Assessing Readiness to Change among Clients Seeking Help for Hypersexual Behavior

Abstract

Mental health professionals may erroneously assume that clients seeking help for hypersexual behavior are ready to begin working on their issues at the outset of treatment. Prochaska and DiClemente (e.g., 1983, 1984) proposed the transtheoretical model (TTM) stages of change to advance their belief that clients move through several stages when attempting to alter specific target behaviors. If a clinician gets ahead of a client by administering interventions that are improperly matched with the client's readiness to change, treatment may be prematurely terminated or high levels of resistance may be encountered during therapy. In this study, clients (N = 67) who were referred for treatment in a specialty outpatient clinic for hypersexual behavior completed the Sexual Compulsivity Scale (Kalichman et al., 1994; Kalichman & Rompa, 1995, 2001) and the Stages of Change Scale (McConnaughy, DiClemente, Prochaska, & Velicer, 1989; McConnaughy, Prochaska, & Velicer, 1983). The data collected from these measures revealed that 70% (n = 47) of clients who expressed an interest in receiving help with issues related to hypersexuality also had high levels of ambivalence about the changes they desired to make and that individuals with ADHD were significantly (chi-square, p ≤ .001) more likely to be in the contemplation stage than subjects presenting with alternative diagnoses. Implications for these finding are discussed and suggestions for future research are offered.

ACKNOWLEDGEMENTS

Landon Poppleton at Brigham Young University assisted with the data analysis for this study.

Notes

¹Percentage of entire subject pool (67 participants) is rounded to 1 decimal.

² ADHD diagnosis was made only after subjects completed the Adult ADHD Self-Report Scale, the Wender Utah Rating Scale for retroactive endorsement of ADHD symptoms, and the Conner's Adult ADHD Rating Scale—Long Form. These subjects were also given a clinical interview for ADHD, and the initial diagnosis by the primary therapist was confirmed by a second evaluation administered by a psychiatrist or a licensed Advanced Practice Registered Nurse.

³ The 8 subjects diagnosed with Impulse Control NOS all appeared to be functioning well in most aspects of their lives. These participants did not meet the full criteria for any other Axis I diagnosis and were subsequently placed in this category. Almost all of the entire sample in this study could have been given a diagnosis of Impulse Control NOS (or similarly Sexual Disorder NOS), however, this diagnosis would not have provided any meaningful interpretation of psychopathology. The category of Impulse Control NOS was reserved exclusively for individuals who did not meet diagnostic criteria for any other Axis I disorder.