The purpose of this 18 month proposal is to develop and refine a clinical/research instrument for assessing client readiness for entering an remaining in substance abuse treatment. The project will complete a rigorous psychometric revision of an existing instrument, measuring four domains. Circumstances, Motivation, Readiness and Suitability for treatmen (ie., the CMRS). An adolescent and an adult version of the revised CMRS-R will be developed along with manuals containing information on administration, scoring and psychometric data necessary for proper evaluation. The revision will be completed through secondary analyses of a existing data set collected on approximately 2000 consecutive admissions to a large urban traditional Therapeutic Community in New York. This data set includes the original CMRS scales along with an extensive array of socio- demographic, psychological, psychiatric and treatment progress measures. There are 3 specific aims:
Aim 1. Item analyses: Separate-item analyses of the CMRS will be carried ou for the 457 adolescent and 559 adult clients in Cohort 1 (1984-85 admissions) and separate instruments developed for the adolescent and adult subsamples.
Aim 2. Cross Validation: A cross-validation study will be base upon the 455 adolescent and 500 adult cases in Cohort 2 (1986-87 admissions to confirm the stability of the revised CMRS-R. It will include confirmatory factor analyses and predictive validity studies to determine the correlation between the revised CMRS-R, retention, and treatment progress.
Aim 3 Generalizability: Several studies will examine the validity and generalizability of the CMRS-R for substance abusers in different settings and treatment modalities. These studies will involve smaller samples of drug abusers on whom original CMRS data have been collected in different investigations. The final phase of the project will be to assemble brief manuals for implementation of the revised CMRS-R. The present project is the first of a series of planned efforts by the investigative team to illuminate the contribution of dynamic client factors (such as motivation and readiness) to retention, treatment process, client- treatment matching, recovery status and outcomes. Specifically it will yield the data and prototype for assessing changes in readiness through treatment and for studies in other subpopulations and settings.
|Melnick, Gerald; Hawke, Josephine; De Leon, George (2014) Motivation and readiness for drug treatment: differences by modality and special populations. J Addict Dis 33:134-47|
|De Leon, G; Melnick, G; Kressel, D et al. (1994) Circumstances, motivation, readiness, and suitability (the CMRS scales): predicting retention in therapeutic community treatment. Am J Drug Alcohol Abuse 20:495-515|