Autobiografía y anorexia: una alternativa cualitativa al modelo de estados del cambio de Prochaska y DiClemente
Loading...
Official URL
Full text at PDC
Publication date
2012
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Citations
Exportar
Citation
Díaz, F., Solano Pinto, N., & Solbes, I. (2012). Autobiography and Anorexia: A Qualitative Alternative to Prochaska and DiClemente’s Stages of Change Model. Forum Qualitative Sozialforschung Forum: Qualitative Social Research, 14(1). https://doi.org/10.17169/fqs-14.1.1792
Abstract
En este artículo proponemos una aproximación cualitativa a las formas en que las personas plantean sus problemas y trayectorias vitales en el ámbito de la salud. El "modelo transteórico" de PROCHASKA y DiCLEMENTE (1982, 1983, 1984, 1986, 1992) ha ganado protagonismo en las últimas décadas como paradigma para evaluar la disposición hacia el cambio en pacientes. Revisamos las características del modelo y las técnicas habituales para evaluar la disposición hacia el cambio, destacando sus problemas metodológicos y conceptuales. Particularmente, discutimos las paradojas que plantea el concepto de "precontemplación"; la definición exógena de problemas humanos en base a criterios institucionales y clínicos; y la ambigüedad del modelo, donde el propósito de acompañar y orientar al paciente contrasta con la imposición de definiciones de problemas y estrategias de solución. Proponemos el análisis narrativo de autobiografías como una alternativa que revaloriza las nociones de "cambio", "problema" y "recorrido vital" de las propias pacientes. Ilustramos esta posibilidad con el análisis de una entrevista autobiográfica a una mujer con historia de anorexia.
In this article, we propose a qualitative approach to the study of the ways in which people face good and poor health issues. During the last 30 years, Prochaska and DiClemente's "trans-theoretical model" (1982, 1983, 1984, 1986, 1992) has gained relevance as a model to assess disposition for change in patients. We revise the features of the model and its common techniques to assess stages of change, underlining its methodological and conceptual problems. Particularly, we discuss the paradoxes set by "pre-contemplation" as a concept; the exogenous definition of human problems in terms of institutional and clinical criteria; and the ambiguity of the model, where the purpose of accompanying and orienting the patient contrasts with the imposition of problem definitions and solution strategies. We propose a narrative analysis of autobiographies of patients as an alternative that recasts their own notions of "change," "problem," and "vital trajectory." We illustrate this possibility with the analysis of an autobiographic interview with a woman who has a history of anorexia.
In this article, we propose a qualitative approach to the study of the ways in which people face good and poor health issues. During the last 30 years, Prochaska and DiClemente's "trans-theoretical model" (1982, 1983, 1984, 1986, 1992) has gained relevance as a model to assess disposition for change in patients. We revise the features of the model and its common techniques to assess stages of change, underlining its methodological and conceptual problems. Particularly, we discuss the paradoxes set by "pre-contemplation" as a concept; the exogenous definition of human problems in terms of institutional and clinical criteria; and the ambiguity of the model, where the purpose of accompanying and orienting the patient contrasts with the imposition of problem definitions and solution strategies. We propose a narrative analysis of autobiographies of patients as an alternative that recasts their own notions of "change," "problem," and "vital trajectory." We illustrate this possibility with the analysis of an autobiographic interview with a woman who has a history of anorexia.
Description
Referencias bibliográficas:
• • Álvarez García, Nieves (2001). Yo vencí la anorexia. Barcelona: RBA.
• Beato-Fernández, Luis & Rodríguez-Cano, Teresa (2003). El cuestionario de actitudes frente al cambio en los trastornos de la conducta alimentaria (ACTA): Desarrollo y propiedades psicométricas. Actas Españolas de Psiquiatría, 31(3), 111-119.
• Blake, Wendy; Turnbull, Sue & Treasure, Janet (1997). Stages and processes of change in eating disorders: Implications for therapy. Clinical Psychology and Psychotherapy, 4, 186-191.
