CONSTRUCT-VALIDITY AND PREDICTIVE UTILITY OF THE STAGES OF CHANGE SCALE FOR ALCOHOLICS

Recent theory and research suggest that the process of changing addict ive behaviors may be conceptualized as a stage phenomenon consisting o f precontemplation, contemplation, preparation, action, and maintenanc e stages. Accurately assessing motivation or commitment to change seem s to be a crucial step in matching patients to appropriate interventio ns. Using the University of Rhode Island Change Assessment Scale (URIC A; McConnaughy, Prochaska, & Velicer, 1983), previous research has ide ntified subtypes of outpatient alcoholics based on their attitude towa rd each of the stages of change. Profiles derived for each subtype rou ghly corresponded to one of the specific stages of change. The goals o f this study were to determine if similar groups could be identified f or patients receiving substance abuse treatment in a residential setti ng and to examine whether these groups would differ on other theoretic ally relevant variables. Stage of change scale scores for 141 patients entering an alcohol treatment program at a VA domiciliary were submit ted to a hierarchical cluster analysis. A two-cluster solution appeare d to fit the data best, with group means suggesting the existence of p recontemplation and contemplation/action stage groups in this populati on. The two dusters did not differ on demographic variables, biochemic al markers of alcohol consumption, or self-reported awareness of alcoh ol-related problems. However, participants in the precontemplation clu ster reported being less worried about their use, less receptive to he lp, and having sought out help fewer rimes in the past Participants in the contemplation/action cluster also reported greater symptoms of de pression and anxiety. Preliminary treatment outcome data for each grou p are presented, as well as suggestions for treatment matching. Result s suggest that the URICA can be used to identify clinically meaningful subtypes of treatment seeking alcoholics.