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Factors Associated with Readiness to Change among Adults Admitted to Outpatient Substance Abuse Treatment Programs

Thomas Gregoire
College of Social Work
Ohio State Univeristy
1947 College Rd. Rm. 325 Stillman Hall
Columbus OH 43210
(614) 292-6288
FAX: (614) 292-6940
gregoire.5@osu.edu

Anna Burke
College of Social Work
The Ohio State University
1947 College Rd. Rm. 340A Stillman Hall
Columbus OH 43210
(614) 292-6288
FAX: (614) 292-6940
burke.59@osu.edu

This study examines factors associated with variation in the readiness to change among adults admitted to outpatient substance abuse treatment using a stages of change approach adapted from Prochoska & DiClemente's Transtheoretical Model (1982).

Data for this study were obtained from intake interviews conducted with 320 adults admitted to outpatient treatment in five large, public facilities over a four month period. The short form of Prochoska & DiClemente's stages of change scale was adapted for use with this population to determine their readiness for change, along with information about a wide range of sociodemographic characteristics, referral source,history of substance use, prior treatment, and addiction severity through administration of the Addiction Severity Index (McLellen, et al., 1992). Logistic regression is used to determine the likelihood of membership in particular stages of change for clients with various characteristics.

Even when controlling for the severity of their substance abuse problem, persons who indicated that the court had compelled them to accept treatment were more likely to be located in the "action" stage than clients not court ordered. Being legally coerced was associated with over two and one half times greater likelihood of endorsing items indicating readiness for behavioral change. With two exceptions addiction severity was not associated with clients' stage of change. Persons with more severe alcohol or mental health problems were less likely than their counterparts to be in the action stage at admission.

Findings suggest clients enter treatment with divergent orientations to change. Greater severity of problems with substances or in other life domains does not necessarily predispose clients to be more open to change. Court involvement, however, may have some impact on clients' intentions to act to address substance abuse problems. Practitioners need to consider readiness to change when planning treatment along with problem severity and court involvement.