In rehabilitation, we often measure what a person can do. Their functional capacity, cognitive skills, concentration, tolerance, and endurance are assessed carefully and documented thoroughly. Yet many clinicians will recognise the familiar scenario: someone appears to have the capacity to progress, but progress stalls. This disconnect is not always about ability. More often, it reflects something different altogether: readiness.
Understanding the difference
Capacity refers to a person’s functional ability. It includes physical capability, cognitive functioning, psychological stability, and practical skills. It is what we typically measure through assessments, clinical observations, and standardised tools.
Readiness, on the other hand, relates to a person’s psychological and emotional willingness to engage in change. It reflects motivation, confidence, beliefs about recovery, emotional processing, and a sense of safety in moving forward.
A person can have high capacity and low readiness at the same time. They may be technically able to return to work, participate in therapy, or build new routines, yet remain stuck due to fear, grief, loss of identity, low self-efficacy, or unresolved emotional barriers.
Why readiness matters in rehabilitation
Decades of behavioural science research highlight that sustainable change is not driven by ability alone. Several well-established frameworks support this understanding:
The Transtheoretical Model of Change (Prochaska & DiClemente) describes behaviour change as a staged process (precontemplation, contemplation, preparation, action, maintenance). This model reminds us that interventions need to match a person’s stage of readiness, not just their functional profile.
Self-efficacy theory (Bandura) demonstrates that people’s belief in their ability to succeed strongly influences whether they initiate and persist with behaviours. In rehabilitation, confidence often predicts engagement just as much as capability.
Motivational Interviewing (Miller & Rollnick) provides practical strategies for strengthening internal motivation and resolving ambivalence, rather than attempting to persuade or direct behaviour change.
Together, these approaches reinforce a consistent message: sustainable outcomes require psychological engagement, not just clinical clearance.
What this looks like in practice
Consider a worker recovering from psychological injury who presents with improved concentration, stable mood, and supportive medical guidance for a graded return to work. On paper, their capacity aligns with progression. Yet attendance becomes inconsistent. Tasks are avoided. Communication decreases.
When explored more deeply, the barrier may not be skill-based. It may be fear of re-injury, unresolved conflict, loss of confidence, or a belief that returning means invalidating their experience. Until these factors are addressed, progress is likely to remain fragile, even if capacity remains intact.
Shifting practice to include readiness
- Supporting readiness does not replace clinical work. It complements it.
- Some practical approaches include:
- Beginning sessions with brief emotional and motivational check-ins, not only task reviews
- Exploring beliefs about recovery and work, rather than assuming alignment
- Matching interventions to the person’s stage of change
- Building self-efficacy through achievable goals and visible progress
- Using collaborative language that supports autonomy and ownership
- These are small shifts, but they often lead to greater engagement, stronger therapeutic alliances, and more sustainable outcomes.
A more holistic approach to rehabilitation
Modern rehabilitation is increasingly recognising that outcomes are shaped by the interaction between function, psychology, environment, and meaning. Progress is rarely linear, and genuine recovery involves more than meeting functional benchmarks.
When clinicians make space for both capacity and readiness, rehabilitation becomes less about compliance and more about collaboration. This is where meaningful, lasting change tends to occur.
How ELEV8 Consulting approaches this in practice
At ELEV8 Consulting, we intentionally integrate psychological readiness into our rehabilitation framework rather than treating it as an afterthought. Our programs and service delivery models are designed to support not only functional recovery, but also confidence, autonomy, identity, and long-term sustainability.
Through structured psychosocial programs such as RenewYou, Clear Path, and Thrive & Flourish, alongside evidence-informed rehabilitation planning, we support individuals to:
Strengthen self-efficacy and psychological resources
Develop insight into barriers impacting engagement
Build realistic, meaningful goals aligned with their values
Transition back to work in a way that feels safe and sustainable
This integrated approach allows rehabilitation to move beyond short-term functional outcomes toward genuine long-term recovery and workforce participation.
Key references
Prochaska, J O, & DiClemente, C C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioural change. Psychological Review.
Miller, W R, & Rollnick, S. (2012). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.
Safe Work Australia. (2022–2024). Managing psychosocial hazards at work – Code of Practice and supporting guidance.
