transdiagnostic, transtherapeutic predictor of sudden gains that would replicate in different settings and populations. Specifically, we examined intraindividual variability in symptoms. Method: We examined data from a randomized controlled trial (RCT) of prolonged exposure therapy for posttraumatic stress disorder (PTSD) in children and adolescents (n = 63), an RCT of cognitive and behavioral therapies for obsessive-compulsive disorder (OCD) in adults (n = 91), and psychodynamic therapy delivered under routine clinical conditions in a naturalistic setting for diverse disorders (n = 106). In all 3 data sets, we examined whether a measure of variability in symptoms occurring during the first sessions could predict sudden gains. Results: Variability in symptoms was found to be independent of total change during treatment. Variability in symptoms significantly predicted sudden gains in all 3 data sets and correctly classified 81.0%, 69.2%, and 76.9% of individuals to sudden gain or nonsudden gain status, respectively. Conclusions: The present study represents the first examination of variability in symptoms as a predictor of sudden gains. Findings indicated that sudden gains are significantly predicted by intraindividual variability in symptoms, in diverse settings, contexts, and populations. Advantages of this predictor, as well as clinical and research implications are discussed. [ABSTRACT FROM AUTHOR]

Intersections between Grawe’s General Psychotherapy and Prochaska’s Transtheoretical Model were investigated in group therapy in a longitudinal design. It was assumed that general change mechanisms have an impact on patients’ stages of change. Specifically, the main hypotheses were that experiential change mechanisms (ECM; clarification of meaning, problem actuation, emotional bond and group cohesion) should be especially relevant for early stages of change (precontemplation and contemplation), whereas behavioral change mechanisms (BCM; resource activation, mastery/coping and task and goals) should be especially relevant for late stages of change (action and maintenance). Therefore, 140 outpatients attending different types of group therapy, with a typical duration of 8 sessions, were investigated. Patients completed the Form for the Evaluation of Therapeutic Processes in Group Therapy (FEPiG), the University of Rhode Island Change Assessment, short version (URICA-S) and several symptomatology measures (BDI-II, BSCL and IIP-32) at two measuring times. Intersections were analysed through correlational analyses, cross-lagged panels and a path-analytic model, supporting the hypotheses. Specifically, results suggested that experiencing ECM at t1 predicted higher levels of reported contemplation at t2. Patients experiencing higher levels of BCM at t1 reported higher levels of action at t2. Clinical implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the effectiveness of a compassion focused therapy (CFT) group with a transdiagnostic population, as compared to treatment as usual (TAU). A secondary aim was to explore the potential processes of change within the treatment. Design: A non‐randomized control trial was used. Method: Fifty‐eight participants who engaged in group CFT were compared to 29 participants receiving TAU. Group CFT consisted of 14 sessions twice weekly for 5 weeks and once weekly for 4 weeks. Participants completed measures of psychopathology, shame, self‐criticism, fears of self‐compassion, and social safeness, at pre‐treatment, post‐treatment, and 2‐month follow‐up. Potential processes of change were examined using correlations and regression analysis. Results: Significantly greater improvements were found for levels of psychopathology, fears of self‐compassion and social safeness for CFT, compared to TAU. Additionally, analyses showed improvements in shame and self‐criticism within the CFT group but not the TAU group. All improvements were maintained at 2‐month follow‐up. Improvements in psychopathology were predicted by changes in self‐criticism and fears of self‐compassion. Conclusion: Compassion focused therapy appears to be an effective group intervention for a range of mental health difficulties. The positive impact of the CFT model with a transdiagnostic group emphasizes the value of addressing underlying psychological process, rather than symptoms alone. Practitioner points: Compassion focused therapy is a multimodal therapy designed to target high levels of shame and self‐criticism. Compassion focused therapy has been shown previously to have positive results within a range of diagnostic‐specific populations. While there is an emerging research base, limited studies assessing effectiveness with transdiagnostic populations have been published. CFT was shown to have a significant effect in reducing levels of psychopathology, compared to TAU. A number of potential processes of change were identified: Changes in psychopathology were significantly correlated with changes in self‐criticism and fears of self‐compassion. [ABSTRACT FROM AUTHOR]

