Session 15--Assessing Readiness for Change


Published on

The video for this presentation is available on our Youtube channel: A continuing education course for this presentation can be found at

In this session, we discuss Prochaska and DiClemente's readiness for change model and how it can be used to tailor intervention strategies.

This powerpoint is part of AllCEU's Addiction Counselor Training Series. Each week we provide 8 hours of face-to-face continuing education and precertification training to LPCs, LADCs, and those wishing to become addiction counselors. Many states allow precertification to be done via online learning as well. We are approved education providers by NAADAC #599 and NBCC #6261.

Published in: Business, Technology
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Session 15--Assessing Readiness for Change

  1. 1. Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, NCC Executive Director,
  2. 2.  Define Readiness  Learn how to use the readiness ruler  Identify the 4 types of precontemplators  Identify processes people use to move through the stages of change  Explore the TransTheoretical Model of Change  Discuss the 7 steps in the change process
  3. 3.  "Readiness" refers to the combination of factors evident in participants: their previous experience with such endeavors, the degree to which they have the necessary skills and knowledge for the tasks ahead and their attitude toward undertaking this change
  4. 4.  Types of precontemplators ◦ Reluctant precontemplators  Lack sufficient knowledge about the problem, or the personal impact it can have, to think change is necessary.  Sensitively provide feedback about how substance use is actually affecting their lives ◦ Rebellious precontemplators  Afraid of losing control over their lives and have a large investment in their substance of choice  Help them shift energy into making positive choices rather than rebelling against what they perceive as coercion
  5. 5.  Types cont… ◦ Resigned precontemplators  Feel hopeless about change  Feel overwhelmed by the energy required  Help them regain hope, optimism about capacity for change  Explore specific barriers that impede new beginnings ◦ Rationalizing precontemplators  Have all the answers. Substance use may be a problem for others but not for them  Double-sided reflection seems the most effective strategy for this type of client
  6. 6.  If the person's mark is on the left of center:  How will you know when it is time to think about changing?  What signals will tell you to think about making a change?  What qualities in yourself are important to you?  What connection is there between those qualities and not considering a change?
  7. 7.  Change Extrinsic to Intrinsic Motivation  Intrinsic motivation often begins at the point when clients recognize the discrepancies between "where they are" and “where they want to be.”  Start with the client's current situation and find a natural link between existing external motivators and intrinsic ones the client may not be aware of  Understand what change means to clients and what their expectations of treatment are
  8. 8.  If the person's mark is near the center:  Why did you put your mark there and not closer to the left?  What might make you put your mark further to the right?  What are the good things about the way you are currently trying to change?  What are the things that are not so good?  What would be a good result of changing?  What are the barriers to changing?
  9. 9.  Signs of readiness ◦ Decreased resistance. ◦ Fewer questions about the problem. ◦ Resolve. ◦ Self-motivational statements reflecting willingness ("I have to do something") and optimism ("I can beat it"). ◦ More questions about change. ◦ Envisioning. ◦ Experimenting.
  10. 10.  If the person's mark is on the right of center: ◦ What is one barrier to change? ◦ What are some things that could help you overcome this barrier? ◦ Pick one of those things that could help and decide to do it by____________________(specific date).
  11. 11.  If the person has taken a serious step toward change: ◦ What made you decide on that particular step? ◦ What has worked in taking this step? ◦ What helped it work? ◦ What could help it work even better? ◦ What else would help? ◦ Can you break that step down into smaller parts?  Pick one of those parts and decide to do it by______(specific date).
  12. 12.  If the person is changing and trying to maintain that change: ◦ Congratulations! What's helping you? ◦ What else would help? ◦ What makes it hard to maintain the change?
