University of Rhode Island Change Assessment Scale (URICA) – Alcohol Version

Abstract

The University of Rhode Island Change Assessment Scale (URICA) – Alcohol Version is a specialized psychometric instrument designed to measure an individual’s readiness and motivation to change problematic behaviors related to alcohol use. It operationalizes the core components of the Transtheoretical Model (TTM), developed by Prochaska and DiClemente, by assessing where a person falls among the four key stages of change: Precontemplation, Contemplation, Action, and Maintenance. The scale is widely used in clinical settings, particularly in substance abuse treatment, to tailor interventions to the client’s current motivational stage, thereby optimizing therapeutic effectiveness.

Keywords

University of Rhode Island Change Assessment Scale, URICA, Transtheoretical Model, TTM, Stages of Change, Alcohol Use Disorder, Substance Abuse, Motivation to Change, Precontemplation, Contemplation, Action, Maintenance

Authors

Carlo C. DiClemente, James O. Prochaska, Wayne F. Velicer, and colleagues

Purpose

The primary purpose of the URICA – Alcohol Version is to provide a quantitative assessment of an individual’s readiness for change regarding their alcohol consumption patterns. By locating the client within one of the four stages of the Transtheoretical Model, clinicians can select appropriate intervention strategies. For instance, an individual in the Precontemplation stage requires consciousness-raising, while someone in the Action stage needs behavioral management strategies.

The scale serves as a crucial tool for research and clinical practice in addiction treatment, allowing for the measurement of movement through the stages of change over time, which is predictive of treatment retention and outcome success in addressing alcohol use disorder.

Construct

The URICA measures the core dimensions of the Transtheoretical Model (TTM), which posits that intentional behavior change occurs through a sequence of discrete, time-ordered stages. These four stages are represented as distinct subscales within the URICA:

• Precontemplation: Characterized by the individual having no intention to change behavior in the foreseeable future (usually defined as the next six months). They are often unaware or under-aware of their problem (e.g., alcohol use).
• Contemplation: The individual is aware a problem exists and is seriously considering overcoming it but has not yet committed to taking action. This stage is marked by ambivalence.
• Action: The individual modifies their behavior, experiences, or environment to overcome their problems. This stage typically lasts around six months and requires significant commitment of time and energy.
• Maintenance: The individual works to prevent relapse and consolidate the gains achieved during the Action stage. This stage is sustained over a longer period, typically six months to five years.

Validity

The validity of the URICA is supported by its strong theoretical grounding in the TTM and its capacity to differentiate motivational profiles predictive of treatment outcomes. Studies have consistently shown that URICA subscale scores correlate logically with various measures of psychological functioning and treatment engagement.

For instance, research by Carbonari and DiClemente (2000) demonstrated that TTM profiles derived from the URICA could effectively differentiate levels of alcohol abstinence success, supporting its criterion validity. Furthermore, the scale’s ability to distinguish between individuals seeking different levels of care (outpatient vs. aftercare) and those with co-occurring disorders (Pantalon et al., 2002) highlights its utility and clinical relevance, suggesting strong predictive and construct validity within the context of addiction treatment.

Reliability

The URICA demonstrates acceptable to strong internal consistency across its various versions and subscales, as measured by Cronbach’s alpha coefficients reported in multiple validation studies:

• Studies (Carney & Kivlahan, 1995; Carbonari & DiClemente, 2000) generally reported alpha coefficients ranging from .68 to .85 across the four subscales.
• Specific reliability data for the 4 subscales across different populations include:
  • DiClemente et al. (1990): Precontemplation (.69); Contemplation (.75); Action (.82); Maintenance (.80).
  • Carbonari et al. (1994, Outpatient/Aftercare): Precontemplation (.75/.74); Contemplation (.81/.79); Action (.83/.82); Maintenance (.86/.74).
  • Project DELTA (Reduced Drinking Version): Precontemplation (.66); Contemplation (.73); Action (.74); Maintenance (.81).

These coefficients indicate that the items within each stage subscale consistently measure the intended construct, providing reliable measurement of motivational readiness.

Factor Analysis

Factor analysis of the URICA consistently supports a four-factor structure corresponding directly to the four stages of change defined by the Transtheoretical Model (Precontemplation, Contemplation, Action, and Maintenance). These factors are typically derived using principal components analysis or confirmatory factor analysis, confirming the theoretical model underlying the instrument.

The factor structure ensures that the scale items load appropriately onto their respective theoretical stage, confirming that the URICA is measuring four distinct, yet related, dimensions of readiness to change problem drinking behavior. The consistency of this factor structure across diverse clinical populations reinforces the scale’s fundamental construct validity.

