Readiness to Change Questionnaire (RCQ): Scoring and how to use it

Key Takeaways

The Readiness to Change Questionnaire (RCQ), developed by Rollnick, Heather, Gold, and Hall in 1992, measures a client’s readiness to change their drinking specifically

Its 12 items score three subscales – precontemplation, contemplation, and action – and the highest-scoring subscale sets the client’s stage, not a single summed total

Each subscale ranges from -10 to +10, and this version of the RCQ has no separate maintenance subscale

Practice management software like Pabau can store completed questionnaires in the client record and track how each subscale shifts across sessions

Download your free readiness to change questionnaire (RCQ)

A client in addiction treatment might insist their drinking isn’t a problem, or they might already be quietly cutting back on their own. The Readiness to Change Questionnaire, developed by Rollnick, Heather, Gold, and Hall, measures which position a client actually holds toward their drinking.

This guide covers how the RCQ’s three subscales work, how to score them, and how to fit the questionnaire into an alcohol-use treatment workflow.

What is a readiness for change questionnaire?

A readiness for change questionnaire is a clinical assessment instrument that measures how ready someone is to change a specific behavior. The most widely used version, the Readiness to Change Questionnaire (RCQ), was developed by Rollnick, Heather, Gold, and Hall in 1992 specifically for drinking behavior.

It’s grounded in the transtheoretical model of change, developed by Prochaska and DiClemente, which describes behavior change as a process across stages rather than a single event.

The RCQ was validated on people who drank excessively but weren’t seeking treatment, and it’s since been used across addiction treatment, alcohol counseling, and substance-use programs. The 12 items ask specifically about a client’s drinking, so it isn’t a substitute for a broader intake or a general behavior-change assessment.

A mental state examination or comparable clinical assessment covers the wider picture; the RCQ narrows in on one thing, a client’s readiness to change how much they drink.

The three stages the RCQ scores

The RCQ places a client’s drinking-related readiness into one of three stages: precontemplation, contemplation, or action. Understanding each stage helps you choose the right response once you have their scores.

How to score and interpret readiness to change questionnaire results

Score all 12 items on a 5-point scale: -2 for strongly disagree, -1 for disagree, 0 for unsure, +1 for agree, and +2 for strongly agree. Four items belong to each of the three subscales – precontemplation (PC), contemplation (C), and action (A) – so add the four item scores within each subscale separately.

Each subscale can range from -10 to +10, and whichever subscale scores highest sets the client’s stage. There’s no single overall score, and no separate maintenance subscale in this version of the RCQ.

Because a client can score positively on more than one subscale, compare all three totals before deciding on their stage – a high precontemplation score alongside a modest contemplation score still points to precontemplation. Store completed questionnaires in your client record system to track how each subscale shifts across sessions.

How to use the readiness for change questionnaire in clinical practice

Administration is straightforward. Give the questionnaire after rapport is established but before you set treatment goals. Explain the purpose: “I’d like to understand where you’re at with your drinking right now. This helps me tailor our approach.”

1. Present the form as a digital intake form or printed copy.
2. Score all three subscales and discuss the results together in session, validating whichever stage they land in.
3. Adapt your language to their stage: explore ambivalence about drinking (precontemplation), tip the balance (contemplation), or set concrete steps to cut down or quit (action).
4. Re-administer every 4-8 weeks to track whether their subscale scores are shifting.

Pair the RCQ with automated workflows that send stage-appropriate follow-ups: clients in action benefit from weekly check-ins, while those still in contemplation tend to respond better to a lighter, bi-weekly message.

Pabau’s AI scribe, our AI note-taking feature, can automatically document the readiness conversation itself, so the discussion is captured in the client record without manual note-taking. Log the RCQ scores themselves separately, in a format like a BIRP note, which keeps the behavior, intervention, response, and plan from that session together.

Streamline patient readiness assessment with Pabau

Administer the RCQ digitally, score all three subscales automatically, and track how a client's stage of change shifts across sessions – all in one integrated practice management platform.

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Who benefits from the readiness for change questionnaire?

The RCQ is validated specifically for drinking behavior, so it fits addiction treatment, alcohol counseling, and substance-use programs rather than general intake. Programs use it at intake to gauge a client’s readiness to cut down or quit, then use the subscale scores each session to decide whether to build awareness or reinforce an existing plan.

It also pairs naturally with step-based recovery work – many programs use it alongside a client’s own AA Step 12 worksheet once they reach the action stage. Psychology practice software that tracks readiness scores helps clinicians match their approach to where a client currently stands, instead of pushing too hard or letting avoidance continue unchecked.

Conclusion

The RCQ answers a specific question: is this client ready to change their drinking right now, and in which direction? Whichever subscale scores highest shapes your next conversation, whether that’s building awareness, tipping the balance, or reinforcing a plan already in motion.

Book a demo to see how Pabau’s digital questionnaires and client records keep that stage-of-change picture up to date across every session.

Continue your research

Want to track mood alongside readiness scores? Major Depression Inventory gives you a validated screen to run alongside the RCQ when depression symptoms are also present.

Need a tool for day-to-day affect, not just stage of change? Emotional scales track a client’s emotional intensity between sessions.

Want to adjust how you talk to clients at each stage? Communication styles worksheets help you match your approach to how a client processes information.

Planning ahead for a client leaving treatment? Discharge planning worksheets document next steps once a client reaches the action stage.

Frequently Asked Questions