Processes of Change Questionnaire

Drug Abstinence Self-efficacy Scale Client ID#_________________

Date: ______/______/______

Assessment Point: _____________

Listed below are a number of situations that lead some people to use illegal drugs. We would like to know how Confident you are that you would not use illegal drugs in each situation.

circle the number that best describes your feelings of confidence to not use illegal drugs in each situation during the past week according to the following scale:

1=Not at all confident

2=Not very confident

3=Moderately confident

4=Very confident

5=Extremely confident

Situation	Confident not to use illegal drugs
	Not at all	Not very	Moderately	Very	Extremely
1) When I am in agony because of stopping or withdrawing from drug use.	1	2	3	4	5
2) When I have a headache.	1	2	3	4	5
3) When I am feeling depressed.	1	2	3	4	5
4) When I am on vacation and want to relax.	1	2	3	4	5
5) When I am concerned about someone.	1	2	3	4	5
6) When I am worried.	1	2	3	4	5
7) When I have the urge to use drugs to see what happens.	1	2	3	4	5
8) When I am being offered drugs in a social situation.	1	2	3	4	5
9) When I dream about using drugs.	1	2	3	4	5
10) When I want to test my will power over using drugs.	1	2	3	4	5

Situation	Confident not to use illegal drugs
	Not at all	Not very	Moderately	Very	Extremely
11) When I am feeling a physical need or craving for drugs.	1	2	3	4	5
12) When I am physically tired.	1	2	3	4	5
13) When I am experiencing some physical pain or injury.	1	2	3	4	5
14) When I feel like blowing up because of frustration.	1	2	3	4	5
15) When I see others using drugs at a bar or a party.	1	2	3	4	5
16) When I sense everything is going wrong for me.	1	2	3	4	5
17) When people I used to use drugs with encourage me to use drugs.	1	2	3	4	5
18) When I am feeling angry inside.	1	2	3	4	5
19) When I experience an urge or impulse to use drugs that catches me unprepared.	1	2	3	4	5
20) When I am excited or celebrating with others.	1	2	3	4	5

(12-Item Version)