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

Abstract

The University of Rhode Island Change Assessment Scale (URICA) – Drug Version is a specialized psychometric instrument designed to assess an individual’s readiness and motivation to change problematic behaviors, specifically related to substance abuse. Rooted in the Transtheoretical Model (TTM) of change developed by Prochaska and DiClemente, the scale categorizes clients into one of four stages: Precontemplation, Contemplation, Action, or Maintenance. This measure is crucial for clinicians and researchers in addiction treatment settings, allowing for the tailoring of interventions to match the client’s current stage of change, thereby optimizing therapeutic efficacy.

Keywords

URICA, Transtheoretical Model, TTM, Stages of Change, Substance Abuse, Addiction Treatment, Motivation, Readiness to Change, Psychometrics, Drug Use.

Authors

James O. Prochaska, Carlo C. DiClemente, J.P. Carbonari, A. Zweben.

Purpose

The primary purpose of the URICA – Drug Version is to provide a reliable and valid measure of an individual’s stage of readiness for therapeutic intervention regarding drug use behaviors. By quantifying a client’s level of motivation across the four core stages of the TTM, the instrument helps guide treatment planning. For instance, a client scoring high in the Precontemplation stage requires interventions focused on increasing awareness, whereas a client in the Action stage benefits from skill-building and behavioral modification techniques.

Construct

The URICA is constructed based on the Transtheoretical Model (TTM), which posits that intentional behavior change proceeds through a sequence of discrete stages. The scale measures the degree to which an individual endorses statements characteristic of these four stages concerning their drug use problem:

• Precontemplation: The individual has no intention of changing behavior in the foreseeable future (typically defined as the next six months) and is often unaware or under-aware of the problem.
• Contemplation: The individual is aware a problem exists and is seriously thinking about overcoming it but has not yet made a commitment to take action.
• Action: The individual modifies behavior, experiences, or environment in order to overcome the problem. This stage requires considerable commitment of time and energy.
• Maintenance: The individual works to prevent relapse and consolidate the gains achieved during the Action stage.

Validity

The URICA – Drug Version demonstrates strong evidence of construct validity, primarily through its ability to differentiate between individuals at various stages of change as predicted by the TTM. Studies focusing on substance-abusing populations have consistently supported the scale’s theoretical grounding. For example, research has shown that scores on the Action and Maintenance subscales increase significantly as clients progress through treatment, while Precontemplation scores decrease. Furthermore, the scale has shown convergent validity, correlating appropriately with other measures of motivation and treatment engagement among veterans and individuals seeking treatment for concurrent alcohol and cocaine problems (Carney & Kivlahan, 1995; Pantalon et al., 2002).

Reliability

Internal consistency, typically measured using Cronbach’s alpha, has been assessed across various versions of the URICA – Drug Version. The reliability coefficients generally indicate acceptable to good internal consistency for the core TTM stages, although values for the Maintenance stage sometimes dip lower, particularly in shorter versions. Examples of internal consistency reported in the literature include:

• 34-item version (Belding et al., 1996): Precontemplation (.71); Contemplation (.71); Action (.69); Maintenance (.52).
• 12-item version (Rothfleisch et al., 1998): Precontemplation (.55); Contemplation (.62); Action (.84); Maintenance (.35).
• 32-item version (Siegal et al., 2001): Precontemplation (.79); Contemplation (.83); Action (.85); Maintenance (.76).

The 32-item version, as validated by Siegal et al. (2001), generally exhibits the strongest internal consistency across all four subscales, reinforcing its utility in clinical research settings focusing on drug users, particularly crack cocaine users.

Factor Analysis

Factor analytic studies of the URICA consistently aim to confirm the underlying four-factor structure corresponding to the TTM stages (Precontemplation, Contemplation, Action, and Maintenance). Successful factor analysis supports the construct validity, demonstrating that the items group together conceptually as intended. The scale is designed such that items load cleanly onto the stage they are intended to measure, although some cross-loading may occur, especially in shorter versions. The different item versions (32, 28, and 24 items) represent refinements aimed at improving the factor structure and psychometric properties for specific populations, such as those in methadone maintenance or seeking treatment for substance abuse.

Instrument

Test Type: Self-report questionnaire / Psychometric Scale

Format: Multiple versions exist (32, 28, 24 items). Responses are rated on a 5-point Likert scale, where 1=Strongly Disagree, 2=Disagree, 3=Undecided, 4=Agree, and 5=Strongly Agree.

Language Available: Primarily English; translations may exist for research purposes.

