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Development and validation of the Readiness for Therapy Questionnaire (RTQ)

Published online by Cambridge University Press:  17 November 2020

Mahdi Ghomi ,
Miles Wrightman ,
Aisan Ghaemian ,
Nick Grey ,
Tabitha Pickup  and
Thomas Richardson Open the ORCID record for Thomas Richardson [Opens in a new window]
Mahdi Ghomi*
Affiliation:
Talking Change, Solent NHS Trust, Portsmouth, UK
Miles Wrightman
Affiliation:
Talking Change, Solent NHS Trust, Portsmouth, UK
Aisan Ghaemian
Affiliation:
Talking Change, Solent NHS Trust, Portsmouth, UK
Nick Grey
Affiliation:
Sussex Partnership NHS Foundation Trust Department of Psychology, University of Sussex, Brighton, UK
Tabitha Pickup
Affiliation:
Talking Change, Solent NHS Trust, Portsmouth, UK
Thomas Richardson
Affiliation:
School of Psychology, University of Southampton, Southampton, UK
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Motivational factors are generally regarded as an important ingredient for change in therapy. However, there is currently a lack of available instruments that can measure clients’ readiness for change in therapy.

Aim:

The objective of this paper was to create an instrument, the Readiness for Therapy Questionnaire (RTQ), which could measure clients’ readiness for change.

Method:

The RTQ was created by researchers following analysis of themes drawn from a review of the literature and interviews with patients at the end of therapy. This included both people who completed therapy and those who dropped out. As part of the standard assessment process, the RTQ was administered to 349 participants (69.6% female and 30.4% male; mean age 37.1 years; 90.5% Caucasian) who were patients at a psychological therapy service for common mental health difficulties.

Result:

An initial 12-item scale was reduced to 6 items. This scale significantly correlated with post-therapy PHQ-9 and GAD-7 scores and changes in these scores across therapy. After controlling for baseline scores and demographic variables, a logistic regression showed that scores on this 6-item measure pre-therapy significantly predicted three outcome variables: completing therapy, being recovered on both PHQ-9 and GAD-7 post-therapy, and having a reliable change in both the PHQ-9 and GAD-7 post-therapy. However, receiver operating characteristic (ROC) curve analysis showed the measure had poor sensitivity and specificity. Symptom severity did not have a significant impact on motivation to change.

Conclusion:

The RTQ is potentially a valid measure with useful clinical applications in treatment of common mental health difficulties.

