Having recently completed training in OCAIRS, I was inspired to think more about Readiness for Change which is embedded in the OCAIRS assessment. Obviously this is a crucial factor when considering working with someone with a history of hoarding , particularly in the current economic climate. Below I've highlighted a few points related to readiness to change which can be considered as part of the assessment process (they are also included in the case formulation/assessment prompts on another posting). It does not mean that someone has to "tick all boxes" in order to be ready for change, but it may highlight useful starting points or potential barriers. This also may assist in articulating to your team or your manager reasons why or why not you feel the client may be ready to engage with interventions to tackle hoarding.
READINESS
FOR CHANGE
COMMENTS
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·
Appraisal
of hoarding situation and associated behaviours and extent to which this is perceived as a
problem
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·
Perception
of risk associated with hoarding in
relation to skills (motor /process) and environment (social and physical)
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·
Goals
regarding hoarding behaviours and
environment. Priority these goals in
relation to other goals or plans
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·
Emotional and behavioural responses to potential or
actual changes in hoarding routine/activities or environment (e.g accepting/fearful/ resistant/
avoidant)
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·
Capacity
to modify routine or performance in activity related to acquiring, discarding or
organising items
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Approach
and attitudes by others in social environment (i.e /rejecting/directive/empathic)
and capacity of others to adapt approach
to support change
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·
History
of coping with changes related to hoarding behaviours (e.g enforced
clearances/therapy) and emotional and behavioural responses to these
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·
History
of coping with other major changes /difficult situations
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·
Access
to support to tackle hoarding (e.g neighbours, family
, voluntary and statutory sector, finances)
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·
Engagement
in current assessment process
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·
Other
factors influencing readiness to change
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