While the benefits of music to people’s mental health have long been recognized, the process of how it works requires further investigation. This paper is based on the results of a community-based music project offered to a group of mental health service users by a Hong Kong social service centre. A six-dimensional framework, which contains emotional, psychological, social, cognitive, behavioural and spiritual dimensions, is constructed for understanding how musical activities may produce benefits for mental health service users. Through conducting 23 interview sessions with the participants (N = 47) this study examines the processes of change within musical activities. The participants suffered from mental health problems including mood disorders, anxiety disorders, schizophrenia and other psychotic disorders. Feedback was solicited from them by listening to their first-hand experiences as service users of the musical activities. Recorded interviews were transcribed and analysed to generate themes that correspond to the six dimensions the researchers proposed. This study shows that the clinical effects elicited by the musical activities described fit closely with the needs of mental health service users. Its findings suggest that community-based musical activities have clear potential for supporting mental health service users in recovery, which deserve further promotion. [ABSTRACT FROM AUTHOR]

Individual placement and support (IPS) has been found to be an effective intervention for rehabilitation to work in the field of mental health. Being as the principles used in IPS reflect core values in the concept of personal recovery, several other outcomes than just the percentage of clients gaining employment are of interest. The purpose of the study was to describe a number of unique processes and analyze these with a special concern for circumstances perceived as important for the individual IPS process. A collective instrumental case-study design was used and five cases were included. Data from three different sources were collected, both quantitative and qualitative. The findings illustrate how a relationship characterized by curiosity, interest and engagement in the individual client, positive risk-taking and time for reflected experiences resulted in processes of change. It was concluded that providing IPS is a type of specialized relationship-based work that includes advanced problem solving.

The fourteen-factor Processes of Change Scale for Sun Protection assesses behavioral and experiential strategies that underlie the process of sun protection acquisition and maintenance. Variations of this measure have been used effectively in several randomized sun protection trials, both for evaluation and as a basis for intervention. However, there are no published studies, to date, that evaluate the psychometric properties of the scale. The present study evaluated factorial invariance and scale reliability in a national sample (N = 1360) of adults involved in a Transtheoretical model tailored intervention for exercise and sun protection, at baseline. Invariance testing ranged from least to most restrictive: Configural Invariance (constraints only factor structure and zero loadings); Pattern Identity Invariance (equal factor loadings across target groups); and Strong Factorial Invariance (equal factor loadings and measurement errors). Multi-sample structural equation modeling tested the invariance of the measurement model across seven subgroups: age, education, ethnicity, gender, race, skin tone, and Stage of Change for Sun Protection. Strong factorial invariance was found across all subgroups. Internal consistency coefficient Alpha and factor rho reliability, respectively, were .83 and .80 for behavioral processes, .91 and .89 for experiential processes, and .93 and .91 for the global scale. These results provide strong empirical evidence that the scale is consistent, has internal validity and can be used in research interventions with population-based adult samples. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to compare prediction of physical activity (PA) by experiential or behavioral processes of change (POCs) or an interaction between both types of processes.Design: A cross-sectional study.Setting: This study was conducted using an online questionnaire.Participants: A total of 394 participants (244 women, 150 men), with a mean age of 35.12 ± 12.04 years and a mean body mass index of 22.97 ± 4.25 kg/m2 were included.Measures: Participants completed the Processes of Change, Stages of Change questionnaires, and the International Physical Activity Questionnaire to evaluate self-reported PA level (total, vigorous, and moderate PA).Analysis: Hierarchical multiple regression models were used to test the prediction of PA level.Results: For both total PA (β = .261; P < .001) and vigorous PA (β = .297; P < .001), only behavioral POCs were a significant predictor. Regarding moderate PA, only the interaction between experiential and behavioral POCs was a significant predictor (β = .123; P = .017).Conclusion: Our results provide confirmation that behavioral processes are most prominent in PA behavior. Nevertheless, it is of interest to note that the interaction between experiential and behavioral POCs was the only element predicting moderate PA level. Experiential processes were not associated with PA level. [ABSTRACT FROM AUTHOR]