Keywords

assessmentattrition rateclinical outcomecommon mental health difficultiesmotivation
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 4 , July 2021 , pp. 413 - 425
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Brogan, M. M., Prochaska, J. O., & Prochaska, J. M. (1999). Predicting termination and continuation status in psychotherapy using the transtheoretical model. Psychotherapy: Theory, Research, Practice, Training, 36, 105–113. https://doi.org/10.1037/h0087773 CrossRefGoogle Scholar
Buckman, J. E. J., Saunders, R., Fearon, P., Leibowitz, J., & Pilling, S. (2019). Attentional control as a predictor of response to psychological treatment for depression and relapse up to 1 year after treatment: a pilot cohort study. Behavioural and Cognitive Psychotherapy, 47, 318–331. https://doi.org/10.1017/S1352465818000590 CrossRefGoogle ScholarPubMed
Clark, D. M. (2011). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. International Review of Psychiatry, 23, 318–327. https://doi.org/10.3109/09540261.2011.606803 CrossRefGoogle ScholarPubMed
Clark, L. A., & Watson, D. (1995). Constructing validity: basic issues in objective scale cevelopment. Psychological Assessment, 7, 309–319.CrossRefGoogle Scholar
DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59, 295–304.CrossRefGoogle ScholarPubMed
DiClemente, Carlo C., Nidecker, M., & Bellack, A. S. (2008). Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. Journal of Substance Abuse Treatment, 34, 25–35. https://doi.org/10.1016/j.jsat.2006.12.034 CrossRefGoogle ScholarPubMed
Dozois, D. J. A., Westra, H. A., Collins, K. A., Fung, T. S., & Garry, J. K. F. (2004). Stages of change in anxiety: psychometric properties of the University of Rhode Island Change Assessment (URICA) scale. Behaviour Research and Therapy, 42, 711–729. https://doi.org/10.1016/S0005-7967(03)00193-1 CrossRefGoogle ScholarPubMed
Fernandez, E., Salem, D., Swift, J. K., & Ramtahal, N. (2015). Meta-analysis of dropout from cognitive behavioral therapy: magnitude, timing, and moderators. Journal of Consulting and Clinical Psychology, 83, 1108–1122. https://doi.org/10.1037/ccp0000044 CrossRefGoogle ScholarPubMed
First, M. B., Gibbon, M., Spitzer, R. L., & Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders: Clinician Version (SCID-CV): User’s Guide (1st edn). American Psychiatric Press Inc.Google Scholar
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II): User’s Guide (1st edn). American Psychiatric Press Inc.Google Scholar
Geller, J., & Drab, D. L. (1999). The readiness and motivation interview: a symptom-specific measure of readiness for change in the eating disorders. European Eating Disorders Review, 7, 259–278. https://doi.org/10.1002/(SICI)1099-0968(199908)7:4<259:AID-ERV295>3.0.CO;2-63.0.CO;2-6>CrossRefGoogle Scholar
Geller, J., Zaitsoff, S. L., & Srikameswaran, S. (2005). Tracking readiness and motivation for change in individuals with eating disorders over the course of treatment. Cognitive Therapy and Research, 29, 611–625. https://doi.org/10.1007/s10608-005-5774-1 CrossRefGoogle Scholar
Ghaemian, A., Ghomi, M., Wrightman, M., & Ellis-Nee, C. (2020). Therapy discontinuation in a primary care psychological service: why patients drop out. The Cognitive Behaviour Therapist, 13. https://doi.org/10.1017/S1754470X20000240 CrossRefGoogle Scholar
Goddard, E., Wingrove, J., & Moran, P. (2015). The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety. Behaviour Research and Therapy, 73, 1–7. https://doi.org/10.1016/j.brat.2015.07.006 CrossRefGoogle ScholarPubMed
Haggerty, G., Siefert, C., Stoycheva, V., Sinclair, S. J., Baity, M., Zodan, J., Mehra, A., Chand, V., & Blais, M. A. (2014). Determining adolescents’ suitability for inpatient psychotherapy: utility of the clinician-rated Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample. Bulletin of the Menninger Clinic, 78, 349–372. https://doi.org/10.1521/bumc.2014.78.4.349 CrossRefGoogle ScholarPubMed
Hudson, C. C., & Mac Neil, B. A. (2018). Ready or not: examining self-reported readiness for behavior change at intake assessment for adults with an eating disorder. Behavior Modification, 0145445518807129. https://doi.org/10.1177/0145445518807129 Google ScholarPubMed
Joe, G. W., Simpson, D. D., & Broome, K. M. (1998). Effects of readiness for drug abuse treatment on client retention and assessment of process. Addiction; Abingdon, 93, 1177–1190.Google ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Laaksonen, M. A., Lindfors, O., Knekt, P., & Aalberg, V. (2012). Suitability for Psychotherapy Scale (SPS) and its reliability, validity, and prediction. British Journal of Clinical Psychology, 51, 351–375. https://doi.org/10.1111/j.2044-8260.2012.02033.x CrossRefGoogle ScholarPubMed
Marcus, B. H., Rakowski, W., & Rossi, J. S. (1992). Assessing motivational readiness and decision making for exercise. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 11, 257–261.CrossRefGoogle Scholar
