| Summary: | 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.
URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1203209
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