Assessing readiness for change in adolescents with eating disorders.

Abstract

The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the RMI in a younger population, namely, 12- to 18-year-old girls with eating disorders. Study participants (N = 65) completed the RMI and measures of convergent, discriminant, and criterion validity. Adolescents with eating disorders were able to conceptualize and articulate their readiness for change and to report the extent to which change efforts were for themselves versus for others. RMI readiness profiles across eating disorder symptom domains in adolescents were comparable to those in adults, with higher reported readiness to change binge eating than to change dietary restriction or compensatory strategies. Differences in internal consistency between adult and adolescent samples are discussed. Interviewing adolescents early in treatment about readiness may assist clinicians in forming an alliance with this difficult-to-engage population, while also providing valuable information for treatment planning.

Factors associated with improvements in readiness for change: Low vs. normal BMI eating disorders

“…1,22 Although we can only speculate about the temporal sequence of improvements in readiness, distress, and self-esteem, the findings support the notion that improvements in readiness are associated with a number of positive shifts, and that decreasing anxiety or depression may be a useful treatment strategy in preparing individuals for successful symptom-reduction treatment. This is contrary to the commonly held belief that eating disorder clients need to be distressed in order to become ready for change.…”

Motivation to change in the eating disorders: A systematic review

“…The psychometric properties of many of the measures used to assess motivation to change are unknown. Measures for which psychometric data are available include the “stages of change questionnaires” (generic motivation measures such as URICA and disorder‐specific measures such as AN‐/BN‐SOCQ) and the “readiness and motivation interview” (RMI); with the disorder specific measures and RMI displaying the most robust psychometric properties . However, the stage of change questionnaires have been criticized for using discrete categories of change that do not adequately reflect the dynamic nature of the change process…”

Motivation to change in adolescents with bulimia nervosa mediates clinical change after treatment

“…In adolescents with anorexia nervosa, motivation to change has also been related to better treatment response (Ametller, Castro, Serrano, Martínez, & Toro, 2005;CastroFornieles et al, 2007). Some instruments evaluate motivation to change in eating disorders as a whole: for example, the Readiness Motivation Interview (Geller & Drab, 1999) which has also been validated for adolescent patients (Geller et al, 2008). Other instruments are addressed specifically to anorexia nervosa patients, for instance, the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) (Rieger, Touys, Schotte, Beaumont, Russell, Clarke, 2000), or to bulimia nervosa, e.g.…”