Readiness and stages of change in addiction treatment
Abstract
Understanding the role of personal motivation in addiction treatment changed with the advent of the Transtheoretical Model of intentional behavior change, a better understanding of relapse, and a shift in focus from denial to readiness. Motivation is a complex concept that covers many diverse aspects of the process of intentional behavior change. This review examines current perspectives on readiness and the stages of change, criticisms and measurement issues, and clinical applications and future research in this area. Although significant challenges remain, properly incorporating the concepts of readiness and the stages of change into addiction treatment enables providers to address the diverse needs of substance abusers and treatment seekers, supports more proactive interventions, creates a concentration on motivational enhancement, and helps researchers understand the larger process of change where addict and treatment provider meet. Better measurement, more frequent assessments, and a better understanding of the stage subtasks and how they relate to readiness and successful change are needed to deepen our understanding of motivation and its role in the treatment of addiction. (Am J Addict 2004;13:103–119)
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Readiness to change was measured with the 32-item version of the University of Rhode Island Change Assessment.
“Readiness to change was measured with the 32-item version of the University of Rhode Island Change Assessment (URICA; α = .72) (DiClemente, Schlundt, & Gemmell, 2004).”
From Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial (2016) · cites this paper as DiClemente et al., 2004
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Self-citationThe Stages of Change of Rural African-American Smokers
Schorling, J. B. (1995) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30469-0 · Cited by 27 · see citing works
MEASURING READINESS FOR CHANGE AMONG CRACK COCAINE USERS: A DESCRIPTIVE ANALYSIS
Siegal, H., Li, L., Rapp, R., & Saha, P. (2001) · Substance Use & Misuse · doi:10.1081/ja-100104085 · Cited by 27 · see citing works
STAGE TRANSITIONS AND THE TRANSTHEORETICAL STAGES OF CHANGE MODEL OF SMOKING CESSATION
Carbonari, J. P., DiClemente, C. C., & Sewell, K. B. (1999) · Swiss Journal of Psychology · doi:10.1024/1421-0185.58.2.134 · Cited by 27 · see citing works
Self-citationSelf-efficacy, decisional balance and the stages of change for smoking cessation in a German sample
Keller, S., Nigg, C. R., Jäkle, C., et al. (1999) · Swiss Journal of Psychology · doi:10.1024//1421-0185.58.2.101 · Cited by 22 · see citing works
Carbonari, J. P., DiClemente, C. C., & Sewell, K. B. (1999) · Swiss Journal of Psychology · doi:10.1024//1421-0185.58.2.134 · Cited by 20 · see citing works
Self-citationAvants, S. K., Margolin, A., & Kosten, T. R. (1996) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.10.3.147 · Cited by 14 · see citing works
Treatment of Drug and Alcohol Abuse
O’Brien, C. P. (1984) · Contemporary Psychology · doi:10.1037/022978 · Cited by 10 · see citing works
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Time for a change: putting the transtheoretical (stages of change) model to rest
WEST, R. (2005) · Addiction · doi:10.1111/j.1360-0443.2005.01139.x · Cited by 700 · see citing works
Potential self-regulatory mechanisms of yoga for psychological health
Gard, T., Noggle, J. J., Park, C. L., Vago, D. R., & Wilson, A. (2014) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2014.00770 · Cited by 472 · see citing works
Hammarlund, R. A., Crapanzano, K. A., Luce, L., Mulligan, L. A., & Ward, K. M. (2018) · Substance Abuse and Rehabilitation · doi:10.2147/sar.s183256 · Cited by 330 · see citing works
Garland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.11.012 · Cited by 173 · see citing works
Cavicchioli, M., Movalli, M., Vassena, G., Ramella, P., Prudenziati, F., & Maffei, C. (2019) · Addictive Behaviors · doi:10.1016/j.addbeh.2019.106035 · Cited by 94 · see citing works
Kelly, J. F., Pagano, M. E., Stout, R. L., & Johnson, S. M. (2011) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2011.72.1000 · Cited by 87 · see citing works
Prediction of remission in obsessive compulsive disorder using a novel machine learning strategy
Askland, K. D., Garnaat, S., Sibrava, N. J., Boisseau, C. L., Strong, D., Mancebo, M., Greenberg, B., Rasmussen, S., & Eisen, J. (2015) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1463 · Cited by 75 · see citing works
Brown, T. G., Dongier, M., Ouimet, M. C., Tremblay, J., Chanut, F., Legault, L., & Ng Ying Kin, N. M. K. (2010) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2009.01092.x · Cited by 62 · see citing works
Garland, E. L., Roberts-Lewis, A., Kelley, K., Tronnier, C., & Hanley, A. (2014) · Substance Use & Misuse · doi:10.3109/10826084.2014.850309 · Cited by 59 · see citing works
Yang, Y., Perkins, D. R., & Stearns, A. E. (2018) · Qualitative Health Research · doi:10.1177/1049732318771005 · Cited by 46 · see citing works
Prendergast, M. L., McCollister, K., & Warda, U. (2017) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2016.12.011 · Cited by 42 · see citing works
Benchaya, M. C., Moreira, T. D. C., Constant, H. M. R. M., Pereira, N. M., Freese, L., Ferigolo, M., & Barros, H. M. T. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16183432 · Cited by 35 · see citing works
- Authors
- DiClemente, C. C., Schlundt, D., & Gemmell, L.
- Affiliations
- University of Maryland, Baltimore County (US)
- Corresponding author
- DiClemente, Carlo C.
- ORCID
- DiClemente, Carlo C.
- Venue
- The American Journal on Addictions
- Publisher
- Wiley
- Published
- 2004-03-04
- Volume
- 13
- Issue
- 2
- Pages
- 103-119
- ISSN
- 1055-0496 (ISSN-L)
- 1521-0391
- OpenAlex
- W2117919944
- Cited by
- 569
- References
- 120
- Citations by year
- 2026: 23 · 2025: 24 · 2024: 29 · 2023: 11 · 2022: 22 · 2021: 32 · 2020: 20 · 2019: 40 · 2018: 24 · 2017: 22 · 2016: 32 · 2015: 39 · 2014: 39 · 2013: 37 · 2012: 22
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal on Addictions (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- readiness to change, stages of change, transtheoretical model, addiction treatment, motivation, behavior change, relapse, motivation enhancement, treatment seeking
- MeSH terms
- Humans, Motivation, Patient Acceptance of Health Care, Tobacco Use Disorder, Health Behavior, Behavior, Addictive, Substance-Related Disorders, Secondary Prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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