Readiness for Change in people living with Severe and Multiple Disadvantage
Creators: name: Barston, Alex
Publisher: name: University of Lincoln
Year: 2025
Subjects: C842 - Clinical psychology

description: People that experience a combination of psychosocial disadvantages such as homelessness and mental health difficulties are likely to face severe and multiple disadvantage (SMD). Indeed, the number of people experiencing SMD is increasing within the United Kingdom. There are existing interventions that aim to support those facing SMD. Most have a focus on supporting behavioural change to help with gaining and retaining housing, recovery in terms of substance use and / or mental health, and a reduction in offending behaviour. However, there is a lack of research that explores the processes involved in the development of readiness for change in people facing SMD. Understanding this may be fundamental to effective intervention. Therefore, this research aimed to explore processes involved in the development of readiness for change in people living with SMD. The research aim was explored utilising a constructivist grounded theory approach outlined by Charmaz (2014), underpinned by interpretivist epistemology. Within this approach, we considered the participants’ and the researcher’s lived experiences and subsequent interpretations of these, in understanding meaningful processes involved in readiness for change. Tools of reflexivity such as memo-writing and supervision were utilised to support with the data collection, analysis and construction of the theory. Overall, twelve interviews were undertaken with twelve people experiencing SMD that met the inclusion criteria. Participants were recruited from across the cities of Lincoln and Nottingham and were all in contact with homelessness supporting organisations at the time of recruitment. Following multiple stages of coding and comparison, six descriptive categories were constructed: Reflecting on Disadvantage, Recognising the Cycle, Developing a Purpose for Change, Identifying Changes to Make, Feeling Supported and Changing Causing Further Readiness for Change. A theory was constructed that consisted of three theoretical categories. The first two categories were: Envisioning Change and Supported Motivation for Change. The framework outlines that readiness for change is developed through a combination of these first two processes and that a person cannot be ready to change if they cannot envision change, or if they do not have an adequate support network available to them, as these factors can motivate them to make changes. A third theoretical category recognises Increasing Opportunity for Change, following on from previous changes and subsequently leading to further psychosocial improvements. The results indicated that providers supporting those facing SMD can help to facilitate readiness for change by incorporating a multi-faceted approach into their service provision, focusing on both intrapersonal and interpersonal processes. We use the grounded theory as a base to discuss existing psychological interventions and theories that can be incorporated and adapted to facilitate the development of readiness for change within this population. The research was evaluated using a grounded theory evaluative framework (Charmaz, 2014), and demonstrated credibility, resonance, originality and usefulness. However, there were several limitations due to the sample demographics and further research is warranted to expand on the present findings.