Population Group: Individuals struggling with problematic behaviors, specifically those seeking or receiving treatment for drug and alcohol addiction.

Age Group: Adolescents and Adults (typically used with adult populations in substance abuse treatment).

Population Details: Used across diverse substance-abusing populations, including veterans, methadone maintenance patients, and crack cocaine users.

Test Methodology: Quantitative assessment of motivation based on the Transtheoretical Model. Subscale scores reflect the individual’s current stage profile.

Keywords

Psychological Assessment, Drug Treatment, TTM Stages, Motivation Assessment, Prochaska, DiClemente, Psychometrics, Relapse Prevention, Behavioral Change, Addiction.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material. Information regarding the instrument can be found at the Habits Lab website: http://habitslab.umbc.edu/urica/

Permissions & Fee and Test Year

The original URICA scale was developed in the 1980s by Prochaska and DiClemente. Specific drug versions and validations, such as the 1994 paper by Carbonari, DiClemente, and Zweben, mark the development of this specialized instrument. Permissions for use, especially in large-scale commercial or clinical applications, should be sought from the primary authors or the University of Rhode Island.

Reference’s

• 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.
• Belding‚ M.A.‚ Iguchi‚ M.Y.‚ and Lamb‚ R.J. (1996). Stages of change in methadone maintenance: Assessing the convergent validity of two measures. Psychology of Addictive Behaviors‚ 10‚ 157-166.
• Rothfleisch‚ J. (1998). Comparison of two measures of stages of change among drug abusers. Dissertation Abstracts International: Section B: The Sciences and Engineering‚ 59(6-B)‚ Dec 1998. pp. 3073.
• 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.
• Siegal‚ H.A.‚ Li L.‚ Rapp‚ R.C.‚ Saha‚ P. (2001). Measuring readiness for change among crack cocaine users: A descriptive analysis. Substance Use and Misuse‚ 36‚ 687-700.
• 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.

Items of the University of Rhode Island Change Assessment Scale (URICA) -Drug Version

Drug Version 32 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. It might be worthwhile to work on my problem.
5. I’m not the problem one. It doesn’t make much sense for me to consider changing.
6. It worries me that I might slip back on a problem I have already changed‚ so I am looking for help.
7. I am finally doing some work on my problem.
8. I’ve been thinking that I might want to change something about myself.
9. I have been successful in working on my problem but I’m not sure I can keep up the effort on my own.
10. At times my problem is difficult‚ but I’m working on it.
11. Trying to change is pretty much a waste of time for me because the problem doesn’t have to do with me.
12. I’m hoping that I will be able to understand myself better.
13. I guess I have faults‚ but there’s nothing that I really need to change.
14. I am really working hard to change.
15. I have a problem and I really think I should work on it.
16. 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.
17. Even though I’m not always successful in changing‚ I am at least working on my problem.
18. I thought once I had resolved the problem I would be free of it‚ but sometimes I still find myself struggling with it.
19. I wish I had more ideas on how to solve my problem.
20. I have started working on my problem but I would like help.
21. Maybe someone or something will be able to help me.
22. I may need a boost right now to help me maintain the changes I’ve already made.
23. I may be part of the problem‚ but I don’t really think I am.
24. I hope that someone will have some good advice for me.
25. Anyone can talk about changing; I’m actually doing something about it.
26. All this talk about psychology is boring. Why can’t people just forget about their problems?
27. I’m struggling to prevent myself from ha‎ving a relapse of my problem.
28. It is frustrating‚ but I feel I might be ha‎ving a recurrence of a problem I thought I had resolved.
29. I have worries but so does the next guy. Why spend time thinking about them?
30. I am actively working on my problem.
31. I would rather cope with my faults than try to change them.
32. After all I had done to try and change my problem‚ every now and then it comes back to haunt me.

Drug 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 though 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.

Scoring Key for 32 Item Version (1=Strongly Disagree, 5=Strongly Agree)

• Precontemplation: Items 1, 5, 11, 13, 23, 26, 29, 31 (Note: Item 31 is often omitted in certain scoring procedures).
• Contemplation: Items 2, 4, 8, 12, 15, 19, 21, 24 (Note: Item 4 is often omitted in certain scoring procedures).
• Action: Items 3, 7, 10, 14, 17, 20, 25, 30 (Note: Item 20 is often omitted in certain scoring procedures).
• Maintenance: Items 6, 9, 16, 18, 22, 27, 28, 32 (Note: Item 9 is often omitted in certain scoring procedures).

Scoring Key for 24 Item Version

• 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