Readiness to change as a moderator of outcome in transdiagnostic treatment

Boswell, James F.; Sauer‐Zavala, Shannon; Gallagher, Matthew W.; Delgado, Nicole; Barlow, David H.

doi:10.1080/10503307.2012.688884

Cited by 30 publications

(16 citation statements)

References 45 publications

(41 reference statements)

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“…An interesting variable to investigate in the context of early treatment response might be readiness to change. Boswell et al (2012), for example, found that readiness to change moderated the relationship between pre- and post-treatment levels of depression and anxiety. The highly negative association between levels of pre-treatment impairment and pre-to-post change was reversed for patients with higher levels of readiness to change.…”

Section: Discussionmentioning

confidence: 99%

Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.

Lutz¹,

Hofmann²,

Rubel³

et al. 2014

Journal of Consulting and Clinical Psychology

Self Cite

108

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Objective Recently, innovative statistical tools have been used to model patterns of change in psychological treatments. These tools can detect patterns of change in patient progress early in treatment and allow for the prediction of treatment outcomes and treatment length. Method We used Growth Mixture Modeling to identify different latent classes of early change in patients with panic disorder (N = 326) who underwent a manualized cognitive-behavioral treatment. Results Four latent subgroups were identified, showing clusters of change trajectories over the first five sessions. One of the subgroups consisted of patients whose symptoms rapidly decreased and also showed the best outcomes. This information improved treatment prediction by 16.1% over patient intake characteristics. Early change patterns also significantly predicted patients’ early treatment termination. Patient intake characteristics that significantly predicted class membership included functional impairment and separation anxiety. Conclusions These findings suggest that early treatment changes are uniquely predictive of treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.

Lutz¹,

Hofmann²,

Rubel³

et al. 2014

Journal of Consulting and Clinical Psychology

Self Cite

108

View full text Add to dashboard Cite

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“…University of Rhode Island Change Assessment —This 28‐item self‐report instrument measured an individuals’ motivational readiness to change their drug use behavior. Individuals respond to a series of statements with respect to how much they agree or disagree (along a 5‐point scale), with the overall “readiness” score most commonly reported …”

Section: Methodsmentioning

confidence: 99%

“…Individuals respond to a series of statements with respect to how much they agree or disagree (along a 5-point scale), with the overall "readiness" score most commonly reported. 24…”

Section: Assessmentsmentioning

confidence: 99%

Prompted to treatment by the criminal justice system: Relationships with treatment retention and outcome among cocaine users

et al. 2015

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Background and Objectives A substantial portion of individuals entering treatment for substance use have been referred by the criminal justice system, yet there are conflicting reports regarding treatment engagement and outcome differences compared to those not referred. This study examined baseline characteristic and treatment outcome differences among cocaine-dependent individuals participating in cocaine treatment randomized trials. Methods This secondary analysis pooled samples across five completed randomized controlled trials, resulting in 434 participants. Of these, 67 (15%) were prompted to treatment by the criminal justice system. Results This subsample of criminal justice prompted (CJP) individuals did not differ from those not prompted by the criminal justice system in terms of gender, race/ethnicity, marital status, or age. However, the CJP group reported more years of regular cocaine use, more severe employment and legal problems, as well as less readiness to change prior to treatment. Treatment outcomes did not differ significantly from those without a criminal justice prompt, and on some measures the outcomes for CJP group were better (e.g., percentage of days cocaine abstinent, number of therapy sessions attended). Discussion and Conclusions These findings suggest that being prompted to treatment by the criminal justice system may not lead to poorer treatment engagement or substance use outcomes for individuals participating in randomized controlled treatment trials. Scientific Significance Despite some baseline indicators of poorer treatment prognosis, individuals who have been prompted to treatment by the criminal justice system have similar treatment outcomes as those presenting to treatment voluntarily.

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“…Willingness to change problematic behaviour was found to be a moderator in a study of transdiagnostic face-to-face treatment (Boswell et al, 2012) as well as in an uncontrolled study of face-to-face treatment for participants with somatoform disorders (Heider et al, 2017). Additionally, the "action"-subscale of willingness to change was found to moderate the effect of an online intervention addressing marijuana use among students (Palfai et al, 2016).…”

Section: Introductionmentioning

confidence: 92%

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

Lüdtke

Pult

Schröder

et al. 2018

Psychiatry Research

119

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Depressive symptoms are common, yet only a subset of individuals receives adequate treatment. To reduce the treatment gap, several online self-help programs have been developed, yielding small to moderate effects. We developed a self-help application for mobile devices addressing depressive symptoms. The aim of this study was to evaluate its feasibility and efficacy in a sample of participants reporting a subjective need for help (a diagnosis of depression was not mandatory). We conducted a randomized-controlled trial (N = 90). The primary outcome was a reduction of depressive symptoms measured with the Patient Health Questionnaire-9 (PHQ-9). Secondary outcomes included improved self-esteem (Rosenberg Self-Esteem Scale) and quality of life (WHOQOL-BREF). The intervention group obtained access to the application for four weeks, the wait-list group received access after the post assessment. No group differences emerged in either outcome in intention-to-treat analyses. Per protocol analyses with frequent users (i.e., several times a week or more) yielded a significant moderate effect on the reduction of depressive symptoms in favor of the treatment group. However, 39% of the participants did not use the application frequently.Mobile self-help applications represent a promising addition to existing treatments, but it is important to increase patients' motivation to use them.

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Readiness to change as a moderator of outcome in transdiagnostic treatment

Cited by 30 publications

References 45 publications

Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.

Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder.

Prompted to treatment by the criminal justice system: Relationships with treatment retention and outcome among cocaine users

A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms

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