Ascellus Blog

Small Steps Matter: Learn the Readiness Ruler Technique

January 18, 2021
man on computer for telehealth appointment

The Readiness Ruler technique gauges whether someone is ready for change. Ascellus Clinical Quality Assurance Advisor Dr. Miranda Kofeldt, Ph.D., explains this technique, its benefits and presents a small group exercise that teaches you ways to practice this skill.

What is the Readiness Ruler Technique?

This technique measures a client’s readiness to change and helps them verbalize what they need in order to progress. It gives those working with the client an indication of where the client stands, and it aids in addressing barriers and meeting needs to move them along.

When you have a sense of what their perceptions are, you can then have motivational conversations about what is obtainable and what is more challenging. 

Benefits of using this technique:

Increasing readiness helps a person move through the five stages of change:

  1. “No, not me.” (pre-contemplation)
  2. “Well, maybe.” (contemplation)
  3. “So, ok. What do I do now?” (preparation)
  4. “Ok. Let’s do this.” (action)
  5. “It is possible.” (maintenance)

Other details that support this technique:

The Center for Evidence-Based Practices at Case Western Reserve University is a very good resource for therapy tools. You can click here to learn more about the Readiness Ruler technique and other resources.

Workers’ Compensation Readiness Exercise:

The following images show both sides of the 2-sided readiness ruler tool, providing a visual representation of a client’s readiness to change and an assessment of how that readiness changes over time.

The client should identify a number on the ruler in answer to these questions: 

  • “On a scale from 1-10, how ready do you feel to return to work?”
  • “On a scale from 1-10, how able do you feel to return to work?” 
  • “On a scale from 1-10, how willing are you to return to the same work?”

Now, ask questions to prompt the client to provide reasons for their answers, for example: 

  • What led you to choose a 5 instead of a 3?
  • What would help you move to a 6 or 7?
  • What would motivate you to take the first step?
  • When you think about the future, how would you like this to change?
  • What steps are you comfortable with in the short term to reach that goal?

Use the following phrases to encourage the client to expound on their reasons:

  • Build confidence: Tell me about other times you’ve made hard changes.
  • Build importance: Tell me about what is important to you now, in your recovery.

Ask the client to use the following “Change Talk” phrases in their answers. Research shows that people who express change-talk are more likely to change.

  • Desire: I’d like to …
  • Ability: I could …
  • Reasons: It’s important because …
  • Need: I have to …
  • Commitment: I will…
  • Activation: I’m ready to …
  • Taking steps (“I’ve tried …,” “I am doing …”)

For more small group exercises and practice in clear communication, be sure to read more in our Practice Exercises blog series and learn more about cognitive behavioral therapy techniques that change outcomes.

Ascellus’s Clinical Quality Assurance Advisor, Miranda Kofeldt, is a licensed clinical psychologist and holds a Ph.D. in clinical psychology and behavioral medicine from the University of Maryland Baltimore County. She has experience treating adult individuals and groups in recovery from addictions, trauma and serious mental illness, depression and bipolar, anxiety, stressful/chronic health diagnosis; trauma and PTSD, problems with emotion, regulation stress management and anger management. 

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Ascellus bridges the gap between mental and physical health to accelerate recovery for our nation's workforce. By connecting the workers' compensation industry with our expert behavioral care and evidence-based treatments, we deliver high-quality outcomes, helping injured workers reemerge with increased strength, purpose and resilience in the workplace.