Assessing Readiness to Change Substance Abuse: A Critical Review of Instruments

This literature review summarizes the psychometric properties of 12 measures used to assess readiness to change substance abuse. Assessment methods vary, and include algorithms, self-administered questionnaires, and clinical ratings. We describe each and summarize reliability and validity information. Some measures have poor psychometric properties, whereas limited psychometric data are available for others. No single measure emerges as best for use in clinical settings, and promising candidates differ regarding target population and assessment method. Although the Transtheoretical Model inspired much of the empirical work on readiness to change, the psychometric literature provides inconsistent support for the stages of change. Readiness to change may best be conceptualized as a multidimensional and continuous construct with complex relationships to behavior, cognition, and environmental context.