Study Suggests Readiness Ruler Best Tool for Adolescent Alcohol Behavior

Adolescents who enter treatment for alcohol use disorders (AUD) must be ready to change their behavior in order for treatment to work. Unlike adults, many adolescents are sent to treatment against their will and do not desire to make the changes necessary to overcome their problems with alcohol. Measuring the motivation level of the adolescents, and determining what stage of readiness they are in, is a critical component to ensuring a positive treatment outcome. The three primary measures used to assess readiness to change in the adult population are the Stages of Change and Treatment Eagerness Scale (SOCRATES), the Readiness Ruler (RR) and the staging Algorithm. The SOCRATES measures readiness to change through scaling, the RR is a ten question scale, and the algorithm bases its evaluation of readiness on a five stage scale.

Stephen A. Maisto, of the Department of Psychology at Syracuse University wanted to determine which scale would be the most effective at assessing adolescents’ readiness and measuring drinks per drinking day (DDD). For his study, Maisto administered all three measures to 161 adolescents who were undergoing treatment for AUD and found that the RR was the most effective tool. “In this regard, Readiness Ruler scores showed the most consistent pattern of evidence for both concurrent and predictive validity; the Staging Algorithm showed good concurrent validity and predictive validity for the DDD outcome at both 6 and 12 months, and Taking Steps scores showed good concurrent validity but poor predictive validity,” said Maisto. “To add to the advantages of using the Readiness Ruler, it is the briefest and easiest to complete of the three readiness measures, as it consists of one 10-point Likert-type scale that the respondent self-administers.” He added, “In general, the data show that the field would be advanced by additional systematic research on the construct validity of measures of readiness to change, given the importance of the construct in clinical practice with adolescents presenting for treatment of alcohol- and other drug-use disorders.”

Maisto, Stephen A., Marketa Krenek, Tammy Chung, Christopher S. Martin, Duncan Clark, and Jack Cornelius. “A Comparison of the Concurrent and Predictive Validity of Three Measures of Readiness to Change Alcohol Use in a Clinical Sample of Adolescents.” Psychological Assessment 23.4 (2011): 983-94. Print.

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Rich


    December 27th, 2011 at 5:27 AM

    If someone is not ready to get treatment, regardless of their age, t is not going to stick. Why do you think there is such a high recidivism rate among addicts as a whole? Because many of them enter treatment thinking that they are ready, but really they are doing it for others.

  • S.Felix


    December 27th, 2011 at 12:26 PM

    Well of course you cannot help someone change if the person does not want to change himself.But then treatments should provide some sort of an encouragement so that people feel inclined to change, rather than just saying it depends on the willingness.

  • mason


    December 27th, 2011 at 4:41 PM

    These are great predictors and I sincerely hope that the young kids who need help with issues surrounding drinking are able to get the help that they need by utilizing this model in treatment.

    However I think that like almost anything else it is so important to remember that what works for one does not work for all, and that maybe what points to a problem in one chaild does not mean that it is going to be this way for every kid.

    Important for therapists and parents alkie to remember this.

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