Psychology 2012. Vol.3, No.6, 494-499 Published Online June 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.36070 Copyright © 2012 SciRes. 494 Relationships between Stages and Processes of Change for Effective Stress Management in Japanese College Students * Satoshi Horiuchi 1 , Akira Tsuda 2 , Janice M. Prochaska 3 , Hisanori Kobayashi 4 , Kengo Mihara 5 1 Cancer Prevention Research Center, University of Rhode Island, Kingston, USA 2 Department of Psychology, Kurume University, Kurume, Japan 3 Pro-Change Behavior Systems, Inc., Kingston, USA 4 Department of Psychology, University of Rhode Island, Kingston, USA 5 Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan Email: satosato.007@nifty.com Received March 5 th , 2012; revised April 3 rd , 2012; accepted May 4 th , 2012 With a primary prevention focus, it would be important to help populations engage in stress management. The Transtheoretical Model of Behavior Change is one of potentially useful models to formulate inter- ventions. The model describes behavior change as progression through five stages: precontemplation (not ready), contemplation (getting ready), preparation (ready), action, and maintenance. Processes of change (strategies and techniques to enhance the progression) facilitate stage transition. Their use is hypothesized to depend on stage of change. The processes tend to be used the least at the precontemplation stage. Use of experiential processes (affective and/or cognitive strategies such as seeking information) increase over time and tend to peak at the contemplation or preparation stage and then decease. In contrast, behavioral processes (behavioral strategies such as seeking social support) tend to be used most at the action and/or maintenance stage. This study examined relationships between stages and processes of change for effec- tive stress management. Effective stress management is defined as any form of healthy activity such as exercising, meditating, relaxing, and seeking social support, which is practiced for at least 20 minutes. Four hundred and five Japanese college students participated in this study. A paper-pencil survey was conducted at colleges in Japan. The process use was least in precontemplation. Experiential processes peaked in preparation. Except for one experiential process, no significant difference was found between preparation and maintenance. Behavioral processes peaked in preparation, action, or maintenance. Most of these inter-stage differences of processes are in line with the prediction from the model. This study represented an initial but important test of validity of applying processes of change to stress management. The results partially supported its application. Keywords: Processes of Change; Stage of Change; Effective Stress Management; Transtheoretical Model Introduction Psychological stress inversely affects both health (Kopp, Skrabski, Székely, Stauder, & Williams, 2007) and productivity (Watts & Robertson, 2011). Relatively high portions of people who are stressed have been reported in countries such as Japan (Japan Health Promotion & Fitness Foundation, 1996), the United States (Anderson et al., 2010), and European countries (European Foundation for the Improvement of Living and Working Conditions, 2006). With a primary prevention focus, it would be important to help populations engage in healthy stress management activities such as exercise, talking with others, or regular relaxation to manage stress (Evers, Prochaska, Johnson, Mauriello, Padula, & Prochaska, 2006; Prochaska et al., 2008). For designing such interventions, it is first necessary to find theories of behavior change to understand people’s readiness to initiate and maintain stress management. The Transtheoretical Model (TTM) (Prochaska & DiCle- mente, 1983) is one of the leading theories of behavior change. It has received international attention from health promotion practitioners for modifying health behaviors (Redding et al., 1999). The TTM extracts and integrates elements from major theories of psychotherapies and social-cognitive models (Pro- chaska, DiClemente, & Norcross, 1992). According to the TTM, behavior change is described as progression through five stages: precontemplation (not ready), contemplation (getting ready), preparation (ready), action, and maintenance. Additional con- structs such as processes of change, decisional balance, and self-efficacy are found to facilitate stage transitions. Processes of change refer to the covert and overt activities that individuals are encouraged to perform in order to progress to the next stage. The five experiential processes include con- sciousness-raising (increasing awareness), dramatic relief (re- acting emotionally to warnings about the unhealthy behavior), environmental reevaluation (considering how the practice or lack of healthy behavior affects others), self-reevaluation (rea- lizing that the behavior change can enhance one’s identity), and social liberation (acknowledging how society is changing to encourage the healthy behavior). The five behavioral processes include self-liberation (making a commitment for behavior change), stimulus control (restructuring one’s environment to facilitate the healthy behavior), counter conditioning (substitut- * This work was supported by Grant-in-Aid for Scientific Research (A) (18203035) and (B) (22330196) to A. T.