Predicting and Enhancing 

Psychotherapeutic Change 

Precursors Assessment Form 

Problem or Issue: 

Precursor & Its Markers 

None (0) 

Trace (1) 

Small (2) 

Adequate (3) 

Abundant (4) 

1. Sense of Necessity 


 Expresses desire for change 

 Feels a sense of urgency 

 

 

 

 

 

2. Willing for Anxiety 


 Openness to experience 

 Likely to take risks 

 

 

 

 

 

3. Awareness 


 Able to identify problems 

 Identifies thoughts, feelings 

 

 

 

 

 

4. Confronting the Problem 


 Courageously faces problems 

 Sustained attention to issues 

 

 

 

 

 

5. Effort toward Change 


 Eagerly does homework 

 High energy; active cooperation 

 

 

 

 

 

6. Hope for Change 


 Positive outlook; open to future; 

 High coping; therapeutic humor 

 

 

 

 

 

7. Social Support for Change 


 Wide network of friends, family 

 Many confiding relationships 

 

 

 

 

 

Total Score = 

Scoring Guide* 

0-6: Change unlikely: Educate client on change: Focus on precursors with lowest rating. 

7-14: Change limited or erratic: Educate client and focus on precursors with lowest rating. 

15-21: Change is steady and noticeable: Use the lowest rated precursors to stay on track 

22-28: Highly motivated to inspired client: Change occurs easily: Standard approaches work well. 

*Scoring is intended only as a general guide to a complex process: Some precursors may be more potent. 



References 

Hanna, F. J. (2002). Therapy with difficult clients: Using the precursors model to awaken change. Washington, DC: American 
Psychological Association. 

Hanna, F. J. (1996). Precursors of change: Pivotal points of involvement and resistance in psychotherapy. Journal of 
Psychotherapy Integration, 6(3), 227-264. 

Hanna, F. J. & Richie, M. H. (1995). Seeking the active ingredients of psychotherapeutic change: Within and outside the 
context of therapy. Professional psychology: Research and Practice, 26(2), 176-183. 

Hanna, F. J., Giordano F, Dupuy, P., & Puhakka, K. (1995) Agency and transcendence: The experience of therapeutic change. 
The Humanistic Psychologist, 23(2), 139-160 

Hanna, F. J., & Puhakka, K. (1991). When psychotherapy works: Pinpointing an element of change. Psychotherapy, 28(4), 
598-607.