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A Cognitive-Behavioral Approach: Treating Cocaine Addiction



Exhibit 14: CBT Rating Scale

Study Subject Date
     

Site Therapist Week Session
       

Please complete the following based on this session:

  1. What session topic(s) was covered this week?

    Introduction to treatment and CBT
    Coping with craving
    Shoring up motivation and commitment to stop
    Refusal skills/assertiveness
    Seemingly irrelevant decisions
    All-purpose coping skills
    problem solving skills
    Case management
    HIV risk reduction
    Spouse/significant other session
    Termination

  2. Did a significant other attend the session?

    Yes [Circle: spouse/partner, parent, sibling, friend, other]
    No

    Key Items: Circle number that applies

  3. To what extent did the therapist discuss any high-risk situations the patient encountered since the last session and explore and coping skills used?

    1
    2
    3
    4
    5
    6
    7
    no
    discussion
    a little
    discussion
    some
    discussion
    considerable
    discussion
    extensive
    discussion

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  4. To what extent did the therapist attempt to teach, model, rehearse, review, or discuss specific skills (e.g. drug refusal, coping with craving, problem solving skills)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent

    4A. Approximately how many minutes of this session were devoted to discussion of the scheduled manual topic? _____ minutes

  5. To what extent did the therapist encourage the patient to anticipate any high-risk situations that might be encountered before the next session and formulate appropriate coping strategies for such situations?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  6. To what extent did the therapist assess the patient's use of cocaine or other substances since the last session?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  7. Asessment of general functioning: To what extent did the therapist assess the patient's general level of functioning in major life spheres (e.g. work, intimate relationships, family life, social life)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  8. Task assignment: Did the therapist develop one or more specific assignments for the patient to engage in between sessions?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  9. To what extent did the therapist review the patient's reactions to the last session's assignment, explore or address any difficulties encountered in carrying out the assignment, or provide a rationale for homework, or reinforce the importance of extra-session practice of skills?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  10. Did the patient do the last session's homework?

    No, no attempt made
    Some attempt made
    Practice exercise completed adequately
    N/A, not assigned
  11. Structure of session: To what extent did the therapist follow the 20/20/20 rule?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  12. To what extent did the therapist discuss or address the patient's current commitment to abstinence?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  13. To what extent did the therapist discuss, review, or reformulate the patient's goals for treatment?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  14. To what extent did the therapist encourage the patient to make a commitment to change cocaine use?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  15. Eliciting patient concerns about cocaine use: To what extent did the therapist encourage the patient to explore the positive and negative consequences of cocaine use?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  16. Ambivalence: To what extent did the therapist attempt to focus on the patient's ambivalence about changing the level of cocaine use?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  17. To what extent did the therapist ask the patient to monitor, report, or evaluate specific cognitions associated with cocaine use or related problems?

    1
    2
    3
    4
    5
    6
    7
    no
    discussion
    a little
    discussion
    some
    discussion
    considerable
    discussion
    extensive
    discussion

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  18. To what extent did the therapist apply problem solving strategy to a problem/issue raised during the session (this can include psychosocial problems other than cocaine use, as in the case management module)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  19. Did the therapist role-play during this session?

    No
    Yes
  20. To what extent did the therapist attempt to identify, assess, or prioritize psychosocial problems other than cocaine and other substance abuse?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  21. To what extent did the therapist attempt to develop a support plan with the patient?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  22. Consistency of problem focus: To what extent did the therapist attempt to keep the session focused on prescribed activities (e.g., by redirecting dialog when it strayed off tasks, by organizing the session so defined tasks were covered)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  23. Agenda setting: To what extent did the therapist articulate and maintain an explicit agenda for the session?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  24. Continuity/reference to past sessions: To what extent did the therapist refer to material discussed or experiences of past sessions as a means of building continuity across sessions (e.g., by stressing rehearsal and repetition as a means of mastering problems, buiding on past lessons)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  25. Reflective listening: To what extent did the therapist communicate understanding of the patient's comments and concerns?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  26. Empathy: To what degree did the therapist respond empathically to the patient (e.g., through a non-judgmental stance, showing genuine warmth and concern, helping the patient feel accepted in the relationship)?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  27. Family support: To what extent did the therapist inquire about or discuss the availability and nature of family or social support for the patient's involvement in treatment or efforts to become abstinent?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent
  28. Termination: To what extent did the therapist discuss the termination of the therapy (e.g., encourage the patient to discuss feelings or thoughts about termination, discuss plans for further treatment?

    1
    2
    3
    4
    5
    6
    7
    not at all a little somewhat considerably extensively

    Skill:

    1
    2
    3
    4
    5
    6
    7
    not done poor fair adequate very good excellent

Copyright Carroll 1997.

 

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