Professional Documents
Culture Documents
CENTERFORTHERAPEUTICCOMMUNITYRESEARCH
CIRCUMSTANCES,MOTIVATION,andREADINESS
SCALESforSUBSTANCEABUSETREATMENT
CMRFACTORSCALES
IntakeVersion
CLIENTIDNUMBER...........................................(___/___/___/___/___/___/___/___) (18)
CLIENTGENDER...................................................................................................(___) (9)
1=Male 2=Female
CLIENTETHNICITY..............................................................................................(___) (10)
1=AfricanAmerican 2=Hispanic 3=White 4=Other
CLIENTAGE....................................................................................................(___/___) (1112)
PRIMARYDRUG.............................................................................................(___/___) (1314)
1=Noncrackcocaine 5=Alcohol
2=Crack 6=PolyDrug
3=Opiates 8=Other
4=Marijuana
TREATMENTMODALITY.............................................................................(___/___) (1516)
1=DrugFreeOutpatient 7=NoTreatmentEntered
2=DayTreatment 8=DetoxificationOnly
3=MethadoneMaintenance 9=DetoxificationasEntryintoTreatment
4=BriefResidential(03months)10=HospitalInpatient
5=ShortTermResidential(4to6months)11=ReferralCenter
6=LongTermResidential(Morethan6months)12=Other
DATEOFADMINISTRATION..........................................(___/___/___/___/___/___) (1722)
FORCTCRUSEONLY.PLEASELEAVEBLANK.
Copyright1993byGeorgeDeLeon,Ph.D.,Director,CenterforTherapeutic
CommunityResearch(CTCR)atNDRI,Inc.,71West23rdStreet,8thFl.,NewYork,NY
10010.Allrightsreserved.Nopartofthismaterialmaybereproducedinanyformof
printingorbyanyothermean,electronicormechanical,includingbutnotlimitedto
photocopying,audiovisualrecordingandtransmission,andportrayalorduplicationinany
informationstorageandretrievalsystem,withoutpermissioninwritingfromtheauthor.
INSTRUMENTVERSION......................................................................................(___) (23)
PROGRAMNUMBER.....................................................................................(___/___) (2425)
October26,1998Revision
Copyright1993byGeorgeDeLeon,Ph.D.,Director,CenterforTherapeutic
CommunityResearch(CTCR)atNDRI,Inc.,71West23rdStreet,8thFl.,NewYork,NY
10010.Allrightsreserved.Nopartofthismaterialmaybereproducedinanyformof
printingorbyanyothermean,electronicormechanical,includingbutnotlimitedto
photocopying,audiovisualrecordingandtransmission,andportrayalorduplicationinany
informationstorageandretrievalsystem,withoutpermissioninwritingfromtheauthor.
Howyoufeelcanhaveapowerfuleffectontreatment.Thesefeelingsincludeyourcircumstances,the
problems inyourlife, yourfeelings aboutyourself,andyourfeelings abouttreatment. Carefully
considereachofthequestionsbelowandindicatehowcloselytheydescribeyourownthoughtsand
feelings.
Circlethenumberthatbestdescribesyourresponse.
1 2 3 4 5 9
Strongly Disagree Neither Agree Strongly Not
Disagree AgreeorDisagree Agree Applicable
2
11. Itismoreimportanttomethananythingelse 123459 ___ (36)
thatIstopusingdrugs.
3
1 2 3 4 5 9
Strongly Disagree Neither Agree Strongly Not
Disagree AgreeorDisagree Agree Applicable
4
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