EACH STATEMENT BELOW DESCRIBES A HOW A PERSON MIGHT FEEL WHEN STARTING THERAPY OR APPROACHING PROBLEMS IN THEIR LIVES. PLEASE INDICATE THE EXTENT TO WHICH YOU TEND TO AGREE OR DISAGREE WITH EACH STATEMENT. IN EACH CASE, MAKE YOUR CHOICE IN TERMS OF HOW YOU FEEL RIGHT NOW, NOT WHAT YOU HAVE FELT IN THE PAST OR WOULD LIKE TO FEEL. FOR ALL STATEMENTS THAT REFER TO YOUR “PROBLEM”, ANSWER IN TERMS OF PROBLEMS RELATED TO YOUR DRINKING. THE WORDS “HERE” AND “THIS PLACE” REFER TO YOUR TREATMENT CENTER.
THERE ARE FIVE POSSIBLE RESPONSES TO EACH OF THE ITEMS IN THE QUESTIONNAIRE:
1=Strongly Disagree
2=Disagree
3=Undecided
4=Agree
5=Strongly Agree