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CMRS Scales for Substance Abuse Treatment

User Information

Acronym:

CMR

Author/Developer / Address:

George DeLeon
Center for Therapeutic Community Research (CTCR).
2 World Trade Center, 16th Fl.
New York,
NY 10048.
Phone: 1 212 845 4400
Fax: 1 212 845 4698

Publication dates:

1993, October 1998 revision.

Description / Type of Assessment:

CMR is an 18-item self administered questionnaire.

Primary use / Purpose:

CMR is designed to measure motivation and readiness for treatment and to predict retention in treatment among abusers of illicit drugs.

Domains measured / Life Areas / Problems Assessed:

The instrument consists of four factor derived scales:Circumstances 1 (external influences to enter or remain in treatment, Circumstances 2 (internal influences to leave treatment), Motivation (internal recognition of the need to change). Readiness for treatment.

Population:

Adult and adolescent illicit drug misusers in treatment. In the event that respondents are non literate, the instrument can be read to the respondent.

Administration / Completion Time:

Most clients complete the CMR in less than 10 minutes.

Scoring Procedures:

CMR consists of 18 Likert type items. The respondents uses a 5-point scale to rate each statement from strongly disagree to strongly agree. Items may also be scored as Not Applicable. Circumstances 1 consists of items 1-3. Circumstances 2 consists of items 4-6. Motivation consists of questions 7-11 and Readiness consists of items 12-18. Scoring involves reversing the score values for questions 4, 5, 6 and 12 (scores of 5=1, 4=2, 3=3, 2=4, and 1=5). The individual score values of each scale are then summed to derive the scale values. The scale values are then summed to derive the Total Score. Not Applicable responses are recoded to the client's mean score for its scale.

Scoring Time:

Approximately 5 minutes to sum the scores and compare scores to reference scores for the agency.

Credentials/Training:

There are not special credentials necessary for the administration of the CMR. The major functions of the test administrator is to answer any questions concerning the purpose of the testing, explain the instructions and check the completed instrument.

Source of Psychometrics:

George DeLeon & Gerald Melnick. (Se address above).

Languages:

English and Spanish.

Availability / Inquiries:

George DeLeon / Gerald Melnick.Center for Therapeutic Community Research (CTCR).
2 World Trade Center, 16th Fl.
New York,
NY 10048.
Phone: 1 212 845 4400
Fax: 1 212 845 4698.
E-mail: gerry.melnick@ndri.org

Price:

There are no costs for the use of the CMR.

Practicability / usefulness:

CMR can be used as an intake device, clinical treatment planning tool, and research instrument. CMR is a useful instrument in the identification of client risk for early drop-out in different treatment modalities, specially for residential therapeutic communities.

Comments:

The authors request the users of CMR being informed about findings using the instrument, so they can update their database and improve the range of comparative data available for clinicians and researchers. Users can contact George DeLeon or Gerald Melnick about advice or help in using the instruments or analyzing the results. CMR must be used as appears (complete). If modifications are necessary, the user can consult with the authors about potential changes in the items. The authors ask the CMR not be used as an item pool from which to select a more limited number of items.

Relevant Studies
Circumstances, motivation, readiness and suitability (The CMRS Scales)
DeLeon, G., Melnick, G., Kressel, D., Jainchill, N. Circumstances, motivation, readiness and suitability (The CMRS Scales): Predicting retention in therapeutic community treatment. American Journal of Drug and Alcohol Abuse, 20(4), 495-515, (1994).

Based upon clinical considerations, scales were developed measuring client perceptions across four interrelated domains: circumstances (external pressures), motivation (internal pressures), readiness and suitability (CMRS) for residential TC treatment. The paper reports findings on the reliability of the CMRS and its validity as a predictor of retention in TC treatment in three cohorts of consecutive admissions to a long-term residential TC. Discriminant and factor analysis confirm the face validity of the original four rationale scales. Scores distribute into four groups, with most scores in the moderately low to moderately high range. Two cross-validation studies confirm the internal consistency of the scales, and a linear relationship between the separate and total CMRS scores and short-term retention in all three cohorts and long-term retention in two cohorts. The study provides impressive support on the reliability and validity of the CMRS scales as predictors of retention in long-term TCs. Although still experimental, awaiting replicational studies and firm conclusions concerning generalizability, the CMRS holds considerable promise for research, theory and practice.

Motivation and readiness for therapeutic community treatment among cocaine and other drug abusers
DeLeon, G., Melnick, G., Kressel, D. Motivation and readiness for therapeutic community treatment among cocaine and other drug abusers. American Journal of Drug and Alcohol Abuse, 23(2), 169-189, (1997).

In the present study, the CMRS scales are used to assess motivation and readiness for treatment of a large sample of primary alcohol, marijuana, heroin, cocaine and crack cocaine abusers admitted to a long-term therapeutic community. Findings show few significant differences in overall retention or initial motivation and readiness. Initial motivation and readiness scores persist as significant predictors of short-term retention in treatment across most groups. The findings are consistent with prior research emphasising the importance of dynamic factors as determinants of retention.

Is the therapeutic community culturally relevant?
DeLeon, G., Melnick, G., Schoket, D., Jainchill, N. Is the therapeutic community culturally relevant?. Findings on race/ethnic differences in retention in treatment. Journal of Psychoactive Drugs, 25(1), 77-86, (1993).

This paper briefly reviews pertinent research and present findings from recent studies on race/ethnic differences in readiness and suitability for, and retention in, TC treatment.

The main instrument used for the study was the CMRS scales. Measures of client perceptions (CMRS levels) were strong correlates of 30-day retention in treatment for the different cultural/ethnic groups, but there were some race/ethnic interactions: the relationships between CMRS scores and 30-day retention in treatment was most stable among Blacks and least stable among Hispanics. One-year retention was related less to initial CMRS scores or to race7ethnic differences, although Blacks tended to maintain their higher retention rates and a more stable relationship between CMRS and retention. Among the low and high scores on the S scale, Hispanics yielded the poorest one-year retention.

A framework is outlined for the empirical study of cultural relevance issues in TCs.

Motivation and readiness for therapeutic community treatment among adolescent and adult substance abusers.
Melnick, G., DeLeon, G., Hawke, J., Jainchill, N., Kresell, D. Motivation and readiness for therapeutic community treatment among adolescent and adult substance abusers. American Journal of Drug and Alcohol Abuse, 23(4), 485-507, (1997).

The study reports findings from a large scale research of motivation and readiness differences among adolescents treated in residential therapeutic communities for illicit substance misusers. Data were collected with an instrument assessing circumstances, motivation , readiness and suitability for TC treatment (i.e., CMRS). The CMRS scores were the largest and most consistent predictors of short term across all age groups. Although confined to TC treatment samples, the findings support clinical observations about the importance of motivation and readiness factors in the treatment process, regardless of age.

Page last updated: Wednesday, 14 July 2004