RE: Early recognition of seriousness

["Julia H. Littell" <jlittell@xxxxxxxxxxxx>]

The Carey et al. review is a good one, but only a handful of studies have
used continuous measures of "readiness for change." While these have some
clear advantages over stage measures, it is not always clear what the
continuum is supposed to represent. As Carey et al. note, some authors
conflate readiness for change with readiness for treatment or (worse)
readiness to participate in particular intervention. One of the problems
may be that (as Miller observed in a 1985 article on motivation for
treatment for alcoholism) people's intentions are not particularly good
predictors of their behaviors. 

Carey et al. focus on the psyhometric properties of measures that have been
used to assess readiness for change, while our review focuses on the
construct validity (and, to a lesser extent, predictive validity) of the
stages of change. We argue that the stages of change may have heuristic
value, but is overly simplistic and (hence) may impede efforts to assess
and study readiness for change.

There is a growing debate on this, particular among British scholars in the
field addictions. A critique of the stages of change model also appears in
Albert Bandura's 1997 book on Self-Efficacy.



At 11:55 AM 5/14/2001 -0400, you wrote:
>At the same time, continuous (as opposed to discrete, stage-based) measures
>of readiness to change have shown utility in predicting retention and
>outcome in treatment, even after controlling for other predictors like SES.
>For a review, see:
>
>	Carey, K.B., Purnine, D.M., Maisto, S.A., & Carey, M.P. (1999).  Assessing
>readiness to change substance abuse:  A critical review of instruments.
>Clinical Psychology:  Research and Practice, 6, 245-266.
>
>___________________________________
>Steven J. Ondersma, Ph.D.
>Assistant Professor--Research
>Merrill-Palmer Institute
>Wayne State University
>71 E. Ferry Ave.
>Detroit, MI  48202
>Office:  (313) 872-2706
>Fax:  (313) 875-0947
>S.Ondersma@wayne.edu
>www.mpi.wayne.edu
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>
>
>-----Original Message-----
>From: owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu
>[mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu]On Behalf Of
>Julia H. Littell
>Sent: Monday, May 14, 2001 10:55 AM
>To: Child Maltreatment Researchers
>Subject: Re: Early recognition of seriousness
>
>
>Bill, I think you're right. Although the stages of change have been widely
>studied in relation to a number of problem behaviors in health psychology
>(e.g., smoking cessation, suncreen use, substance abuse) and mental health,
>the evidence for discrete stages of change is very shakey even in those
>fields. A review of the empirical evidence for stages of change (by Heather
>Girvin and me) is in press in Behavior Modification.
>
>At 12:57 PM 5/11/2001 -0700, you wrote:
>>It was my understanding that there is little or no
>>evidence to support stages of change in a social work
>>setting.  Is this not true?
>>
>>Bill
>>
>>
>>--- DSWLFSU@aol.com wrote:
>>> Two thoughts occur to me about this:
>>> 1) I think there is a great need to build into
>>> assessments and subsequent
>>> family work the Prochaska/diClemente model of change
>>> which i think isn't as
>>> central to practice as it should be. There's a
>>> summary of this work in the
>>> Reader accompanying the new Framework
>>> 2) I believe that all case files should have a
>>> Critical Incident File at the
>>> front of the file so that all incidents of note can
>>> be put down and this,
>>> freed from all the vast accumulation of detail that
>>> files inevitably gather,
>>> can give a readily available overview of the pattern
>>> of events. A particular
>>> inquiry into a child death in Sheffield a few years
>>> ago argued this point
>>> very persuasively.
>>>
>>> David Saltiel
>>> Service Manager
>>> West Leeds Family Service Units
>>> Tel: 0113-275-7600
>>> email: dswlfsu@aol.com
>>>
>>
>>
>>__________________________________________________
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>>
>
>