Development and validation of the Readiness for Therapy Questionnaire (RTQ)

Abstract

Background: motivational factors are generally regarded as an important ingredient for change in therapy. However, there is currently a lack of available instruments that can measure clients' readiness for change in therapy. 

Aim: the objective of this paper was to create an instrument, the Readiness for Therapy Questionnaire (RTQ), which could measure clients' readiness for change. Method: The RTQ was created by researchers following analysis of themes drawn from a review of the literature and interviews with patients at the end of therapy. This included both people who completed therapy and those who dropped out. As part of the standard assessment process, the RTQ was administered to 349 participants (69.6% female and 30.4% male; mean age 37.1 years; 90.5% Caucasian) who were patients at a psychological therapy service for common mental health difficulties. 

Result: an initial 12-item scale was reduced to 6 items. This scale significantly correlated with post-Therapy PHQ-9 and GAD-7 scores and changes in these scores across therapy. After controlling for baseline scores and demographic variables, a logistic regression showed that scores on this 6-item measure pre-Therapy significantly predicted three outcome variables: completing therapy, being recovered on both PHQ-9 and GAD-7 post-Therapy, and having a reliable change in both the PHQ-9 and GAD-7 post-Therapy. However, receiver operating characteristic (ROC) curve analysis showed the measure had poor sensitivity and specificity. Symptom severity did not have a significant impact on motivation to change.

Conclusion: the RTQ is potentially a valid measure with useful clinical applications in treatment of common mental health difficulties.

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