The Processes of Change are covert and overt activities that people use to move through the Stages  of Change. They are independent variables  that have been  demonstrated to support change. This means  that young people ‘can’  rather  than  ‘need’ to apply  them  to support their efforts to change.

Prochaska, DiClemente and Norcross (1992) identify 10 processes, five that are experiential and five that are behavioural. The efficacy of each process is likely to be maximised when tailored to a young person’s stage  of change. Studies have been  conducted into which change processes and styles of intervention match best with  particular stages  of change (Miller & Rollnick, 2002; Perz et al, 1996; Thornton et al, 1998).

The five experiential change processes have been demonstrated to be most  effective for people in the pre-contemplation or contemplation stages.  They accord with  non-confrontational interventions that are delivered with  empathy and take account of young people’s perspective.

Processes that are behavioural in nature (i.e., counter-conditioning, stimulus control, contingency management) have been  found to be more  effective for individuals in the preparation, action  or maintenance stages.  These  processes accord with  action-oriented interventions that focus  on the development of skills and strategies that support and reinforce change.

The same  researchers found that adopting a passive, non-action approach with  people in later stages  of change is likely to be counterproductive. Conversely, applying action-oriented, behavioural approaches with people in the pre-contemplation or contemplation stages is unlikely to win cooperation. “Confronted with the need  for change, an ambivalent person naturally responds with  the other  side of the decisional balance, with  the end result  being  a misinterpretation of this response as ‘denial’ or ‘resistance’ ” (Giovazazolias & Davies,  2005)  (p174).

Each of the Levels of Change identified by Prochaska, DiClemente and Norcross (1992) can influence and are influenced by the changes people make.  The levels are situational and symptomatic, relating to the cognitions of the person making changes and interpersonal problems they may experience, including family  and system  conflicts.

Experiential Processes

  • Consciousness Raising [Increasing awareness] involves increased awareness about  the causes,  consequences and potential ways of dealing with problematic substance-using behaviour.
  • Dramatic Relief [Emotional arousal]  involves  people being moved emotionally by the impact of substance use in their lives. This might  stem  from  a growing or sudden awareness of the connection between their actions  and consequences experienced as negative. Strong grief  reactions often  result which, if dealt with constructively, can be a catalyst  for change.
  • Environmental Re-evaluation [Social reappraisal] combines both  affective and cognitive assessments of how  substance use affects one’s  social environment.
  • Social Liberation [Re-engineering] requires an increase in social opportunities or alternatives, especially for people who  are relatively  deprived or oppressed.
  • Self Re-evaluation combines both  cognitive and affective assessments of how  substance use shapes  one’s  self-image and one’s  image  in the eyes of others.       

Action Oriented / Behavioural Processes

  • Stimulus Control removes cues or triggers for unhealthy substance-using behaviour and adds prompts for healthier alternatives. It involves  creating the conditions that support change and reduce risks for relapse.
  • Helping Relationships [Supporting] provide support for healthy behaviour change. These  relationships most  commonly feature openness, trust and acceptance.
  • Counter Conditioning [Substituting] requires substituting problematic substance use with rewarding healthy behaviours.
  • Reinforcement Management [Rewarding] provides predictable consequences for taking  steps in a particular direction. This includes both  rewards and punishments. Philosophically, the Transtheoretical Model orients  practitioners to working in harmony with how  people change naturally. This involves  enabling young people to understand the logical consequences of particular decisions, actions  and consequences.
  • Self-liberation [Committing] relates  directly  to the belief  that change is possible, stemming from  both  enhanced self-efficacy & the perception that social and environmental conditions are conducive to change. Self-liberation involves  a continuous process of committing to act on the belief  that change is beneficial possible.