A classification and regression tree (CART) analysis was applied to data for 237 male participants (M = 31.93 years, SD = 7.64) in a prison-based substance abuse treatment program to study the integrity of the Stages of Change model of treatment readiness. Using the Stages of Change Questionnaire (STOCQ), participants were assigned to Contemplation (102), Action (118), or Maintenance (17) groups. A CART analysis then examined differences in the overall group profiles on the basis of scores on the Psychological Inventory of Criminal Thinking, the Situational Confidence Questionnaire, and the Carlson Psychological Survey. The assumption of discrete stages of change was not supported. Alternative models are suggested: one based on states of change and one on personality characteristics. A focus on equal attention to both cognitive and behavioral aspects of substance abuse treatment readiness is suggested.
AnnisH. M.GrahamJ. M. (1988). Situational Confidence Questionnaire (SCQ-39): User’s guide. Toronto, Ontario, Canada: Addiction Research Foundation.
2.
ArmitageC. J. (2009). Is there utility in the transtheoretical model?British Journal of Health Psychology, 14, 195-210.
3.
BanduraA. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.
4.
BreimanL.FriedmanJ. H.OlshenR. A.StoneC. J. (1984). Classification and regression trees (2nd ed.). Monterey, CA: Wadsworth.
5.
BroganM. M.ProchaskaJ. O.ProchaskaJ. M. (1999). Predicting termination and continuation status in psychotherapy using the transtheoretical model. Psychotherapy: Theory, Research, Practice, Training, 36, 105-113.
6.
BuddR. J.RollnickS. (1996). The structure of the Readiness to Change Questionnaire: A test of Prochaska & DiClemente’s transtheoretical model. British Journal of Health Psychology, 1, 365-376.
7.
BuntonR.BaldwinS.FlynnD.WhitelawS. (2000). The stages of change model in health promotion: Science and ideology. Critical Public Health, 10, 56-70.
8.
BurrowesN.NeedsA. (2009). Time to contemplate change? A framework for assessing readiness to change with offenders. Aggression and Violent Behavior, 14, 39-49.
9.
CarlsonK. A. (1997). Manual for the Carlson Psychological Survey. Port Huron, MI: Sigma Assessment Systems.
10.
CarneyM. M.KivlahanD. R. (1995). Motivational subtypes among veterans seeking substance abuse treatment: Profiles based on stages of change. Psychology of Addictive Behaviors, 9, 135-142.
11.
CaseyS.DayA.HowellsK. (2005). The application of the transtheoretical model to offender populations: Some critical issues. Legal and Criminological Psychology, 10, 157-171.
12.
DavidsonR. (1992). Prochaska and DiClemente’s model of change: A case study?British Journal of Addiction, 87, 821-822.
13.
DavidsonR.MillerW. R.HeatherN. (1998). The transtheoretical model: A critical overview. New York, NY: Plenum.
14.
DeFrancescoJ. J. (2000). A reliability study of the Carlson Psychological Survey. Psychology: A Journal of Human Behavior, 37, 41.
15.
DiClementeC. C.SchlundtD.GemmellL. (2004). Readiness and stages of change in addiction treatment. American Journal on Addictions, 13, 103-119.
16.
DrieschnerK. H.LammersS. M.van der StaakC. P. (2004). Treatment motivation: An attempt for clarification of an ambiguous concept. Clinical Psychology Review, 23, 1115-1137.
17.
ElderJ. P.de MoorC.YoungR. L.WildeyM. B. (1990). Stages of adolescent tobacco-use acquisition. Addictive Behaviors, 15, 449-454.
18.
FreyerJ.ToniganJ.KellerS.RumpfH.-J.JohnU.HapkeU. (2005). Readiness for change and readiness for help-seeking: A composite assessment of client motivation. Alcohol and Alcoholism, 40, 540-544.
19.
GarzottoM.BeerT.HudsonR. G.PetersL.HsiehY.-C.BarreraE.. . . MoriM. (2005). Improved detection of prostate cancer using classification and regression tree analysis. Journal of Clinical Oncology, 23, 4322-4329.
20.
HanlonT.NurcoD.BatemanR.O’GradyK. (1998). The response of drug abuser parolees to a combination of treatment and intensive supervision. The Prison Journal, 78, 31-44.
21.
HerzogT. A. (2005). When popularity outstrips the evidence: Comment on West (2005). Addiction, 100, 1040-1050.
22.
HowellsK.DayA. (2006). Affective determinants of treatment engagement in violent offenders. International Journal of Offender Therapy and Comparative Criminology, 50, 174-186.
23.
JohnsonM. A.BrownC. H.WellsS. J. (2002). Using classification and regression trees (CART) to support worker decision making. Social Work Research, 26, 19-29.
24.
Kear-ColwellJ.PollockP. (1997). Motivation or confrontation: Which approach to the child sex offender?Criminal Justice and Behavior, 24, 20-33.
25.
KuchibhatlaM.FillenbaumG. G. (2003). Alternative statistical approaches to identifying dementia in a community-dwelling sample. Aging and Mental Health, 7, 383-389.
26.
LemonS. C.RoyJ.ClarkM. A.FriedmannP. D.RakowskiW. (2003). Classification and regression tree analysis in public health: Methodological review and comparison with logistic regression. Annals of Behavioral Medicine, 26, 172-181.
27.
