Floyd Jennifer, Zebrowski Patricia M, Flamme Gregory A
J Fluency Disord. 2007;32(2):95-120. doi: 10.1016/j.jfludis.2007.03.001. Epub 2007 Mar 14.
As a way to better understand the process of change that occurs in stuttering, Craig [Craig, A. (1998). Relapse following treatment for stuttering: a critical review and correlative data. Journal of Fluency Disorders, 23, 1-30] compared the behavioral changes that people who stutter often experience with and without treatment to those that have been observed for certain (non)addictive behavior disorders such as smoking, overeating, phobia and anxiety disorder. The process underlying these behavioral changes has been described by the transtheoretical or "stages of change" model, which is a model of behavior change that can illuminate "where" a person is in the process of change, and how this may relate to the outcome of either treatment or self-change attempts [Prochaska, J. O., & DiClemente, C. C. (1986). The transtheoretical approach. In J. C. Norcross (Ed.), Handbook of eclectic psychotherapy. New York: Brunner/Mazel]. The purpose of the present study was to analyze the extent to which the responses of adults who stutter on a modified Stages of Change Questionnaire yield interrelations among questionnaire items that are consistent with a stage-based interpretation. Results of both confirmatory and exploratory factor analyses indicated that while the modified questionnaire was a relatively good fit for participant responses, the structure derived from the exploratory analysis provided a significantly better fit to the observed data. Results suggest that a questionnaire incorporating items that better reflect the unique behavioral, cognitive and affective variables that characterize stuttering may better discriminate stages of change in people who stutter as they move through therapy, or are engaged in self-directed change.
After reading this paper, the learner will be able to: (1) describe the transtheoretical or "stages of change" model; (2) describe the various processes that are associated with different stages of change; (3) summarize research findings in stages of change as they apply to a variety of clinical populations; (4) discuss the applicability of the findings from the present study to stuttering treatment, and (5) relate conventional strategies and techniques used in stuttering therapy to different stages in the process of change.
作为更好地理解口吃中发生的变化过程的一种方式，克雷格[克雷格，A.（1998年）。口吃治疗后的复发：批判性综述及相关数据。《流畅性障碍杂志》，23，1 - 30]将口吃者在接受治疗和未接受治疗时经常经历的行为变化与在某些（非）成瘾行为障碍（如吸烟、暴饮暴食、恐惧症和焦虑症）中观察到的行为变化进行了比较。这些行为变化背后的过程已由跨理论或“变化阶段”模型进行了描述，该模型是一种行为变化模型，能够阐明一个人在变化过程中处于“何处”，以及这可能如何与治疗或自我改变尝试的结果相关[普罗查斯卡，J. O.，& 迪克莱门特，C. C.（1986年）。跨理论方法。载于J. C.诺克罗斯（编），《折衷心理治疗手册》。纽约：布鲁纳/梅泽尔]。本研究的目的是分析口吃成年人在一份修改后的《变化阶段问卷》上的回答在多大程度上产生与基于阶段的解释一致的问卷项目之间的相互关系。验证性和探索性因素分析的结果表明，虽然修改后的问卷与参与者的回答拟合度相对较好，但探索性分析得出的结构与观察数据的拟合度明显更好。结果表明，一份纳入能更好反映口吃所特有的独特行为、认知和情感变量的项目的问卷，可能在口吃者接受治疗或进行自我导向改变时，能更好地区分他们的变化阶段。
阅读本文后，学习者将能够：（1）描述跨理论或“变化阶段”模型；（2）描述与不同变化阶段相关的各种过程；（3）总结变化阶段的研究结果在应用于各种临床人群时的情况；（4）讨论本研究结果对口吃治疗的适用性；（5）将口吃治疗中使用的传统策略和技术与变化过程中的不同阶段联系起来。