• Bowman, Grace (2006). Thin: A memoir of anorexia and recovery. Londres: Penguin.
• Brooks, Anna; LeCouteur, Amanda & Hepworth, Julie (1998). Accounts of experiences of bulimia: A discourse analytic study. International Journal of Eating Disorders, 24, 193-205.
• Chan, Zenobia, & Ma, Joice (2003). Anorexic body: A qualitative study. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 4(1), Art. 1, http://nbnresolving. de/urn:nbn:de:0114-fqs030117 [Fecha de acceso: 15-11-2011].
• Davidson, Robin (1992). Prochaska and DiClemente's model of change. British Journal of Addiction, 87, 821-822.
• Duncan, Peter & Cribb, Alan (1996). Helping people change-an ethical approach? Health Education Research. Theory and Practice, 11, 339-348.
• Dunn, Erin C.; Neighbors, Clayton & Larimer, Mary (2003). Assessing readiness to change binge eating and compensatory behaviors. Eating Behaviors, 4, 305-314.
• Feld, Rachel; Woodside, D. Blake; Kaplan, Allan S.; Olmsted, Marion P. & Carter, Jacqueline C. (2001). Pre-treatment motivational enhancement therapy for eating disorders. International Journal of Eating Disorders, 29, 393-400.
• Foucault, Michel (1987 [1984]). Historia de la sexualidad, Vol. 3. La inquietud de sí. Madrid: Siglo Veintiuno.
• Franko, Drebra L. (1997). Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa. Group, 21(1), 39-45.
• Geller, Josie & Drab, Danae L. (1999). The readiness and motivation Interview: A symptom specific measure of readiness for change in the eating disorders. European Eating Disorders Review, 7, 259-78.
• Greene, Geoffrey W.; Ross, Susan R. & Reed, Gabrielle Richards (1993). The effect of feedback on dietary intent to reduct fat. Topics in Clinical Nutrition, 9, 20-28.
• Gusella, Joanne; Butler, Gordon; Nichols, Laura & Bird, Debbie (2002). A brief questionnaire to assess readiness for change in adolescents with eating disorders. European Eating Disorders Review, 11, 58-71.
• Hasler, Gregor; Delsignore, Aba; Milos, Gabriella; Buddeberg, Claus & Schnyder, Ulrich (2004). Application of Prochaska's transtheoretical model of change to patients with eating disorders. Journal of Psychosomatic Research, 57, 67-72.
• Jefferson, Gail (1984). On stepwise transition from talk about a trouble to inappropriately nextpositioned matters. En John Maxwell Atkinson & John Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp.191-222). Cambridge: Cambridge University Press.
• Jimerson, David C. (2007). Eating disorders and stress. En George Fink (Ed.), Encyclopedia of stress (segunda ed., pp.876-879). Nueva York: Academic Press.
• Joseph, Jay; Breslin, Curtis & Skinner, Harvey (1999). Critical perspectives on the transtheoretical model and the stages of change. En Jalie A. Tucker, Dennis M. Donovan & G. Alan Marlatt (Eds.), Changing addictive behavior: Bridging clinical and public health strategies (pp.160-190). Nueva York: Guilford.
• Levy, Rachel Katherine (1997). The transtheoretical model of change: An application to bulimia nervosa. Psychotherapy, 34(3), 278-285.
• Littel, Julia H. & Girvin, Helen (2002). Stages of change: A critique. Behavior Modification, 26(2), 223-273.
• Márquez Guerrero, María (2010). El discurso como síntoma, criterio de pronóstico y elemento terapéutico. En Beatriz Gallardo Paúls y Verónica Moreno Campos (Eds.) Aplicaciones Clínicas (pp. 117-145). Valencia: Universitat de València.
• Martins, Renata K. & McNeil, Daniel W. (2009). Review of motivational interviewing in promoting health behaviors. Clinical Psychology Review, 29, 283-293.
• McConnaughy, Eileen A.; Prochaska, James O. & Velicer, Wayne F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy, 20, 368-375.
