COMPARISON ::: Recovery Scales
scale characteristics and quality framework scores

The scales compared here have different uses. Recovery is a broad concept at the heart of which is the idea of living a normal life. For many people 'normal life' also means a life without psychoactive substances (except perhaps nicotine). Recovery also means a feeling of contentment about a future without psychoactive substances. Recovery is all about achieving positive lifestyle changes for people dealing with an addiction problem. The focus on positive change is reflected in recovery scales.


ARQ ::Β Addiction Recovery QuestionnaireΒ designed for self monitoring, treatment planning and research

The ARQ was developed for use as a measure of recovery in routine clinical practice or self directed change. The ARQ measures recovery as described by service users themselves and provides coverage of the elements with three subscales. There are 12 questions: i) normal living Q1: sufficient money  Q2: trusted  Q3: suitable accommodation Q4: doing daily activities Q5: no criminal activity;  ii) abstinence  Q6: avoid people with substance use problems  Q7: mix with people supportive of recovery  Q8: abstinence Q9: no prescribed psychoactive medications;  iii) positive expectancy  Q10: optimism for future  Q11: self esteem  Q12: self efficacy. Timeframe :: The last 30 days. Scoring :: All items are scored 0-1-2-3 giving a maximum of 36. Up to two unanswered items can be pro-rated by allocating the mean score for the valid responses. Completion time :: <2minutes. Cut-off score :: The scale developers recommend seeing recovery as a continuous data variable and have not suggested cut-off points. A very high score would indicate a lifestyle beyond most people in the general population. No cut-off scores specified

Quality framework score...

  • Completion time βž•
  • Universal βž•
  • Content validity βž•βž•
  • Face validity βž•
  • Internal consistency ?
  • Convergent validity βž•
  • Discriminant validity ?
  • Concurrent validity ?
  • Predictive validity  ?
  • Significant change ?
  • Floor & ceiling effects ?
  • Independent evaluation ?
  • Cross cultural evaluation ?
  • Language checked βž•
  • Use without staff training βž•βž•
  • Copyright & permissions βž•
  • Free to use βž•
  • Interpretability βž•
 

Points to consider...

Features in RESULT My Recovery self completion measures πŸ”΄

Generated by service users and important others

Brief and user friendly

Can replace other assessment and outcome measurement tools


TPS :: Twelve Promises ScaleΒ designed for assessing outcome in 12 step programmes

The Twelve Promises feature prominently in 12-step philosophy and culture and are one of the few documented explications of the cognitive, affective, and behavioural benefits that members might accrue. The scale has 26 items tapping into two factors: psychological wellbeing and absence of craving. In summary the 12 promises are:  i) new freedom and a new happiness ii) no regret of the past iii) to comprehend serenity iv) know peace v) benefit others vi) self pity to disappear vii) take an interest in others viii) stop self-seeking ix) change outlook on life x) become economic insecurity xi) handle situations xii) recognise help from 'God'. Timeframe :: Current. Scoring :: The items are rated according to how true they currently are for respondents from 'never true' (=1) to 'true most of the time' (=5). Three items, Q2 Q6 & Q12, are reversed scored. Completion time :: <2minutes. Cut-off score :: No cut-off scores have been designated. The scale is a means whereby individuals can monitor progress - the higher score the better

Quality framework score...

  • Completion time ?
  • Universal βž•
  • Content validity βž•βž•
  • Face validity βž•
  • Internal consistency βž•
  • Convergent validity ?
  • Discriminant validity ?
  • Concurrent validity  ?
  • Predictive validity  βž•
  • Significant change  ?
  • Floor & ceiling effects  ?
  • Independent evaluation ?
  • Cross cultural evaluation ?
  • Language checked βž•
  • Use without staff training βž•βž•
  • Copyright & permissions βž•
  • Free to use βž•
  • Interpretability βž•
 

Points to consider...

A useful indirect measure of benefits from mutual aid groups

Need not be limited to 12 step groups

Self monitoring with TPS may itself encourage mutual aid

Meaningful to service users


ARC :: Assessment of Recovery CapitalΒ Β designed for detailed treatment planning or research

The ARC measures 10 domains of recovery each comprising five items assessing recovery strengths. The goal in the design process was to create a scale that could capture positive measures of personal and social resources along a continuum that would inform treatment planning. The ten domains are:  i) substance use and sobriety ii) global psychological health iii) global physical health iv) citizenship and community involvement  v) social support vi) meaningful activities vii) housing and safety viii) risk-taking ix) coping and life functioning x) recovery experience. Timeframe :: The day of assessment. Scoring :: The scale is scored by individuals ticking only the boxes for statements that they agree with and that describe their experience - in effect a Yes/No for the 50 statements. Thus a score between 0 and 5 could be reached for each recovery domain. The overall score is calculated by summing the scores for each domain. Completion time :: Not stated. Cut-off score :: A higher Assessment of Recovery Capital score indicates higher recovery capital. No cut-offs have been defined

Quality framework score...

