Readiness to Change: Understanding Where Clients Are

Rewire CBT is only one piece of the training puzzle. SRP case managers are also being trained in the Transtheoretical Model (TTM) of readiness to change — a foundational framework in behavioral health that helps practitioners understand where an individual is in their motivation to make a change, and how to tailor their engagement accordingly.

The TTM breaks an individual’s journey toward change into five stages:

Pre-Contemplation: The person isn’t yet considering change — they may not see their behavior as a problem, or may feel resistant or defensive.
Contemplation: The person is aware a problem exists and is thinking seriously about change, but has mixed feelings about the costs and benefits.
Preparation: The person has decided to change and is beginning to make small adjustments or gather support.
Action: The person is actively changing their behavior — making clear, observable efforts to shift habits or routines.
Maintenance: The person works to sustain change over time, building coping strategies and preventing relapse.

CJA uses the University of Rhode Island Change Assessment (URICA) — one of the most widely researched and validated tools in behavioral health — to assess participants’ readiness to change. Originally developed for adult outpatient psychotherapy, URICA is now applied across diverse settings, including substance use treatment, primary care, and community health programs. It measures where individuals fall across the five TTM stages, producing a readiness profile that reflects the nuance of a person’s motivational state rather than reducing them to a single category.

For SRP case managers, understanding a client’s stage of readiness isn’t just theoretically interesting — it’s operationally essential. A client in pre-contemplation needs something very different from a client in the action stage. Trying to problem-solve with someone who doesn’t yet see a problem or dwelling on ambivalence with someone who is ready to act, can undermine even the strongest case management relationship. Training staff to read these signals and respond in stage-appropriate ways is what makes the difference between engagement that sticks and engagement that doesn’t.

Related Content