Instrument

Test Type: Self-report questionnaire / Motivational assessment scale

Format: Likert scale responses

Language Available: Primarily English (translations may exist for general URICA versions)

Population Group: Individuals presenting with problematic alcohol use or Alcohol Use Disorder.

Age Group: Typically adults and adolescents seeking treatment for substance use.

Population Details: Used across various clinical settings including outpatient treatment, inpatient rehabilitation, and aftercare programs for alcoholism and polysubstance abuse.

Test Methodology: Respondents rate each item on a 5-point scale based on their level of agreement:

1. Strongly Disagree
2. Disagree
3. Undecided
4. Agree
5. Strongly Agree

Keywords

Addiction Psychology, Clinical Assessment, Readiness to Change, Alcoholism Treatment, Intervention Matching, URICA 28, URICA 24, Project DELTA

Authors

Author ORCID Identifier: N/A (Information not provided in source)

Affiliation Email addresses: N/A (Information not provided in source)

Correspondence Address: N/A (Information not provided in source)

Permissions & Fee and Test Year

The original URICA scale was developed in the 1980s based on TTM research conducted by Prochaska and DiClemente (1983). The instrument and further information can typically be found through the researchers’ official academic pages. The instrument can be found at: http://habitslab.umbc.edu/urica/

Reference’s

• DiClemente, C.C. and Hughes, S.O. (1990). Stages of change profiles in outpatient alcoholism treatment. Journal of Substance Abuse, 2, 217-235.
• Carbonari, J.P., DiClemente, C.C., and Zweben, A. (1994, November). A readiness to change measure. Paper presented at the meeting of the Association for Behavioral and Cognitive Therapies, San Diego, CA.
• Carney, M.M. and Kivlahan, D.R. (1995). Motivational subtypes among veterans seeking substance abuse treatment: Profiles based on stages of change. Psychology of Addictive Behaviors, 9, 135-142.
• Levesque, D.A., Gelles, R.J., & Velicer, W.F. (2000). Development and validation of a stages of change measure for men in batterer treatment. Cognitive Therapy and Research, 24(2), 175-199.
• Carbonari, J.P. and DiClemente, C.C. (2000). Using theoretical model profiles to differentiate levels of alcohol abstinence success. Journal of Consulting and Clinical Psychology, 68, 810-817.
• Grencavage, L.M. (2001). Demand-withdraw couple interaction, disease-model beliefs, and readiness to change problem drinking. Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 61(8-B), Feb 2001. pp. 4406.
• Pantalon, M.V., Nich, C., Frankforter, T., and Carroll, K.M. (2002). The URICA as a measure of motivation to change among treatment-seeking individuals with concurrent alcohol and cocaine problems. Psychology of Addictive Behaviors, 16, 299-307.
• DiClemente, C.C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addiction treatment. American Journal on Addictions, 13(2), 103-119.
• DiClemente, C.C. (2005). Conceptual models and applied research: The ongoing contribution of the Transtheoretical Model. Journal of Addictions Nursing, 16(1&2), 5-12.
• Soderstrom, C.A., DiClemente, C.C., Dischinger, P.C., Hebel, J.R., McDuff, D.R., Auman, K.M., Kufera, J.A. (2007). A Controlled Trial of Brief Intervention Versus Brief Advice for At-Risk Drinking Trauma Center Patients. Journal of Trauma-Injury Infection & Critical Care, 62(5), 1102-1112.

Items of the University of Rhode Island Change Assessment Scale (URICA) – Alcohol Version

Alcohol Version 28 items

1. As far as I’m concerned‚ I don’t have any problems that need changing.
2. I think I might be ready for some self-improvement.
3. I am doing something about the problems that had been bothering me.
4. I’m not the problem one. It doesn’t make much sense for me to consider changing.
5. It worries me that I might slip back on a problem I have already changed‚ so I am looking for help.
6. I am finally doing some work on my problem.
7. I’ve been thinking that I might want to change something about myself.
8. At times my problem is difficult‚ but I’m working on it.
9. Trying to change is pretty much a waste of time for me because the problem doesn’t have to do with me
10. I’m hoping that I will be able to understand myself better.
11. I guess I have faults‚ but there’s nothing that I really need to change.
12. I am really working hard to change.
13. I have a problem and I really think I should work on it.
14. I’m not following through with what I had already changed as well as I had hoped‚ and I want to prevent a relapse of the problem.
15. Even though I’m not always successful in changing‚ I am at least working on my problem.
16. I thought once I had resolved the problem I would be free of it‚ but sometimes I still find myself struggling with it.
17. I wish I had more ideas on how to solve my problem.
18. Maybe someone or something will be able to help me.
19. I may need a boost right now to help me maintain the changes I’ve already made.
20. I may be part of the problem‚ but I don’t really think I am.
21. I hope that someone will have some good advice for me.
22. Anyone can talk about changing; I’m actually doing something about it.
23. All this talk about psychology is boring. Why can’t people just forget about their problems?
24. I’m struggling to prevent myself from ha‎ving a relapse of my problem.
25. It is frustrating‚ but I feel I might be ha‎ving a recurrence of a problem I thought I had resolved.
26. I have worries but so does the next guy. Why spend time thinking about them?
27. I am actively working on my problem.
28. After all I had done to try and change my problem‚ every now and then it comes back to haunt me.

