For people with post-traumatic stress disorder (PTSD), the concept of being 'ready' for trauma-focused therapy (TFT) has emerged from research as an important factor in initiation and completion of therapy. Lack of readiness of individual service users has been proposed as a reason for poor uptake of TFT in large implementation programs. However, there has been almost no investigation of what constitutes readiness for TFT. In this review we build a conceptual case for readiness for TFT. We use qualitative research exploring PTSD treatment service users' and providers' experiences and perspectives of care together with two motivational theories (self-determination theory and motivation to engage in treatment) to propose a model of readiness for TFT. Readiness appears to encompass a) a motivational factor that includes willingness to undertake TFT and b) a set of determinants of motivation that may include the emotional burden of TFT, perceived suitability of TFT rationale
outcome expectancy
level of suffering
perceived competence
therapeutic relationship
autonomy
social supports
stigma
and problem recognition. This review is designed to encourage further research into this important clinical construct. It offers a new perspective on the need for a preparation phase before exposure in TFT, an issue of debate in the field.