The relationship between readiness to change, decisional balance and self-efficacy among substance abuse patients.

Abstract

Substance abuse and its related risk behaviours feature among the greatest threats to public health. Despite the advances made in interventions for addictive behaviours in the last two decades, there continues to be a high rate of recidivism among substance abusers. While many factors contribute to recidivist rates, an important part of treatment success is the motivation or readiness of the patients to change their addictive behaviours. Significant work in understanding the process of change has emerged from the health promotion literature in the form of the transtheoretical model of change (TIM). While the model comprises several dimensions, its core constructs centre on stages of change, i.e., behavior change occurs through a series of stages. Individuals in treatment could then be at various stages of change, which would enhance or limit the effects of the treatment. An individual decision to change is also affected by an evaluation of the pros and cons of change. The self-efficacy to change constitutes a third element for successful change to occur. Using a cross sectional survey design, this study explored the relationship between readiness to change, decisional-balance and self-efficacy in a sample of 88 inpatients at a public treatment facility admitted for alcohol and other drug use. The results showed that patients were indeed at various stages of change. Thirty-nine percent of inpatients were not ready to change, 43% were in the preparatory stage of change, and less than a quarter (18%) of inpatients was ready to change. Pro decisionalbalance was an important predictor of readiness to change. Further research tailoring treatment programmes to readiness to change among substance abuse patients is suggested.