Deborah A. Levesque

A transtheoretical approach to changing organizations.

Several authors have reflected on the underdeveloped state of organizational change theory, research, and practice. This field needs an integrative framework that can synthesize major approaches to change. The Transtheoretical Model has the potential to do for organizational change what it has done for individual behavior change. Conceptually the stages-of-change dimension can be used to integrate principles and processes of change from divergent models of change. Practically, the stages-of-change dimension can be applied by leaders to reduce resistance, increase participation, reduce dropout, and increase change progress among employees.

Acceptability of a Stage-Matched Expert System Intervention for Domestic Violence Offenders

Most interventions for men who batter are standardized and “one-size-fits-all,” neglecting individual differences in readiness to change. A multimedia expert system intervention based on the transtheoretical model (the “stage model”) was developed as an adjunct to traditional court-mandated programs. The expert system assesses stage of change, decisional balance, self-efficacy, and processes of change and provides immediate individualized stage-matched feedback designed to increase readiness to end the violence. Fifty-eight male batterer intervention program clients were invited by agency staff to complete an expert system session and an evaluation of the program; 33 men were recruited at program intake and the remainder from ongoing groups. Responses to the intervention were very positive. For example, 87% of participants reported that they found the program to be easy to use, and 98% said it could probably or definitely help them change their attitudes or behaviors. Findings provide encouraging evidence of the acceptability of this stage-matched approach to intervention for domestic violence offenders.

Computer-Tailored Intervention for Juvenile Offenders.

Studies assessing the efficacy of juvenile justice interventions show small effects on recidivism and other outcomes. This article describes the development of a prototype of a multimedia computer-tailored intervention (Rise Above Your Situation) that relies on an evidence-based model of behavior change, the transtheoretical model, and expert system technology to deliver assessments, feedback, printed reports, and counselor reports with intervention ideas. In a feasibility test involving 60 system-involved youths and their counselors, evaluations of the program were favorable: 91.7% of youths agreed that the program could help them make positive changes, and 86.7% agreed that the program could give their counselor helpful information about them.

Teen Choices, an Online Stage-Based Program for Healthy, Nonviolent Relationships: Development and Feasibility Trial

ABSTRACT This article describes the theoretical foundation, development, and feasibility testing of an online, evidence-based intervention for teen dating violence prevention designed for dissemination. Teen Choices, a program for healthy, nonviolent relationships, relies on the transtheoretical model of behavior change and expert system technology to deliver assessments and feedback matched to stage of change for using healthy relationship skills. The program also tailors feedback to dating status, risk level, and other key characteristics. Ninety-nine students from high schools in Tennessee and Rhode Island completed a Teen Choices session and 97 completed an 11-item acceptability evaluation. Of participants, 100% completed the intervention session as intended. Evaluations of the program were favorable: 88.7% agreed the program feedback was easy to understand, and 86.7% agreed that the program could help people develop healthier relationships. Findings provide encouraging evidence of the acceptability and feasibility of this approach to dating violence prevention.

Development and Preliminary Psychometric Evaluation of Decisional Balance and Self-Efficacy Measures for Managing Anxiety in a National Sample of Clinically Anxious Adults.

Purpose: Anxiety is the most common and costly mental illness in the United States. Reducing avoidance is a core element of evidence-based treatments. Past research shows readiness to address avoidance affects outcomes. Investigating avoidance from a transtheoretical model (TTM) perspective could facilitate tailored approaches for individuals with low readiness. This study developed and examined psychometric properties of TTM measures for addressing anxiety-based avoidance. Design: Cross-sectional survey. Setting: Community centers, online survey. Participants: Five hundred ninety-four individuals aged 18 to 70 with clinically significant anxiety. Measures: Overall Anxiety Severity Questionnaire, stages of change, decisional balance, and self-efficacy. Analysis: The sample was randomly split into halves for principal component analyses (PCAs) and confirmatory factor analyses (CFAs) to test measurement models. Further analyses examined relationships between constructs. Results: For decisional balance, PCA indicated two 5-item factors (pros and cons). Confirmatory factor analysis supported a 2-factor correlated model, Satorra-Bentler scaled chi-square ( χ SB 2 [ 35 ] = 80.82 ) , comparative fit index (CFI = 0.94), root mean square error of approximation (RMSEA = 0.07), pros: α = 0.87, ρ = 0.87, cons: α = 0.75, and ρ = 0.75. For self-efficacy, PCA indicated one 6-item factor supported by CFA, χ SB 2 ( 9 ) = 30.39 , P < .01, CFI = 0.98, RMSEA = 0.09, α = 0.90, ρ = 0.87. As hypothesized, significant cross-stage differences were observed for pros and self-efficacy, and significant relationships between anxiety severity and pros, cons, and self-efficacy were found. Conclusion: Findings show strong psychometric properties and support the application of a readiness-based model to anxiety. In contrast to findings of other behaviors, cons remain high in action and maintenance. These measures provide a solid empirical foundation to develop TTM-tailored interventions to enhance engagement in treatment.