The transtheoretical model of stages of change as a predictor of attendance, engagement and outcome in psychotherapy.
This study assed client changes during psychotherapy investigated the assumptions underlying the Transtheoretical stages of change model ,and identified salient predictors of the therapeutic alliance, attendance and clinical outcome. A within-subjects repeated-measures design was used, with an out-patient psychiatric population (N= 60).Subjects were assessed on stages of change, symptomology, therapeutic alliance and demographics at various time points throughout therapy (baseline, session one, session three and session eight).The results highlighted methodological flaws in the use of the discrete stages of change model. Using a continuum model many of the claims of proponents of the transtheoretical made were supported. By the end of therapy, individuals Precontemplation, Contemplation and maintenance score had decreased, and Action scores had increased. Participants with high Action scores and low Maintenance scores attended more sessions. Individuals who were in a state of contemplation had more positive therapeutic alliances after session one. By session three individuals who were in a state of Action had better alliances. Individuals who had low scores on precontemplation and high on Action at session three were likely to have an improved clinical outcome. Age was found to be associated with better attendance and the therapeutic alliance. The results indicated that the stages of change are core dimensions that help to explain how people change, and are important process variables that are significant in building the therapeutic alliance and influencing attendance. The results supported a continuum Model being presented.