LevyC. M. (1997). Applying the transtheoretical model of change to court-ordered/DUI outpatient treatment clients. Dissertation Abstracts International Section A: Humanities and Social Sciences, 58, 0391.
28.
LewisR. J. (2000, May). An introduction to classification and regression tree (CART) analysis. Paper presented at the Annual Meeting of the Society for Academic Emergency Medicine, San Francisco, CA.
29.
LittellJ.GirvinH. (2002). Stages of change: A critique. Behaviour Modification, 26, 223-273.
30.
MakkaiT.PayneJ. (2005). Illicit drug use and offending histories: A study of male incarcerated offenders in Australia. Probation Journal: The Journal of Community and Criminal Justice, 52, 153-168.
31.
MartinR. A.VelicerW. F.FavaJ. L. (1996). Latent transition analysis to the stages of change for smoking cessation. Addictive Behaviors, 21, 67-80.
32.
McConnaughyE. A.DiClementeC. C.ProchaskaJ. O.VelicerW. F. (1989). Stages of change in psychotherapy: A follow-up report. Psychotherapy: Theory, Research, Practice, Training, 26, 494-503.
33.
McConnaughyE. A.ProchaskaJ. O.VelicerW. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research & Practice, 20, 368-375.
34.
McKenzieD. P.McFarlaneA. C.CreamerM.IkinJ. F.ForbesA. B.KelsallH. L.. . . SimM. R. (2006). Hazardous or harmful alcohol use in Royal Australian Navy veterans of the 1991 Gulf War: Identification of high risk subgroups. Addictive Behaviors, 31, 1683-1694.
35.
McMurranM.TylerP.HogueT.CooperK.DunseathW.McDaidD. (1998). Measuring motivation to change in offenders. Psychology, Crime and Law, 4, 43-50.
36.
MillerP. J.RossS. M.EmmersonR. Y.TodtE. H. (1989). Self-efficacy in alcoholics: Clinical validation of the situational confidence questionnaire. Addictive Behaviors, 14, 217-224.
37.
MillerW. R.ToniganJ. S. (1996). Assessing drinkers’ motivations for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behaviors, 10, 81-89.
38.
MurphyS. A. (2005). The merits and challenges of the transtheoretical model. Journal of Addictions Nursing, 16(1-2), 3-4.
39.
O’HareT. (1996). Readiness for change: Variation by intensity and domain of client distress. Social Work Research, 20, 13-17.
40.
ProchaskaJ.DiClementeC. C. (1992). Stages of change in the modification of problem behaviors. In HersenM.EislerR.MillerP. M. (Eds.), Progress in behavior modification (Vol. 28, pp. 184-218). New York, NY: Academic Press.
41.
ProchaskaJ.DiClementeC. C.NorcrossJ. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
42.
ProchaskaJ.VelicerW. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38-48.
43.
RainerT. H.LamP. K.WongE. M.CocksR. A. (1999). Derivation of a prediction rule for post-traumatic acute lung injury. Resuscitation, 42, 187-196.
44.
Salford Systems. (2003). CART, version 5.0. San Diego, CA: Author.
45.
SimpsonD.JoeG. W.Rowan-SzalG. A.GreenerJ. M. (1997). Drug abuse treatment process components that improve retention. Journal of Substance Abuse Treatment, 14, 565-572.
46.
SteinbergD.CollaP. (1997). CART—Classification and regression trees. San Diego, CA: Salford Systems.
47.
SuttonS. (2001). Back to the drawing board? A review of applications of the transtheoretical model to substance use. Addiction, 96, 175.
48.
SwanG. E.JavitzH. S.JackL. M.CurryS. J.McAfeeT. (2004). Heterogeneity in 12-month outcome among female and male smokers. Addiction, 99, 237-250.
49.
TaxmanF. S.ThannerM. (2006). Risk, need, and responsivity (RNR): It all depends. Crime & Delinquency, 52, 28-51.
50.
ThannerM. H.TaxmanF. S. (2003). Responsivity: The value of providing intensive services to high-risk offenders. Journal of Substance Abuse Treatment, 24, 137-147.
51.
TierneyD. W.McCabeM. (2002). Motivation for behavior change among sex offenders: A review of the literature. Clinical Psychology Review, 22, 113-129.
52.
WaltersG. D. (1995). The Psychological Inventory of Criminal Thinking Styles: Part I. Reliability and preliminary validity. Criminal Justice and Behavior, 22, 307-325.
53.
WaltersG. D. (2010). The Psychological Inventory of Criminal Thinking Styles (PICTS): Professional manual. Allentown, PA: Center for Lifestyle Studies.
54.
WardT.DayA.HowellsK.BirgdenA. (2004). The multifactor offender readiness model. Aggression and Violent Behavior, 9, 645-673.
55.
WelteJ. W.BarnesG. M.WieczorekW. F.TidwellM. C. (2004). Gambling participation and pathology in the United States—A sociodemographic analysis using classification trees. Addictive Behaviors, 29, 983-989.
56.
WestR. (2005). Time for a change: Putting the theoretical (stages of change) model to rest. Addiction, 100, 1036-1039.
57.
WhitelawS.BaldwinS.BuntonR.FlynnD. (2000). The status of evidence and outcomes in stages of change research. Health Education Research, 15, 707-718.
58.
WilliamsonP.DayA.HowellsK.BubnerS.JaunceyS. (2003). Assessing offender readiness to change problems with anger. Psychology, Crime and Law, 9, 295-307.
