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Eating · Motivation

ED Stages of Change Ruler

Per-behavior readiness — because motivation isn't all-or-nothing

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Motivation in ED treatment is rarely all-in or all-out. This ruler names where the client is on each specific behavior — because someone can be in action on binging and pre-contemplation on restriction on the same day. Meet each behavior where it actually is.

Rate readiness — for each behavior separately
Restriction
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Binging
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Purging
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Over-exercise
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Body checking
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Weighing
0 not ready · 10 already changing
none
1
2
3
4
5
6
7
8
9
10
most
Importance / confidence rulers (overall)
How important is change to me right now
none
1
2
3
4
5
6
7
8
9
10
most
How confident am I that I could change
none
1
2
3
4
5
6
7
8
9
10
most
Why did I rate importance where I did (not lower)?
What would move confidence up by one point?
The one behavior I'm most ready to move on this week
The behavior I'm not ready for yet — and that's okay

Ambivalence is not resistance

Every ED client has both a part that wants recovery and a part that is terrified of it. Naming both, per behavior, lets treatment move forward on the ready pieces without shaming the parts that aren't.

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