This study adds a phase-by-phase perspective to the case of Susan, with the aim of better understanding the processes of change in this therapeutic case. A team of 3 raters integrated the sequential phases of the Paradigmatic Complementarity Metamodel with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process method-to analyse this therapeutic process and clarify what happened throughout that may explain phase gains and how the therapist facilitated them. The results suggest that Susan evolved in accordance with the sequence of phases proposed by the Paradigmatic Complementarity Metamodel. We illustrate and explain this with therapeutic interactions representative of Susan's development within the evolving therapeutic process. This case study is the third of a series intended to contribute towards the optimization of clinical decisions in therapeutic processes by identifying markers of phase progression and assessing the value of the therapeutic interventions offered. [ABSTRACT FROM AUTHOR]

Developing systems that motivate people to change their behaviors, such as an exercise application for the smartphone, is challenging. One solution is to implement motivational strategies from existing behavior change theory and tailor these strategies to preferences based on personal characteristics, like personality and gender. We operationalized strategies by collecting representative motivational text messages and aligning the messages to ten theory-based behavior change strategies. We conducted an online survey with 350 participants, where the participants rated 50 of our text messages (each aligned to one of the ten strategies) on how motivating they found them. Results show that differences in personality and gender relate to significant differences in the evaluations of nine out of ten strategies. Eight out of ten strategies were perceived as either more or less motivating in relation to scores on the personality traits Openness, Extraversion, and Agreeableness. Four strategies were perceived as more motivating by men than by women. These findings show that personality and gender influence how motivational strategies are perceived. We conclude that our theory-based behavior change strategies can be more motivating by tailoring them to personality and gender of users of behavior change systems. [ABSTRACT FROM AUTHOR]

Objective:The dominant theoretical perspective that guides treatment evaluations in addiction assumes linearity in the relationship between treatment and outcomes, viewing behaviour change as a ‘before and after event’. In this study we aim to examine how the direction of the trajectory of the process from addiction to recovery is constructed in personal narratives of active and recovering users. Design:21 life stories from individuals at different stages of recovery and active use were collected and analysed following the principles of narrative analysis. Results:Personal trajectories were constructed in discontinuous, non-linear and long lasting patterns of repeated, and interchangeable, episodes of relapse and abstinence. Relapse appeared to be described as an integral part of a learning process through which knowledge leading to recovery was gradually obtained. Conclusion:The findings show that long-term recovery is represented as being preceded by periods of discontinuity before change is stabilised. Such periods are presented to be lasting longer than most short-term pre-post intervention designs can capture and suggest the need to rethink how change is defined and measured. [ABSTRACT FROM PUBLISHER]

Background: The Transtheoretical model has been widely used in the subject of cigarette smoking. This study aimed to understand the behaviour of smoking in smokers, according to the Transtheoretical model. Material and Methods: Secondary analysis on two separate studies in different cities across the country was performed on 844 individuals who were enrolled via convenient sampling in 2010 and 2013. Measures used in this study include the process of change questionnaire of Prochaska et al., questionnaire of Di Clemente et al., questionnaire of temptation and decisional balance of Velicer et al. The gathered data were analysed using SPSS version 18 and Kruskall Wallis and Mann-Whitney U tests. Cohen's criterion for standardized effect size was used along with Spearman rank correlation. Results: All constructs of the Transtheoretical model showed significant differences along the stages of cigarette consumption. Experiential Process of self-re-evaluation had the largest effect size (0.207). It was followed by the cons of smoking with effect size of 0.17. Dramatic relief and helping relationships had the smallest effect sizes with 0.025 and 0.048 respectively. Conclusion: This study shows that the process of self-re-evaluation and cons of smoking are the most powerful predicators of development during the stages of smoking behaviour change. [ABSTRACT FROM AUTHOR]

The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A'(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults. • This Processes of Change-personalized Transtheoretical model-based intervention constitutes a replicable intervention. • A personalized TTM-based intervention using processes of change levels was tested. • This intervention increased physical activity levels for most participants. [ABSTRACT FROM AUTHOR]