| RPT |
.| .| Stages of Change Readiness and Treatment Eagerness Scale - 8A| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| |
problem drinker.| <*Answer_6893*>| 8. I'm not just thinking about changing my drinking, I'm already doing something about it.| <*Answer_6894*>| 9. I have already changed
my drinking, and I am looking for ways to keep from slipping| back to my old pattern.| <*Answer_6895*>| 10. I have serious problems with drinking.| <*Answer_6896*>|
11. Sometimes I wonder if I am in control of my drinking.| <*Answer_6897*>| 12. My drinking is causing a lot of harm.| <*Answer_6898*>| 13. I am actively doing things now
to cut down or stop drinking.| <*Answer_6899*>| 14. I want help to keep from going back to the drinking problems that I had before.| <*Answer_6900*>| 15. I know that I
have a drinking problem.| <*Answer_6901*>| 16. There are times when I wonder if I drink too much.| <*Answer_6902*>| 17. I am an alcoholic.| <*Answer_6903*>|
18. I am working hard to change my drinking.| <*Answer_6904*>| 19. I have made some changes in my drinking, and I want some help to keep from going back to the way I used to drink.|
<*Answer_6905*>| | | Information contained in this note is based on a self-report assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should
be verified for accuracy and used in conjunction with other diagnostic activities and procedures.| $~
Veteran: <.Patient_Name_Last_First.>| SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | | Guide for interpreting
SOCRATES scores:| | RAW SCORES| Indicator DECILE Recognition Ambivalence Taking Steps| Score Score Score Score |
| Very High 90 19-20 39-40 | 80 18 37-38| High 70 35 17 36|
60 34 16 34-35| Medium 50 32-33 15 33| 40 31 14 31-32| Low 30 29-30
12-13 30| 20 27-28 9-11 26-29| Very Low 10 7-26 4-8 8-25| | <.DLL_String.> | | Questions and
Answers| | 1. I really want to make changes in my drinking.| <*Answer_6887*>| 2. Sometimes I wonder if I am an alcoholic.| <*Answer_6888*>| 3. If I don't change
my drinking soon, my problems are going to get worse.| <*Answer_6889*>| 4. I have already started making some changes in my drinking.| <*Answer_6890*>| 5. I was drinking
too much at one time, but I've managed to change my drinking.| <*Answer_6891*>| 6. Sometimes I wonder if my drinking is hurting other people.| <*Answer_6892*>| 7. I am a
|