• McConnaughy, Eileen A.; DiClemente, Carlo C.; Prochaska, James O. & Velicer, Wayne F. (1989). Stages of change in psychotherapy: A follow-up report. Psychotherapy, 26(4), 494-503.
• Menzie, Morgan (2003). Diary of an anorexic girl. Nashville: Transit.
• Miller, William R. & Rollnick, Stephen (1999). La entrevista motivacional. Preparar para el cambio de conductas adictivas. Barcelona: Paidós Ibérica.
• Miller, William R. & Rollnick, Stephen (2002). Motivational interviewing: Preparing people for change (segunda ed.). Nueva York, NY: Guilford.
• Norman, Paul & Bennet, Paul (1996). Health locus of control. En Mark Conner & Paul Norman (Eds.), Predicting health behaviour (pp.62-94). Buckingham: Open University Press.
• Piper, Stewart & Brown, Peter A. (1998). Psychology as a theoretical foundation for health education in nursing: empowerment or social control? Nurse Education Today, 18, 637-641.
• Potter, Jonathan & Wetherell, Margaret (1987). Discourse and social psychology. Londres: Sage.
• Prochaska, James O. (1979). Systems of psychotherapy: A transtheoretical analysis. Homewood, IL: Dorsey Press.
• Prochaska, James O. & DiClemente, Carlo C. (1982). Transtheoretical therapy: Toward a more integralive model of change. Psychotherapy: Theory, Research, and Practice, 19, 276-288.
• Prochaska, James O. & DiClemente, Carlo C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 5, 390-395.
• Prochaska, James O. & DiClemente, Carlo C. (1984). The transtheoretical approach: Crossing traditional boundaries of therapy. Malabar, FL: Krieger.
• Prochaska, James O. & DiClemente, Carlo C. (1986). Toward a comprehensive model of change. En William R. Miller & Nick Heather (Eds.), Addictive behaviors: Processes of change (pp.3-28). Nueva York: Plenum Press.
• Prochaska, James O. & DiClemente, Carlo C. (1992). Stages of change in the modification of problem behaviors. En Michel Hersen, Richard M. Eisler & Peter M. Miller (Eds.), Progress on behavior modification (pp.184-214). Nueva York: Academic Press.
• Prochaska, James O.; DiClemente, Carlo C. & Norcross, John C. (1992). In search of how people change applications to addictive behaviors. American Psychologist, 47(9), 1102-1114.
• Prochaska, James O.; DiClemente, Carlo C. & Norcross, John C. (1994). Changing for good. Nueva York: Avon Books.
• Prochaska, James O.; Redding, Colleen & Evers, Kerry (1997). The transtheoretical model and stages of change. En Karen Glanz, Barbara K. Rimer & K. Viswanath (Eds.), Health behavior and health education, theory, research and practice (pp.97-121). San Fransisco, CA: Jossey Bass Publishers.
• Prochaska, James O.; Velicer, Wayne F.; DiClemente, Carlo C. & Fava, Joseph (1988). Measuring processes of change: Applications to the cessation of smoking. Journal of Consulting and Clinical Psychology, 56(4), 520-528.
• Rieger, Elisabeth; Touyz, Stephen; Schotte, David; Beaumont, Peter; Russell, Janice; Clarke Simon; Kohn, Michael & Griffiths, Rosalyn (2000). Development of an instrument to assess readiness to recover in anorexia nervosa. International Journal Eating Disorders, 28, 387-396.
• Rodríguez-Cano, Teresa & Beato-Fernández, Luis (2005). Attitudes towards change and treatment outcome in eating disorders. Eating Weight Disorders, 10, 59-65.
• Rodríguez-Cano, Teresa; Beato-Fernández, Luis & Segura Escobar, Estefanía (2006). Influencia de la motivación en la evolución clínica de los trastornos del comportamiento alimentario. Actas Españolas de Psiquiatría, 34(4), 245-250.
