Readiness To Change Questionnaire-Alcoholism


Readiness To Change Questionnaire-Alcoholism
National Library of Medicine (NLM): Readiness To Change Questionnaire

The following questionnaire is designed to identify how you personally feel about your drinking right now. Please think about your current situation and drinking habits, even if you have given up drinking completely. Read each question below carefully, and then decide to what extent you agree or disagree with the statements



SD-Strongly Disagree  D-Disagree  U-Unsure  A-Agree  SA-Strongly Agree

1. 

There is no need for me to change my drinking habits. 

_____ 

_____

_____

_____

_____

 

2.

I enjoy my drinking, but sometimes I drink too much.

_____

_____

_____

_____

_____

 

3.

I have reached the stage where I should seriously think about giving up or drinking less alcohol.

_____

_____

_____

_____

_____

 

4.

I am trying to stop drinking or drink less than I used to.

_____

_____

_____

_____

_____

 

5.

I was drinking too much at one time, but now I've managed to cut down (or stop) my drinking.

_____

_____

_____

_____

_____

 

6.

It's a waste of time thinking about my drinking because I do not have a problem.

_____

_____

_____

_____

_____

 

7.

Sometimes I think I should quit or cut down on my drinking.

_____

_____

_____

_____

_____

 

8.

I have decided to do something about my drinking.

_____

_____

_____

_____

_____

 

9.

I know that my drinking has caused problems, and I'm now trying to correct this.

_____

_____

_____

_____

_____

 

10.

I have changed my drinking habits (either cut down or quit), and I'm trying to keep it that way.

_____

_____

_____

_____

_____

 

11.

There is nothing seriously wrong with my drinking.

_____

_____

_____

_____

_____

 

12.

My drinking is a problem sometimes.

_____

_____

_____

_____

_____

 

13.

I'm preparing to change my drinking habits (either cut down or give up completely).

_____

_____

_____

_____

_____

 

14.

Anyone can talk about wanting to do something about their drinking, but I am actually doing something about it.

_____

_____

_____

_____

_____

 

15.

It is important for me to hold onto the changes I've made, now that I've cut down (or quit) drinking.

_____

_____

_____

_____

_____

 

16.

I am a fairly normal drinker.

_____

_____

_____

_____

_____

 

17.

I am weighing up the advantages and disadvantages of my present drinking habits.

_____

_____

_____

_____

_____

 

18.

I have made a plan to stop or cut down drinking, and I intend to put this plan into practice.

_____

_____

_____

_____

 

Post Discussion

  1. Addict

    I work in a treatment agency and am interested in using this questionnaire in a treatment group. How do I go about receiving permission for such?
    607-762-3292

  2. Addict

    Hi Andrea,

    I know this is really late, but just incase no one else has replied to your request, go to the following link:

    http://afcrossroads.com/websites/corc_docs/SG_Toolkit/Bucket3/Readiness_to_Change_Questionnaire_Info.pdf

    There you will find details of the copyright status of the RTCQ and who to contact ( I think its Nick Heather) for permission. Although, as there is no charge for using it, I expect you would only need to cite the author when you use it.

    Good luck

    Jay

  3. Addict

    Thanks, Jay - I appreciate your response.

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