  • Completion time ?
  • Universal βž•
  • Content validity βž•βž•
  • Face validity βž•βž•
  • Internal consistency  ?
  • Convergent validity  βž•βž•
  • Discriminant validity βž•
  • Concurrent validity ?
  • Predictive validity  ?
  • Significant change  ?
  • Floor & ceiling effects  ?
  • Independent evaluation  ?
  • Cross cultural evaluation  ?
  • Language checked  βž•
  • Use without staff training βž•βž•
  • Copyright & permissions βž•
  • Free to use βž•
  • Interpretability βž•
 

Points to consider...

Simple responses to questions but still time consuming

Good psychometric evaluation

Multiple items to assess each domain

Comprehensive coverage of recovery as a concept


LiRS :: Life in Recovery SurveyΒ  designed for detailed surveys of recovery

Based on the experiences of people in recovery and on the available scientific literature, items were selected that reflect events and experiences in key life domains typically affected by active addiction: finances, family, social and civic functioning, physical and mental health, legal status and involvement, and employment/school. A large pool of items representing both positive and negative experiences in each domain was developed; a set of 44 items (37 used in survey) was retained at the end of an iterative process of review by the Faces & Voices’ board of directors and other stakeholders.  Timeframe :: The substantive part of the survey asks about life circumstances while still experiencing an addiction problem and then when in recovery. Scoring :: All items are scored Yes/No (except personal details).  Responses are categorised into time in recovery of <3yrs, 3-10yrs, and >10yrs. Completion time :: approx 10 minutes. Cut-off score :: The scale has been used as a survey tool and results are presented as percent of people endorsing each answer.

Quality framework score...

  • Completion time ?
  • Universal βž•
  • Content validity βž•βž•
  • Face validity βž•
  • Internal consistency ?
  • Convergent validity ?
  • Discriminant validity ?
  • Concurrent validity ?
  • Predictive validity  ?
  • Significant change  ?
  • Floor & ceiling effects  ?
  • Independent evaluation  ?
  • Cross cultural evaluation  ?
  • Language checked ?
  • Use without staff training βž•βž•
  • Copyright & permissions βž•
  • Free to use βž•
  • Interpretability βž•
 

Points to consider...

Designed for surveys rather than individual assessment

Normative data available

Uncomplicated scoring system

Psychometrics weak - validity assumed by item selection method

Β 

RESULT does not have permission to reproduce this scale. Permission has been requested


SATS ::: Substance Abuse Treatment ScaleE designed for assessing stage of treatment

The SATS is a practitioner rated assessment of combing both a motivational state hierarchy and explicit substance use criteria. As the scale is rater scored there is scope for judgement and raters need to be trained. The developers intended a scale that could be applied to people with complex problems, notably multiple diagnoses, and operationally define eight possible states: i) pre-engagement ii) engagement iii) early persuasion iv) late persuasion v) early active treatment vi) late active treatment vii) relapse prevention viii) recovery. The object of this approach is to give the rater the opportunity to collect information from multiple sources - the more complex the case the likely that a number of therapists will be involved. Timeframe :: The last 6 months or if in an institution the 6 months before admission. Scoring :: There is no scoring system, rather, the practitioner assigns their service user to one of the eight states. Completion time :: Not stated. Cut-off score :: The scale is used to designate a motivational and behavioural stage in the treatment process

Quality framework score...

  • Completion time βž•
  • Universal βž•
  • Content validity βž•
  • Face validity ?
  • Internal consistency ?
  • Convergent validity βž•
  • Discriminant validity ?
  • Concurrent validity βž•
  • Predictive validity  ?
  • Significant change  ?
  • Floor & ceiling effects  ?
  • Independent evaluation  ?
  • Cross cultural evaluation  ?
  • Language checked βž•
  • Use without staff training βž•
  • Copyright & permissions βž•
  • Free to use βž•
  • Interpretability βž•
 

Points to consider...

Useful way to demonstrate progress in complex cases

Practitioner rated and requires staff training

The eight states have implications for intervention

Psychometrics weak - need more on inter-rater consistencies