To change or not to change—‘How’ is the question?

The objective was to apply the 'trans-theoretical' model of change to a group of patients with eating disorders. Patients were studied in an in-patient setting. Two sets of questionnaires were used, one to assess 'stage' of change, the other to measure the 'processes' used to achieve change. Three stages and eight processes were examined. Thirty-five patients completed the study. Highest scores were found in the contemplation, and lowest in the precontemplation stage. The most frequently used processes of change were self-reevaluation, helping relationships and consciousness raising, with different processes predominating at different stages. Covariance analysis supported an association between two latent variables 'stage' and 'process'. Despite the limitations of small numbers, our results are in broad agreement with others using the 'trans-theoretical' model, supporting its use in eating disorders. Although further work is necessary, the model suggests a way of thinking about helping this very ambivalent group of patients to institute and sustain change.