McConnaughy, E. A., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: measurement and sample profiles. Psychotherapy: Theory, Research & Practice, 20, 368–375. https://doi.org/10.1037/h0090198 CrossRefGoogle Scholar
McHugh, M. D. (2007). Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa. International Journal of Eating Disorders, 40, 602–612. https://doi.org/10.1002/eat.20425 CrossRefGoogle ScholarPubMed
Murphy, E., Mansell, W., Craven, S., Menary, J., & McEvoy, P. (2013). Pilot study of an investigation of psychological factors associated with first appointment nonattendance in a low-intensity service. Behavioural and Cognitive Psychotherapy, 41, 458–469. https://doi.org/10.1017/S1352465812000811 CrossRefGoogle Scholar
Nidecker, M., DiClemente, C. C., Bennett, M. E., & Bellack, A. S. (2008). Application of the transtheoretical model of change: psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness. Addictive Behaviors, 33, 1021–1030. https://doi.org/10.1016/j.addbeh.2008.03.012 CrossRefGoogle ScholarPubMed
National Collaborating Centre for Mental Health (2020). The Improving Access to Psychological Therapies Manual. https://www.england.nhs.uk/wp-content/uploads/2020/05/iapt-manual-v4.pdf Google Scholar
Norcross, J. C., Krebs, P. M., & Prochaska, J. O. (2011). Stages of change. Journal of Clinical Psychology, 67, 143–154. https://doi.org/10.1002/jclp.20758 CrossRefGoogle ScholarPubMed
Ogrodniczuk, J. S., Joyce, A. S., & Piper, W. E. (2009). Development of the Readiness for Psychotherapy Index. Journal of Nervous and Mental Disease, 197, 427. https://doi.org/10.1097/NMD.0b013e3181a61c56 CrossRefGoogle ScholarPubMed
Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, W., Fiore, C., Harlow, L. L., Redding, C. A., & Rosenbloom, D. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 13, 39–46.CrossRefGoogle ScholarPubMed
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: applications to addictive behaviors. American Psychologist, 47, 1102–1114. https://doi.org/10.1037/0003-066X.47.9.1102 CrossRefGoogle ScholarPubMed
Renaud, J., Russell, J. J., & Myhr, G. (2014). Predicting who benefits most from cognitive-behavioral therapy for anxiety and depression. Journal of Clinical Psychology, 70, 924–932. https://doi.org/10.1002/jclp.22099 CrossRefGoogle ScholarPubMed
Rieger, E., Touyz, S., Schotte, D., Beumont, P., Russell, J., Clarke, S., Kohn, M., & Griffiths, R. (2000). Development of an instrument to assess readiness to recover in anorexia nervosa. International Journal of Eating Disorders, 28, 387–396. https://doi.org/10.1002/1098-108X(200012)28:4<387::AID-EAT6>3.0.CO;2-Y 3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Rieger, E., Touyz, S. W., & Beumont, P. J. V. (2002). The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ): information regarding its psychometric properties. International Journal of Eating Disorders, 32, 24–38. https://doi.org/10.1002/eat.10056 CrossRefGoogle ScholarPubMed
Rogers, E. S., Martin, R., Anthony, W., Massaro, J., Danley, K., Crean, T., & Penk, W. (2001). Assessing readiness for change among persons with severe mental illness. Community Mental Health Journal, 37, 97–112. https://doi.org/10.1023/A:1002705614293 CrossRefGoogle ScholarPubMed
Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing? Behavioural and Cognitive Psychotherapy, 23, 325–334. https://doi.org/10.1017/S135246580001643X CrossRefGoogle Scholar
Rosen, C. S. (2000). Is the sequencing of change processes by stage consistent across health problems? A meta-analysis. Health Psychology, 19, 593–604. https://doi.org/10.1037/0278-6133.19.6.593 CrossRefGoogle ScholarPubMed
Safran, J. D., Vallis, T. M., Segal, Z. V., & Shaw, B. F. (1986). Assessment of core cognitive processes in cognitive therapy. Cognitive Therapy and Research, 10, 509–526. https://doi.org/10.1007/BF01177815 CrossRefGoogle Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097. https://doi.org/10.1001/archinte.166.10.1092 CrossRefGoogle ScholarPubMed
Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53.CrossRefGoogle ScholarPubMed
Truant, G. S. (1999). Assessment of suitability for psychotherapy. American Journal of Psychotherapy, 53, 17–34. https://doi.org/10.1176/appi.psychotherapy.1999.53.1.17 CrossRefGoogle ScholarPubMed
Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: an allegiance-controlled randomized clinical trial. Journal of Consulting and Clinical Psychology, 84, 768–782. https://doi.org/10.1037/ccp0000098 CrossRefGoogle ScholarPubMed
Westra, H. A., & Norouzian, N. (2018). Using motivational interviewing to manage process markers of ambivalence and resistance in cognitive behavioral therapy. Cognitive Therapy and Research, 42, 193–203. https://doi.org/10.1007/s10608-017-9857-6 CrossRefGoogle Scholar
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