Next stop on our ASWB exam content outline tour: Methods to assess motivation, resistance, and readiness to change. Your first thought about this is likely something about Motivational Interviewing--and you're right on target! Let's dig in and then look at how this topic may look on the licensing exam.

Taking a History

Gathering a detailed case history is job one for pretty much any social work intervention. Along with everything else, a good interview can provide insights into clients' motivations, resistance, and readiness to change. Open-ended questions and a nonjudgmental approach are key.

After that, here are some methods commonly used to assess change-readiness:

Motivational Interviewing (MI)

Motivational Interviewing is a client-centered approach designed to enhance motivation to change by exploring and resolving ambivalence. Key techniques include:

  • Open-Ended Questions: Encouraging clients to talk about their thoughts and feelings.
  • Affirmations: Recognizing and reinforcing clients' strengths and efforts.
  • Reflective Listening: Demonstrating understanding by reflecting clients' statements.
  • Summarizing: Recapping conversations to show understanding and encourage further discussion.
  • Change Talk: Identifying and reinforcing clients' expressions of desire, ability, reasons, and need for change.

Stages of Change Model (Transtheoretical Model)

Developed by Prochaska and DiClemente, this model outlines stages individuals go through in the change process. Assessing which stage a client is in can guide appropriate interventions:

  • Precontemplation: Client is not considering change.
  • Contemplation: Client is thinking about change but is ambivalent.
  • Preparation: Client is planning to take action soon.
  • Action: Client is actively making changes.
  • Maintenance: Client is sustaining changes and working to prevent relapse.

Readiness Ruler

A readiness ruler is a visual tool used to assess a client's readiness to change. Clients rate their readiness on a scale from 1 to 10. This helps identify where they are in their change process and can facilitate discussions about what might increase their readiness.

Self-Report Questionnaires and Inventories

Standardized tools and questionnaires--used far more often by psychologists than social workers--can help clinicians (social workers included!) assess motivation, resistance, and readiness to change. Examples include:

  • Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES): Measures readiness to change in clients with substance use disorders.
  • University of Rhode Island Change Assessment (URICA): Assesses the stages of change in various behaviors.
  • Motivational Interviewing Skill Code (MISC): Evaluates the use of motivational interviewing techniques and client responses.

Or, of course, you could just ask.

Goal Setting and Planning

Working with clients to set realistic, achievable goals can reveal their motivation and readiness to change. Assessing their commitment to and progress toward these goals provides ongoing information about their readiness.

On the Exam

How might all this appear on the social work licensing exam? Expect something along these lines:

  • A social worker is using Motivational Interviewing techniques with a client who expresses mixed feelings about quitting smoking. Which technique is the social worker using when they reflect the client’s statement to show understanding?
  • A client states they are not considering making any changes to their drinking habits despite experiencing negative consequences. According to the Stages of Change Model, which stage is the client in?

  • A client shows signs of resistance by frequently missing appointments and not completing agreed-upon tasks. What strategy might a social worker use to address this resistance?

Get practice with these sorts of questions in all areas covered by the exam content outline with Social Work Test Prep's full-length practice tests. Ready? Resistance addressed?

Let's Go!

June 12, 2024
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