• Rogers, Carl (1961). On becoming a person: A therapist's view of psychotherapy. Londres: Constable.
• Rosen, Craig S. (2000). Is the sequencing of change processes by stage consistent across health problems? A meta-analysis. Health Psychology, 19(6), 539-604.
• Rossi, Joseph S.; Rossi, Susan R.; Velicer, Wayne F. & Prochaska, James O. (1995). Motivational readiness to control weight. En David B. Allison (Ed.), Handbook of assessment methods for eating behaviours and weight related problems (pp.387-430). Londres: Sage.
• Rotter, Julian B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General and Applied, 80(1), 1-28.
• Saukko, Paula (2008). The anorexic self. Albany: SUNY.
• Schorr, Gudrun; Ulbricht, Sabina; Schmidt, Carsten O.; Baumeister, Sebastian E.; Rüge, Jeannette; Schumann, Anja; Rumpf, Hans-Jürgen; John, Ulrich & Meyer, Christian (2008). Does precontemplation represent a homogeneous stage category? A latent class analysis on German smokers. Journal of consulting and clinical psychology, 76(5), 840-851.
• Serpell, Lucy; Treasure, Janet; Teasdale, John & Sullivan, Victoria (1999). Anorexia nervosa: Friend or foe? International Journal of Eating Disorders, 25, 177-186.
• Shaw, Jon A. (2009). Chance happenings in life and psychotherapy. Psychiatry, 72(1), 1-12.
• Sullivan, Victoria & Terris, Charlotte (2001). Contemplating the stages of change measure for eating disorders. European Eating Disorders Review, 9, 287-291.
• Sutton, Stephen (1996). Can "stages of change" provide guidance in the treatment of addictions? A critical examination of Prochaska and DiClemente's model. En Griffith Edwards & Christopher Dare (Eds.), Psychotherapy, psychological treatments and the addictions (pp.189-205). Cambridge: Cambridge University Press.
• Treasure, Janet & Schmidt, Ulrike (2001). Ready, willing, and able to change: Motivational aspects of the assessment and treatment of eating disorders. European Eating Disorders Review, 9, 4-18.
• Treasure, Janet L.; Katzman, Melanie; Schmidt, Ulrike; Troop, Nicholas; Todd, Gillian & de Silva. Padmal (1999). Engagement and outcome in the treatment of bulimia nervosa. Behaviour Research and Therapy, 3, 405-418.
• Trilla, Cristina (2007). ¡Hoy he decidido dejar de comer! Diario de una joven anoréxica. Barcelona: Styria.
• Vitousek, Kelly; Watson, Susan & Wilson, G. Terence (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18, 391-420.
• Weaver, Kathryn; Martin-McDonald, Kristine & Spiers, Judith (2012). Mirroring voices of mother, daughter and therapist in anorexia nervosa. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 13(3), Art. 6, http://nbn-resolving.de/urn:nbn:de:0114-fqs120363 [Fecha de acceso: 15-10-2012].
• Wedig, Michelle M. & Nock, Matthew K. (2010). The functional assessment of maladaptive behaviors: A preliminary evaluation of binge eating and purging among women. Psychiatry Research, 178(3), 518-524.
• Weinstein, Neil D.; Rothman, Alexander J. & Sutton, Stephen R. (1998). Stage theories of health behavior: Conceptual and methodological issues. Health Psychology, 17, 290-299.
• Whitelaw, Sandy; Baldwin, Steve; Bunton, Robin & Flynn, Darren (2000). The status of evidence and outcomes in stages of change research. Health education research. Theory and practice, 15(6), 707-718.
• Williams, Sarah & Reid, Marie (2012). "It's like there are two people in my head": A phenomenological exploration of anorexia nervosa and its relationship to the self. Psychology and Health, 27(7), 798-815.
• Wolk, Sara L. & Devlin, Michael J. (2001). Stage of change as a predictor of response to psychotherapy for bulimia nervosa. International Journal of Eating Disorders, 30, 96-100.g/10.1016/j.chiabu.2014.05.009