  13. 13.  To progress through the early stages, people use ◦ Cognitive ◦ Affective ◦ Evaluative processes  In action and maintenance, they rely on ◦ Commitments ◦ Conditioning ◦ Contingencies ◦ Controls (environmental) ◦ Support
  14. 14.  10 covert and overt activities used to progress through the stages of readiness for change ◦ Consciousness-Raising—increasing awareness via information, education, and personal feedback ◦ Dramatic Relief—Feeling inspiration and hope when they hear about how people are able to change ◦ Environmental Reevaluation—realizing how their unhealthy behavior affects others and how they could have more positive effects by changing
  15. 15.  The 10 processes ◦ Social Liberation—realizing that society is more supportive of the healthy behavior ◦ Self-Reevaluation—realizing that the healthy behavior is an important part of who they are and want to be ◦ Stimulus Control—using reminders and cues that encourage healthy behavior as substitutes for those that encourage the unhealthy behavior. ◦ Helping Relationships—finding people who are supportive of their change
  16. 16.  The 10 processes ◦ Counter-Conditioning—substituting healthy ways of acting and thinking for unhealthy ways ◦ Reinforcement Management—increasing the rewards that come from positive behavior and reducing those that come from negative behavior ◦ Self-Liberation—believing in one’s ability to change and making commitments to act on that belief
  17. 17.  Create coalition  Develop vision  Share vision  Empower  Short term wins  Consolidate gains  Anchor change
  18. 18.  Establish rapport  Decisional balance exercises  Roll with resistance
  19. 19.  Define the problem (observable, measurable)  Define the resolution (observable, measurable)  Questions ◦ What do you think you will do? ◦ What does this mean about your drinking? ◦ It must be uncomfortable for you now, seeing all this. What's the next step? ◦ What do you think has to change? ◦ It sounds like things can't stay the way they are now. What are you going to do?
  20. 20.  Questions ◦ Of the things I have mentioned here, which are the most important reasons for a change? ◦ How are you going to do it? ◦ Where do we go from here? ◦ How would you like things to turn out now for you, ideally? ◦ What concerns you about changing your use of drugs? ◦ What would be some of the good things about making a change?
  21. 21.  Develop a plan ◦ Offering a menu of change options ◦ Developing a behavior contract ◦ Lowering barriers to action ◦ Enlisting social support ◦ Educating your client about treatment  Identify intensity and amount of help needed
  22. 22.  Identify available social support— Who, Where, When  Develop a sequence of subgoals or steps in the plan  Discuss how to address multiple concurrent problems--for example, how to deal with legal, financial, and health problems
  23. 23.  Assist patients in implementing plan  Provide encouragement and support  Reward small steps  Troubleshoot ◦ Decreasing motivation ◦ Relapse warning signs
  24. 24.  Identify patient’s goals and rewards ◦ Daily ◦ Weekly ◦ Monthly  Rewards that are sufficiently strong and frequent ◦ Prevent behavior strain ◦ Maintain forward progress
  25. 25.  Monthly treatment plan reviews ◦ Highlight successes ◦ Empower patient to troubleshoot unmet goals ◦ Normalize imperfection
  26. 26.  Relapse prevention planning  Daily grounding/mindfulness activities  Support group meetings
  27. 27.  Defining "Readiness“ as the combination of factors ◦ Their previous experience with such endeavors ◦ The degree to which they have the necessary skills and knowledge for the tasks ahead ◦ Their attitude toward undertaking this change  Explored the use of the Readiness Ruler and questions to ask to propel people toward change.  To progress through the early stages, people use cognitive, affective, evaluative processes
  28. 28.  In action and maintenance, they rely on Commitments, Conditioning, Contingencies, Controls, Support  Goals for System Change ◦ Create coalition ◦ Develop vision ◦ Share vision ◦ Empower ◦ Short term wins ◦ Consolidate gains ◦ Anchor change
  29. 29.  10 activities used to progress through change ◦ Consciousness-Raising ◦ Dramatic Relief ◦ Environmental Reevaluation ◦ Social Liberation ◦ Self-Liberation ◦ Helping Relationships ◦ Stimulus Control ◦ Helping Relationship ◦ Counter-Conditioning ◦ Reinforcement Management