Table 2 Five steps on the ‘ladder of change’

1. Stuck. Service user may not be engaged or interested in change.

2. Getting help. Service user is starting to open up to help, but not yet taking imitative.

3. Trying things out. Service user is trying new things, but may give up easily if they do not seem to work.

4. Finding what works. Service users have made some achievements, and overcome barriers.

5. Choice and self-reliance. Service user is doing well and is on track with their recovery.