University of Rhode Island                                                                  Client ID#_________________

Change Assessment Scale (URICA) :                                               Date: ______/______/______

Drug Version                                                                                      Assessment Point:  _____________

                                                                       

 

EACH STATEMENT BELOW DESCRIBES A HOW A PERSON MIGHT FEEL WHEN STARTING THERAPY OR APPROACHING Problems IN THEIR LIVES.  Please indicate the extent to which YOU TEND to agree or disagree with each statement.  In each case, make your choice in terms of how you feel riGHt now, not what you have felt in the past or would like to feel.  For all statements that refer to your “problem”, answer in terms of problems related to your illegal drug use.   The words “here” and “this place” refer to your treatment center.

 

There are five possible responses to each of the items in the questionnaire:

 

1=Strongly Disagree

2=Disagree

3=Undecided

4=Agree

5=Strongly Agree

 

Circle the number that best describes how much you agree or disagree with each statement.

 

 

Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

1)      As far as I’m concerned, I don’t have any problems that need changing.

1

2

3

4

5

2)      I think I might be ready for some self-improvement.

 

1

2

3

4

5

3)      I am doing something about the problems that had been bothering me.

 

1

2

3

4

5

4)      It might be worthwhile to work on my problem.

1

2

3

4

5

5)      I’m not the problem one. It doesn’t make much sense for me to consider changing.

 

1

2

3

4

5

6)      It worries me that I might slip back on a problem I have already changed, so I am looking for help.

 

1

2

3

4

5

7)      I am finally doing some work on my problem.

1

2

3

4

5

8)      I’ve been thinking that I might want to change something about myself.

1

2

3

4

5

9)      I have been successful in working on my problem but I’m not sure I can keep up the effort on my own.

1

2

3

4

5


 

 

Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

10)  At times my problem is difficult, but I’m working on it.

 

1

2

3

4

5

11)  Trying to change is pretty much a waste of time for me because the problem doesn’t have to do with me.

 

1

2

3

4

5

12)  I’m hoping that I will be able to understand myself better.

 

1

2

3

4

5

13)  I guess I have faults, but there’s nothing that I really need to change.

 

1

2

3

4

5

14)  I am really working hard to change.

 

1

2

3

4

5

15)  I have a problem and I really think I should work on it.

1

2

3

4

5

16)  I’m not following though with what I had already changed as well as I had hoped, and I want to prevent a relapse of the problem.

 

1

2

3

4

5

17)  Even though I’m not always successful in changing, I am at least working on my problem.

 

1

2

3

4

5

18)  I thought once I had resolved the problem I would be free of it, but sometimes I still find myself struggling with it.

 

1

2

3

4

5

19)  I wish I had more ideas on how to solve my problem.

 

1

2

3

4

5

20)  I have started working on my problem but I would like help.

 

1

2

3

4

5

21)  Maybe someone or something will be able to help me.

 

1

2

3

4

5

22)  I may need a boost right now to help me maintain the changes I’ve already made.

 

1

2

3

4

5

23)  I may be part of the problem, but I don’t really think I am.

1

2

3

4

5

24)  I hope that someone will have some good advice for me.

1

2

3

4

5


 

 

Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

25)  Anyone can talk about changing; I’m actually doing something about it.

1

2

3

4

5

26)  All this talk about psychology is boring.  Why can’t people just forget about their problems?

 

1

2

3

4

5

27)  I’m struggling to prevent myself from having a relapse of my problem.

1

2

3

4

5

28)  It is frustrating, but I feel I might be having a recurrence of a problem I thought I had resolved.

 

1

2

3

4

5

29)  I have worries but so does the next guy. Why spend time thinking about them?

 

1

2

3

4

5

30)  I am actively working on my problem.

1

2

3

4

5

31)  I would rather cope with my faults than try to change them.

1

2

3

4

5

32)  After all I had done to try and change my problem, every now and then it comes back to haunt me.

1

2

3

4

5

 


 

(24-Item Version)

 

 

 

 

University of Rhode Island                                                                  Client ID#_________________

Change Assessment Scale (URICA) :                                               Date: ______/______/______

Drug Version                                                                                      Assessment Point:  _____________

                                                                       

EACH STATEMENT BELOW DESCRIBES A HOW A PERSON MIGHT FEEL WHEN STARTING THERAPY OR APPROACHING Problems IN THEIR LIVES.  Please indicate the extent to which YOU TEND to agree or disagree with each statement.  In each case, make your choice in terms of how you feel riGHt now, not what you have felt in the past or would like to feel.  For all statements that refer to your “problem”, answer in terms of problems related to your illegal drug use.   The words “here” and “this place” refer to your treatment center.

 

There are five possible responses to each of the items in the questionnaire:

 

1=Strongly Disagree

2=Disagree

3=Undecided

4=Agree

5=Strongly Agree

 

Circle the number that best describes how much you agree or disagree with each statement.

 

 

Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

1)      I’m not the problem one. It doesn’t make much sense for me to consider changing.

 

1

2

3

4

5

2)      I am finally doing some work on my problem.

1

2

3

4

5

3)      I’ve been thinking that I might want to change something about myself.

1

2

3

4

5

4)      At times my problem is difficult, but I’m working on it.

 

1

2

3

4

5

5)      Trying to change is pretty much a waste of time for me because the problem doesn’t have to do with me.

 

1

2

3

4

5

6)      I’m hoping that I will be able to understand myself better.

 

1

2

3

4

5

7)      I guess I have faults, but there’s nothing that I really need to change.

 

1

2

3

4

5

8)      I am really working hard to change.

 

1

2

3

4

5

9)      I have a problem and I really think I should work on it.

1

2

3

4

5

10)  I’m not following though with what I had already changed as well as I had hoped, and I want to prevent a relapse of the problem.

 

1

2

3

4

5


 

 

Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

11)  Even though I’m not always successful in changing, I am at least working on my problem.

 

1

2

3

4

5

12)  I thought once I had resolved the problem I would be free of it, but sometimes I still find myself struggling with it.

 

1

2

3

4

5

13)  I wish I had more ideas on how to solve my problem.

 

1

2

3

4

5

14)  Maybe someone or something will be able to help me.

 

1

2

3

4

5

15)  I may need a boost right now to help me maintain the changes I’ve already made.

 

1

2

3

4

5

16)  I may be part of the problem, but I don’t really think I am.

1

2

3

4

5

17)  I hope that someone will have some good advice for me.

1

2

3

4

5

18)  Anyone can talk about changing; I’m actually doing something about it.

1

2

3

4

5

19)  All this talk about psychology is boring.  Why can’t people just forget about their problems?

 

1

2

3

4

5

20)  I’m struggling to prevent myself from having a relapse of my problem.

1

2

3

4

5

21)  It is frustrating, but I feel I might be having a recurrence of a problem I thought I had resolved.

 

1

2

3

4

5

22)  I have worries but so does the next guy. Why spend time thinking about them?

 

1

2

3

4

5

23)  I am actively working on my problem.

1

2

3

4

5

24)  After all I had done to try and change my problem, every now and then it comes back to haunt me.

1

2

3

4

5