Readiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder

Gorica Micic*, Cele Richardson, Neralie Cain, Chelsea Reynolds, Kate Bartel, Ben Maddock, Michael Gradisar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
69 Downloads (Pure)


Objectives: Recent evidence indicates that adolescents’ motivation to change sleep-wake patterns is low, despite significant impact of adolescent sleep problems on many areas of daytime functioning. The aim of the present study is to evaluate components of adolescents’ motivation, and subsequent changes in behaviour.

Methods: Fifty-six adolescents, aged 13–23 (M = 15.8 ± 2.3 y; 38% m) diagnosed with Delayed Sleep-Wake Phase Disorder (DSWPD) underwent three therapy sessions involving bright light therapy to phase advance sleep patterns. Adolescents were instructed to advance wake-up times by 30-min daily. Motivation ratings of desire, ability, reason, need and commitment to change sleep patterns were taken at baseline. Sleep diaries were taken at the end of treatment session 1, with sequentially earlier wake-up times in 30-min intervals indicating compliance.

Results: At the outset of therapy, adolescents indicated strong desire, reasons and need, yet moderate ability and commitment to advance their sleep-wake patterns. Following therapy, sleep-onset times were significantly advanced, total sleep time increased and sleep latency decreased (all p < 0.05). Therapy lasted 6–27 days (M = 13.9 ± 4.5) and clients complied for approximately half the time (between 3 and 15 days; M = 8.8 ± 2.7). Commitment was associated with ability (r = 0.66, p < 0.001) but not desire, reason or need (all p > 0.05). Adolescents’ desire to change (r = 0.30, p = 0.03) and commitment (r = 0.30, p = 0.03) were positively correlated with behaviour change, but their need, ability and reasons were not. A mediation analysis showed that ability and desire were important in predicting behaviour change, by total effects through commitment (ie, indirectly and directly).

Conclusion: Our findings suggest that the total effects of ability (ie, confidence) and desire to change are the best predictors of behavioural changes, thus clinicians should focus on these components of the readiness to change model when undertaking treatments with sleep-disordered adolescents.

Original languageEnglish
Pages (from-to)48-55
Number of pages8
JournalSleep Medicine
Publication statusPublished - Mar 2019
Externally publishedYes


  • motivational interviewing
  • adolescents
  • sleep
  • commitment
  • readiness to change
  • sleep disorders


Dive into the research topics of 'Readiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder'. Together they form a unique fingerprint.

Cite this