Measuring Readiness to Change Substance Use, Alcohol Use, and Cannabis Use: An Experimental Manipulation of Cognitive Effort
The Transtheoretical Model supports that readiness to change should predict actual substance-related behavior change, though this relationship is surprisingly modest. Across several behavioral domains, individuals tend to have unrealistic expectations regarding the amount of effort and time required to successfully change one’s behaviors, dubbed the False Hope Syndrome. Based on the False Hope Syndrome, we expect that the standard method of measuring self-reported readiness to change is inaccurate and overestimated. To test this hypothesis, we experimentally manipulated the level of cognitive effort or focus on the practical implications of changing substance use prior to completing readiness to change measures. College students from a large southwestern university who reported using substances in the past 30 days (n = 345) were recruited from a psychology department participant pool to complete this experimental study online. Participants were randomized to one of three conditions: 1) standard low effort condition, 2) medium effort condition (had to select likes/dislikes of substance use, and negative consequences of changing one’s use), and 3) high effort condition (also provided text responses to how they would handle difficult situations related to changing their substance use). We conducted one-way ANOVAs with Tukey post-hoc comparisons to examine differences on three measures of readiness to change: the University of Rhode Island Change Assessment (URICA) scale for overall substance use as well as the readiness and motivation rulers for overall substance use, alcohol use, and cannabis use. Contrary to our hypothesis, all significant statistical tests supported higher cognitive effort conditions reporting higher readiness to change. Although effect sizes were modest, higher cognitive effort appeared to increase self-reported readiness to change substance use. To address the present study’s limitations, additional work is needed to test how self-reported readiness to change relates to actual behavior change when assessed under the different effort conditions.