Abstract
Ambivalence about recovery is a key aspect of the symptom presentation of individuals with eating disorders and increased attention has focused on understanding readiness for change in this group. This research examined shifts in global and symptom-specific readiness and motivation for change during residential eating disorders treatment. Forty-two participants completed the Readiness and Motivation Interview (RMI) prior to treatment, at week 7, and following the 12–15 week program. Demographic and symptom severity measures were completed at pre and at post. Overall, increases in readiness to change behavioral symptoms occurred prior to increases in readiness to change cognitive symptoms. Shifts in locus of control for change were less pronounced during treatment, and occurred only for the cognitive symptom domain. Subgroup analyses revealed that relative to the other eating disorder diagnostic groups (bulimia nervosa and eating disorder not otherwise specified), readiness for change in individuals with anorexia nervosa shifted less over the course of treatment.
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References
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
Beck, A., & Hollon, S. (1993). Controversies in cognitive therapy: A dialogue with Aaron T. Beck and Steve Hollon. Journal of Cognitive Psychotherapy, 7, 79–93.
Blake, W., Turnbull, S., & Treasure, J. (1997). Stages and processes of change in eating disorders: Implications for therapy. Clinical Psychology and Psychotherapy, 4, 186–191.
Cockell, S. J., Geller, J., & Linden, W. (2002). The development of a decisional balance scale for anorexia nervosa. European Eating Disorders Review.
Cooper, P. J., & Fairburn, C. G. (1987). The Eating Disorder Examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders. International Journal of Eating Disorders, 6, 1–8.
Cooper, P. J., & Fairburn, C. G. (1993). Confusion over the core psychopathology of bulimia nervosa. International Journal of Eating Disorders, 13, 385–389.
Derogatis, L. R. (1993). The brief symptom inventory (BSI): Administration, scoring, and procedures manual. Towson, MD: Clinical Psychometric Research.
Fairburn, C. G., Peveler, R. C., Jones, R., Hope, R. A., & Doll, H. A. (1993). Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight. Journal of Consulting & Clinical Psychology, 61, 696–698.
Garner, D. (1991). Eating disorder inventory-2: Professional manual. Odessa, FL: Psychological Assessment Resources.
Geller, J., Johnston, C., & Madsen, K. (1997). The role of shaper and weight in self-concept: The shape and weight based self-esteem inventory. Cognitive Therapy and Research, 21, 5–24.
Geller, J., Johnston, C., Madsen, K., Goldner, E. M., Remick, R. A., & Birmingham, C. L. (1998). Shape and weight based self-esteem and the eating disorders. International Journal of Eating Disorders, 24, 285–298.
Geller, J., & Drab, D. L. (1999). The Readiness and Motivation Interview: A symptom specific measure of readiness for change in the eating disorders. European Eating Disorders Review, 7, 259–278.
Geller, J., Cockell, S. J., & Drab, D. L. (2001). Assessing readiness for change in the eating disorders: The psychometric properties of the Readiness and Motivation Interview. Psychological Assessment, 13, 189–198.
Geller, J., Williams, K., & Srikameswaran, S. (2001). Clinician stance in the treatment of chronic eating disorders. European Eating Disorders Review, 9, 1–9.
Geller, J., Whisenhunt, B., & Drab, D. (2002, November). Predicting clinical outcomes using readiness and motivation for information. Paper presented at the meeting of the Association for the Advancement of Behaviour Therapy, Reno.
Hollingshead, A. B. (1979). Four Factor Index of Social Status. New Haven, CN: privately printed.
Howell, D. C. (1979). Statistical methods for psychology (2nd ed.). Boston, MA: PWS-Kent.
McConnaughy, E. A., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy, 20, 368–375.
Pike, K. (1998). Inpatient treatment for anorexia nervosa: Predictors of outcome. Paper presented at the meeting of the Eating Disorders Research Society, Boston, MA.
Prochaska, J. O. (1979). Systems of psychotherapy: A transtheoretical analysis. Homewood, IL: Dorsey Press.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. American Psychologist, 47, 1102–1114.
Rachman, S. J. (1990). Fear and courage (2nd ed.). New York: W. H. Freeman/Times Books Henry Holt & Co.
Rieger, E., Touyz, S., Schotte, D., Beumont, P., Russell, J., Clarke, S., Kohn, R., & Griffiths, R. (2000). Development of an instrument to assess readiness to recover in anorexia nervosa. International Journal of Eating Disorders, 28, 387–396.
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 6–19.
Serpell, L., Treasure, J., Teasdale, J., & Sullivan, V. (1999). Anorexia nervosa: Friend or foe? International Journal of Eating Disorders, 25, 177–186.
Stanton, A. L., Rebert, W. M., & Zinn, L. M. (1986). Self-change in Bulimia: A preliminary study. International Journal of Eating Disorders, 5, 917–924.
Tang, T. Z., & DeRubeis, R. J. (1999). Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of Consulting & Clinical Psychology, 67, 894–904.
Tang, T. Z., Luborsky, L. & Andrusyna, T. (2002). Sudden gains in recovering from depression: Are they also found in psychotherapies other than cognitive-behavioral therapy? Journal of Consulting & Clinical Psychology, 70, 444–447.
Treasure, J. J., Katzman, M., Schmidt, U., Troop, N., Todd, G., & de Silva, P. (1999). Engagement and outcome in the treatment of bulimia nervosa: First phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy. Behaviour Research and Therapy, 37, 405–418.
Vitousek, K. B., DeViva, J., Slay, J., & Manke, F. (1995). Concerns about change in the eating and anxiety disorders. Paper presented at the Annual Meeting of the American Psychological Association, NY.
Ward, A., Troop, N., Todd, G., & Treasure, J. (1996). To change or not to change “How” is the question? British Journal of Medical Psychology, 69, 139–146.
Zaitsoff, S., Bates, M., & Geller, J. (2002, November). Does Readiness and motivation for change differ across eating disorder diagnostic categories?. Short paper presented at the meeting of the Eating Disorders Research Society, Charleston, South Carolina.
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Geller, J., Zaitsoff, S.L. & Srikameswaran, S. Tracking Readiness and Motivation for Change in Individuals with Eating Disorders Over the Course of Treatment. Cogn Ther Res 29, 611–625 (2005). https://doi.org/10.1007/s10608-005-5774-1
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DOI: https://doi.org/10.1007/s10608-005-5774-1