Assessing the Validity of the Stages of Change Readiness and Treatment Eagerness Scale With Treatment-Seeking Military Service Members

Authors
Mitchell, D. Angelone, D. J.
Publication year
2006
Citation Title
Assessing the validity of the Stages of Change Readiness and Treatment Eagerness Scale with treatment-seeking military service members.
Journal Name
Military Medicine
Journal Volume
171
Issue Number
9
Page Numbers
900-904
DOI
10.7205/MILMED.171.9.900
Summary
Three hundred and seventy-six Active Duty officers and enlisted Service members completed questionnaires to assess the concurrent and predictive validity of the Stages of Change Readiness and Treatment Eagerness Scale for Military Service members undergoing substance abuse treatment compared to the established Addiction Treatment Attitude Questionnaire. All three subscales of the Stages of Change Readiness and Treatment Eagerness Scale were predictive of various treatment outcomes. In addition, a significant correlation existed between the two scales, indicating support for the validity of the Stages of Change Readiness and Treatment Eagerness Scale with military Service members seeking treatment for substance abuse.
Key Findings
Each of the Addiction Treatment Attitude Questionnaire subscales was significantly correlated with each of the corresponding Stages of Change Readiness and Treatment Eagerness Scale subscales. Large effect sizes were found between subscales, (Powerlessness and Recognition, Commitment to Abstinence and Recognition, and Disease Attribution and Taking Steps).
Both age and the Recognition and Ambivalence subscales of the Stages of Change Readiness and Treatment Eagerness Scale were significant predictors of the Service member's length of treatment; the Taking Steps subscale was not a significant predictor of length of treatment.
Neither the Recognition or Taking Steps subscales were predictors of treatment completion.
Implications for Program Leaders
Develop educational modules about alcohol and drug use that describe the readiness to change concept
Provide education to families (e.g., classes, information on websites) about substance abuse and the treatment process
Disseminate information regarding the resources and services available to Service members and their families coping with substance use issues
Implications for Policy Makers
Recommend training for professionals on the risks of alcohol and drug use in Service members
Continue to support a range of programs for Service members dealing with substance abuse issues, including evidence-informed programs that may be more comfortable for some personnel than traditional programs
Encourage collaboration between DoD and community-based programs working with Service members struggling with substance abuse
Methods
Upon admission to the treatment program, participants completed versions of the Stages of Change Readiness and Treatment Eagerness Scale and the Addiction Treatment Attitude Questionnaire customized for the primary presenting problem (alcohol or drug/s).
The Stages of Change Readiness and Treatment Eagerness Scale measure consists of three factors: Recognition, Ambivalence, and Taking Steps. The Addiction Treatment Attitude Questionnaire has three subscales: Powerlessness, Commitment to Abstinence, and Disease Attribution.
Validity was assessed by testing correlations between the Stages of Change Readiness and Treatment Eagerness Scale and the Addiction Treatment Attitude Questionnaire and predicting length of stay in/completion of the program.
Participants
Sample included 357 Active Duty officers and enlisted military Service members from all branches, stationed both domestically and abroad. All had been diagnosed with alcohol and/or drug dependence and admitted to a 4-week substance abuse treatment program.
Participants were 88% male; age range was between 18-52 years old, mean age = 25.9 years (SD = 6.7).
The racial composition of the sample was: 73% White, 9% Black, 7% mixed, 6% Latino/a, 4% Native American, 1% Asian-American.
Limitations
All interpretations relied on self-report measures, with no clinician rating or comparable non-self-report measures of participants’ progress.
Length of stay and treatment completion variables may not be closely related to readiness to change.
Completion of treatment was assessed by a dichotomous variable, which restricts the range of variability and may not measure participants’ true success or progress toward freedom from dependency.
Avenues for Future Research
Examine how these assessment instruments might enhance treatment by identifying possible interventions appropriate for the identified stage of change
Test how readiness-to-change measures relate to longer term goals such as sobriety or career success
Continue to examine substance use issues within the military
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
1 Star - There are several factors that limit the ability to extend the results to a population and therefore the results can only be extended to a very specific subset of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
The purpose of this project was to assess the concurrent and predictive validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) for military service members undergoing substance abuse treatment. Concurrent validity was assessed by examining the correlation of SOCRATES subscales with subscales from the Addiction Treatment Attitude Questionnaire. Predictive validity was assessed by examining the ability of SOCRATES subscales to predict length of stay in treatment and successful completion of treatment. Scores on the SOCRATES were correlated in the expected direction with scores on the Addiction Treatment Attitude Questionnaire and predicted length of stay in treatment and successful completion of treatment. The findings provide support for the validity of the SOCRATES with substance abuse treatment-seeking military service members.
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