Transtheoretical therapy is presented as one alternative within the Zeitgeist seeking a synthesis for the increasing proliferation of therapeutic systems. From a comparative analysis of 18 leading systems, five basic processes of change were identified. Each process can be applied at either the level of the individual's experience or environment. In studying how individuals change on their own compared with change in formalized treatments, four stages of change have been identified. Individuals changing within and without therapy appear to apply three verbal processes of change in the contemplation and determination stages and then apply two behavioral processes in the action and maintenance stages. Rather than being theoretically incompatible, the verbal processes are most important in preparing clients for action, while the behavioral processes become most important once clients have committed themselves to act. Psychotherapy appears to be approaching a crisis or a new wave of creativity. The potential for crisis comes in part from the unprecedented pace at which new therapies are being placed on the market (Prochaska, 1979). In 1975 Parloff reported that there were 130 therapies on the therapeutic marketplace (or jungleplace as he more aptly described it). By 1979 Time magazine was reporting that there were over 200 therapies, and that the confusion of over-choice was adding to the depression of psychiatry. Divergence has dominated the past decade of development within the field of psychotherapy (Prochaska, 1979). Yet divergent 1 This work was partially supported by Grant CA27821 from the National Cancer Institute. * Requests for reprints should be sent to James O. Prochaska, Dept. of Psychology, University of Rhode Island, Kingston, RI 02881. CARLO C. DI CLEMENTE Texas Research Institute of Mental Sciences thinking has been characterized by Guilford (1956), among others, as a necessary part of creativity. The increased divergence in psychotherapy thus provides the potential for a new wave of creativity. What is needed to prevent the increasing divergence from leading to fragmentation, confusion and chaos and allow it to be the foundation for a more fertile future? Heinz Werner's (1948) theory of development may serve as a guide in this regard. Development, as opposed to other forms of change, such as regression or chaos, is characterized by a combination of increasing differentiation and hierarchic integration. The increasing production of new forms of psychotherapy may indeed be an expression of the increasing differentiation of a growing discipline like psychotherapy. Increasing differentiation alone, however, can become like a cancer of uncontrolled growth that threatens to destroy the very body of knowledge in which it is growing. Unless increasing differentiation is matched by more effective forms of integration, then crisis rather than creativity will be the result. In Guilford's (1956) terms an increase in divergent thinking needs to be followed by higher levels of convergent thinking. What have been some of the professional responses to the increasing divergence in psychotherapy? Psychiatry's depression over the increased confusion is being treated in part by an increased reliance on chemotherapy. The emphasis on medication has the advantage of reaffirming psychiatry's medical identity and of relying on treatments that have perhaps the most consistent empirical support {Time, 1979; Luborsky, 1975). Clinical social workers have mounted a se-

http://psycnet.apa.org/doi/10.1037/h0088437

Transtheoretical therapy: Toward a more integrative model of change.

The measurement of meaning

This article summarizes evidence and issues associated with psychological assessment. Data from more than 125 meta-analyses on test validity and 800 samples examining multimethod assessment suggest 4 general conclusions: (a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings. Following principles for optimal nomothetic research, the authors suggest that a multimethod assessment battery provides a structured means for skilled clinicians to maximize the validity of individualized assessments. Future investigations should move beyond an examination of test scales to focus more on the role of psychologists who use tests as helpful tools to furnish patients and referral sources with professional consultation.

Psychological Testing and Psychological Assessment: A Review of Evidence and Issues.

We define mental contamination as the process whereby a person has an unwanted response because of mental processing that is unconscious or uncontrollable This type of bias is distinguishable from the failure to know or apply normative rules of inference and can be further divided into the unwanted consequences of automatic processing and source confusion, which is the confusion of 2 or more causes of a response Mental contamination is difficult to avoid because it results from both fundamental properties of human cognition (eg, a lack of awareness of mental processes) and faulty lay beliefs about the mind (eg, incorrect theories about mental biases) People's lay beliefs determine the steps they take (or fail to take) to correct their judgments and thus are an important but neglected source of biased responses Strategies for avoiding contamination, such as controlling one's exposure to biasing information, are discussed

Mental contamination and mental correction: unwanted influences on judgments and evaluations.

http://psycnet.apa.org/journals/amp/41/3/246.pdf

Toward an understanding of risk factors for bulimia.

Clinical psychologists in the 1970s.

The present study reports on the views of 1S4 clinical psychologists who had designated themselves as eclectics in a previous survey. Both communalities and differences were found among the respondents' characterizations of their theoretical views, as well as a great diversity of combinations of theoretical views and therapeutic techniques. A common theme was that no current theory was adequate for handling the diversity of clients seen in practice and that clinicians must select the approach that best fits a given client. The findings appear to have some implications for research on psychotherapy . In a recent survey of theoretical orientations among a sample of clinical psychologists, it was found that a majority of the sample labeled themselves as eclectics (Garfield & Kurtz, 1974). This was clearly the dominant orientation reported, an increase in adherence to an eclectic viewpoint was reflected as compared with a comparable survey reported some years earlier (Kelly, 1961). In contrast, the number adhering to psychoanalyti c and related orientations had decreased from 417o in the previous survey to 19% in the 1974 survey. Although the latter drop was not totally unexpected, the shift appeared to be primarily toward the eclectic view, rather than to such currently popular orientations as "learning theory" and "humanistic," which increased by only 1 percentage point each and together accounted for slightly less than 13% of the sample. Clearly, a significant shift toward an eclectic view appears to have taken place, with almost 55% of those surveyed identifying themselves as eclectics. Because of this heavy emphasis on an eclectic orientation, it was deemed worthwhile to conduct an additional inquiry concerning this point of view. Most individuals understand that an eclectic does not follow one specific theoretical view but instead draws We would like to acknowledge the assistance of Robert Assacl in tabulating the replies received and to thank the 1S4 psychologists who participated in this study. Requests for reprints should be sent to Sol Gar

A study of eclectic views.

Two comparable samples of college men and women from 1966 and 1996 were compared using the Kurtz Body Attitude Scale (BAS; R. M. Kurtz, 1966). As predicted, women in 1996 reported a significantly more negative body attitude than women in 1966 did. No significant differences in the 2 samples of men were found. With the 1996 sample, the relationship between body attitude and self-esteem was also examined using Marsh's Self-Description Questionnaire-III (SDQ-III; H. W. Marsh & R. O'Neill, 1984). There was a significant relationship between body attitude and general self-esteem, and there were also complex gender differences in the relationships of various SDQ-III facets to body attitudes.

Richard M. Kurtz

Papers

Clinical psychologists in the 1970s.

A study of eclectic views.

Body Attitude, Gender, and Self-Concept: A 30-Year Perspective

A survey of clinical psychologists: Characteristics, activities and orientations.

Sex differences and variations in body attitudes.