URICA 28 Item Versions Subscale Mapping:

• Precontemplation: 1‚ 4‚ 9‚ 11‚ 20‚ 23‚ 26
• Contemplation: 2‚ 7‚ 10‚ 13‚ 17‚ 18‚ 21
• Action: 3‚ 6‚ 8‚ 12‚ 22‚ 27
• Maintenance: 5‚ 14‚ 16‚ 19‚ 24‚ 25‚ 28

Alcohol Version 24 items

1. I’m not the problem one. It doesn’t make much sense for me to consider changing.
2. I am finally doing some work on my problem.
3. I’ve been thinking that I might want to change something about myself.
4. At times my problem is difficult‚ but I’m working on it.
5. Trying to change is pretty much a waste of time for me because the problem doesn’t have to do with me.
6. I’m hoping that I will be able to understand myself better.
7. I guess I have faults‚ but there’s nothing that I really need to change.
8. I am really working hard to change.
9. I have a problem and I really think I should work on it.
10. I’m not following through with what I had already changed as well as I had hoped‚ and I want to prevent a relapse of the problem.
11. Even though I’m not always successful in changing‚ I am at least working on my problem.
12. I thought once I had resolved the problem I would be free of it‚ but sometimes I still find myself struggling with it.
13. I wish I had more ideas on how to solve my problem.
14. Maybe someone or something will be able to help me.
15. I may need a boost right now to help me maintain the changes I’ve already made.
16. I may be part of the problem‚ but I don’t really think I am.
17. I hope that someone will have some good advice for me.
18. Anyone can talk about changing; I’m actually doing something about it.
19. All this talk about psychology is boring. Why can’t people just forget about their problems?
20. I’m struggling to prevent myself from ha‎ving a relapse of my problem.
21. It is frustrating‚ but I feel I might be ha‎ving a recurrence of a problem I thought I had resolved.
22. I have worries but so does the next guy. Why spend time thinking about them?
23. I am actively working on my problem.
24. After all I had done to try and change my problem‚ every now and then it comes back to haunt me.

URICA 24 Item Versions Subscale Mapping:

• Precontemplation: 1‚ 5‚ 7‚ 16‚ 19‚ 22
• Contemplation: 3‚ 6‚ 9‚ 13‚ 14‚ 17
• Action: 2‚ 4‚ 8‚ 11‚ 18‚ 23
• Maintenance: 10‚ 12‚ 15‚ 20‚ 21‚ 24

DELTA Project Reduced Drinking Version (RICA 12 Item Version)

1. It doesn’t make much sense for me to consider changing my drinking.
2. I’ve been thinking that I might want to change something about my drinking.
3. At times my drinking causes problems and I’m determined to change.
4. It is frustrating‚ but I feel I might be ha‎ving a recurrence of a drinking problem I thought I had resolved.
5. Trying to change my drinking is pretty much a waste of time for me.
6. I guess I have faults‚ but there’s nothing that I really need to change about my drinking.
7. I thought once I had resolved my problem drinking I would be free of it‚ but sometimes I still find myself struggling with it.
8. I may have a problem with drinking and I think I should work on it.
9. I am really working hard to change my drinking.
10. I hope that someone will have some good advice for me about my drinking.
11. Anyone can talk about changing the way they drink; I’m actually going to do something about it.
12. After all I had done to try and change my problem drinking‚ every now and then it comes back to haunt me.

RICA 12 Item Version—DELTA Project Reduced Drinking Subscale Mapping:

• Precontemplation: 1‚ 5‚ 6
• Contemplation: 2‚ 8‚ 10
• Action: 3‚ 9‚ 11
• Maintenance: 4‚ 7‚ 12