The University of Rhode Island Change Assessment Scale, or URICA, is a self report measure that is used to assess an individual’s readiness to change when entering addiction treatment. An individual’s level of motivation for change and the information they reveal in the URICA can be used to guide treatment options.
The University of Rhode Island Change Assessment Scale test is made up of 32 questions eliciting information about how a person may feel when entering therapy. Responding to the questions is done in a scale format and is based on how the respondent is feeling at that point in time. A therapist is able to interpret the answers of the questionnaire and determine what areas may need work, what level of treatment may be required and also at what stage of the problem the individual is at. It has four sub-scales that measure the stages of change; Pre-contemplation, contemplation, action and maintenance.
Assessing an individual’s motivation for seeking help for their alcoholism is helpful for therapists and health professionals to develop an accurate understanding of the problem. It can assist in the development of an appropriate and relevant treatment plan as it indicates the reason a person has entered into treatment.
There are a number of different reasons that people enter treatment centers for their alcohol and drug problems. For some, it may be because of health concerns, a court order, personal reasons or family ultimatums. These different motivations have a significant impact on treatment and outcomes. If someone has a low motivational level and does not see the importance of changing their behavior, they may require treatment that is motivational and educational. Individuals who have high motivation may need therapies that focus on behavior change or coping skills.
The University of Rhode Island Change Assessment Scale was developed in conjunction with the development of the Transtheoretical Model of Behavior Change. The transtheoretical model is an assessment of a person’s willingness to change. It provides strategies and processes that can guide a person through significant life changes, such as when an alcoholic stops drinking.
Dr. James Prochaska from the University of Rhode Island developed this theory in the 1970’s and it has been a popular model of heath and psychological care since. The key principles to the transtheoretical model is the stages of change which are the same stages that are assessed in the University of Rhode Island Change Assessment Scale. These stages are considered predictors for behaviour for treatment.
The stages of change for the transtheoretical model have been integrated into the URICA test. These stages are important for therapists and health care workers to develop a clear understanding of the motivations behind someone entering therapy. The transtheoretical model has 6 stages of change, but only four of these have been used for the test: precontemplation, contemplation, action and maintenance.
Precontemplation is the first level in the stages of change and also in the URICA test. It is defined as the stage where an individual is not intending to make any changes or take action in the foreseeable future. They do not see their behaviour or drinking as a problem. They are often in denial that their drinking or drug use is affecting not only themselves but those around them, nor do they consider there to be any negative consequences.
Contemplation is the second stage. Individuals are considering that their drinking or drug use behavior is causing problems. They may be contemplating the costs of continuing to drinking, and thinking about how they may go about reducing their drinking or getting help.
Action is the stage where someone has made significant changes to their lives to overcome their alcoholism or drug addiction. This is the stage many are in when they are in treatment for alcoholism and positive changes have occurred. They have committed to making positive and long lasting changes to their lifestyle and relationships and want to stop drinking.
Maintenance is the last stage and usually the longest. It is the stage whereby someone has made changes to their lifestyle and behavior and wish to maintain their alcohol-free life. This is where skills are needed to prevent a relapse and complacency is at its highest. An individual needs to be aware that a relapse is definitely possible and to get support when they need it most.
The motivation for treatment is critical for therapists and can be the difference between success and failure in treating alcoholism and drug addiction. It also will define an individual’s willingness to set goals, identify intentions, their attitude and changes in activities. Research has found that assessing a person’s willingness to change is not just important for medical professionals, however. It also gives an individual a self-evaluation of what they see as the problem, the severity, their attitude towards treatment and an acknowledgment they they need to take responsibility for their behavior and problem drinking and drug use.
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