Understanding Readiness to Change: Key Stages and Strategies for Success

Introduction

Change is constant, is something that is often said. While change takes place at different levels, it is not readily accepted at all times. Readiness to change, in simple terms, is a person’s willingness to change. In the context of behavioral health, it is the motivation that is required to change a specific behavior, especially one that is not desirable.

At the NuView Treatment Center, we believe that the readiness for change is a very crucial aspect of therapy. We seek to foster the readiness for change among our clients to not just lead a fulfilling life but also to take ownership of the fulfilling life that lies ahead of them.

What is Readiness to Change?

In psychotherapy or counseling, change is common. This change is for the better, as it often involves changing the way a person thinks, feels, or acts, in order to lead a healthy, fulfilling life. However, change is not always welcome and it cannot be “inflicted” on anyone. A person will change only when they are willing to change. This willingness is what is known as “readiness to change.”

Readiness to change is a motivational factor in psychotherapy or counseling, and the change in itself is a journey. When a person is not ready to go through this journey, the intervention is not likely to be effective. So, mental health practitioners often seek to promote readiness to change among their clients.

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The Stages of Change Model (Transtheoretical Model)

The stages of change model or the transtheoretical model proposes six levels of change; it is a very useful model for mental health practitioners when it comes to identifying where a client stands in terms of change and the necessary interventions needed to promote the readiness to change. The model goes like this:

• Precontemplation Stage – 

  In this stage, a client is unwilling to change. They may be in denial of a behavioral health problem or might simply be willing to look past it as they do not consider it to be anything serious.

• Contemplation Stage – 

  In the contemplation stage, the client’s feelings are more ambivalent toward change. They may be willing to weigh the pros and cons of changes as they are no longer in denial of the fact that their behavioral health problem is worth considering.

• Preparation Stage – 

  As the name suggests, the client is starting to consider change as a prospect for betterment. However, they might only be willing to take baby steps at this stage; only small changes.

• Action Stage – 

  In this stage, the client is willing to take a definitive action to change their behavior.

• Maintenance Stage – 

  Even after changing a certain behavior, it is not necessary that it is permanent. So, the client understands this and seeks to maintain the change to make it long-lasting.

• Termination Stage – 

  In this stage, the client has fully integrated change into their lives and does not have any reason or find the need to go back to where they were before incorporating the change into their lives.

At each stage of change, there are strategies that can promote readiness to change and take the client from one stage to the next. Education, identifying personal barriers to change, developing S.M.A.R.T. goals, providing reinforcement, and ongoing support are strategies that can be implemented at each of these levels to promote positive behavior toward change.

How to Create Readiness for Change

Clients can be unwilling to incorporate change into their lives, and hence, it does fall on the psychotherapist or counselor to instill the readiness for change in their clients.

• The first step in creating readiness for change is building a rapport. As mental health professionals often specify, a rapport between the therapist/counselor and the client is the cornerstone of everything that follows. By building a rapport with the client, therapists or counselors win their trust.
• Once rapport and trust have been established between the client and their therapist/counselor, the next step is to raise awareness regarding the risks of a behavior that needs to be altered.
• It is effective to help the client understand that their ambivalence to change is normal. At the same time, it is also crucial to explore the benefits of change to instill the motivation for change.
• Once the client has committed to change and starts taking small steps toward it, the therapist/counselor needs to provide positive reinforcements in order to keep them on track.
• When the client strives to maintain the change they have implemented, the therapist/counselor can provide ongoing support.

Creating readiness for change among clients, especially those who might be in denial or do not think there is any need for change, is very challenging. However, it is also one of the most fulfilling aspects of the therapeutic journey as promoting readiness for change among clients is the first step toward better and fulfilling lives.

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Factors That Influence Readiness to Change

There are certain factors that influence readiness to change, and these factors need to be capitalized upon when considering fostering readiness for change among clients.

• Relationship Factors –

The strength of the therapeutic alliance between the client and their therapist/counselor is a crucial factor when it comes to readiness to change. It indicates the trust clients have in the relationship and the respect and safety they feel within the context of that relationship. These are some things that play a very important role in the client considering changing their behavior(s).

• Growth Mindset – 

A growth mindset indicates that one can improve and grow in their life. When therapists or counselors prime their clients toward a growth mindset, they are more willing to consider change as a way to improve and grow. It is an important part of the journey toward change. In order to create a growth mindset, therapists or counselors must seek to rely on their clients’ strengths and goals in life.

• Techniques – 

Certain techniques to approach change, like the GROW (Goal, Reality, Options, Will) model, transtheoretical model, and motivational interviewing can be important in cultivating readiness to change among clients.

• Expectancy Factors – 

In bringing about change, clients’ expectancies from the change can be vital. It encompasses the belief clients have in the credibility of change, what they can hope to get from the change, and once again, it also comes down to the trust they have in the therapeutic alliance.

Assessing Readiness to Change

Interviews and standard questions can be used to assess the readiness for change among clients. This can be done in person or clients can also be asked to fill out online forms. Motivation assessments can also give an insight into how motivated clients are to incorporate change in their lives.

Standard questionnaires like URICA and the Readiness to Change Questionnaire are widely used measures to assess the readiness to change among clients.

Readiness to Change in Therapy and Substance Abuse Recovery

Overcoming behavioral health problems and substance abuse is not easy. However, to successfully overcome these concerns, readiness for change in therapy is very important.

In substance abuse recovery, mental health practitioners come across different clients. When clients have taken some steps toward controlling their substance use, it indicates that there is a readiness for change present, but some other clients need to develop this readiness.

Motivational Enhancement Therapy (MET) is typically used in substance abuse recovery to promote readiness to change. It is short-term and is based on the transtheoretical model of change. MET is especially useful when clients are not very serious or ambivalent about their substance use. It uses cost-benefit analysis to make clients aware of the need for change. It also develops a clear path for change, the commitment to bring about change, and also instills the confidence needed to bring about change.

Barriers to Change and How to Overcome Them

Barriers to readiness for change are many, and there is a need to overcome them to find success in therapy.

The first barrier is denial. Denial that there is a behavior that needs to be changed can lead to resistance. When there is resistance, therapy or counseling will not find any success. So, to help clients overcome denial, there needs to be education. For instance, if the behavioral health concern is substance abuse, then clients need to be made aware of their behaviors and the risks associated with these behaviors.

Ambivalence is also a very great barrier to change. Clients may often be very unserious about their behavioral health concerns, and might not think there is a need for change. So, identifying and removing these misconceptions is necessary. At the same time, a strong social support system can serve as an additional factor in reducing ambivalence as well.

Low self-worth or self-esteem is something that can prove to be an obstacle to change. Clients might believe they do not have it in them to bring about change. In these cases, identifying negative beliefs and reshaping them, practicing self-compassion, and setting goals as if the clients were already on the path to change can make a significant difference.

In order to overcome any barrier, clients must be made aware of the behavioral concern, why the change is necessary, and develop a clear path to change. Moreover, it is necessary to create a strong rapport with the client as it is a crucial step in trusting the therapist/counselor and also recognizing how credible the process is.