Tools or Processes of Change
| Tool, Processes Used to Change* | Definition | Physician Interventions | Illustrative Quotations From Participants |
|---|---|---|---|
| Adapted from Prochaska et al.40 The 10 tools or processes of change are consciousness-raising, dramatic relief, self-reevaluation, self-liberation, counter-conditioning, stimulus control, reinforcement management, helping relationships, environmental reevaluation, social liberation. | |||
| IPV = intimate partner violence. | |||
| * In this article we focus on the 3 tools used during precontemplation and contemplation by the person trying to change behavior. Definitions and physician’s interventions are interpreted for IPV. Quotations from our data illustrate the 3 tools. | |||
| Consciousness-raising | Increasing information about self and IPV | Ask about IPV | They (prenatal clinic) hooked me up to a stress monitor because he (abuser) gave me a concussion and they wanted to make sure that my baby was still OK …. I did let them know [about the abuse]. |
| Share observations about the relationship | |||
| Educate about the impact of stress/injuries on health | |||
| Dramatic relief | Experiencing and expressing emotions about IPV | Empathize | I had broken my finger. The physician said to me, “You can’t break your finger that way by falling. I understand being afraid.” He was real nice. I remember his name. But, he was like; “I understand fear, being afraid.” He told me his professional opinion as a doctor seeing an abused woman is that “get help, you know, get out.” |
| Identify emotional state | |||
| Self-reevaluation | Assessing how one feels and thinks about the abusive relationship | Clarify values | I just didn’t, you know, want to have that useless, powerless feeling no more. I needed something to gain, and I knew I had to do something to change that, because where I was at was going to [nowhere] and nothing was going to change. |
| Experiences and feelings | |||