Drug-Taking Confidence Questionnaire for Alcohol (DTCQ-8A)
Recommended frequency: Every 4 weeks
With respect to addictive behaviours, an important component of self-efficacy is a person’s perception of his or her ability to resist alcohol or drugs. The Drug-Taking Confidence Questionnaire (DTCQ-8) measures the client’s confidence in his or her abilities to cope in situations that are high-risk for substance use. The tool yields information about client strengths and needs in the area of relapse potential.
The tool allows for exploration of a client’s relapse potential by not only identifying potential high-risk situations for that person, but also by exploring his or her level of confidence in being able to cope with a particular high-risk situation.
The DTCQ-8 was developed to be a reliable and valid brief measure of coping self-efficacy for substance users to serve the needs of clinicians and researchers who desire a global measure of a client’s confidence across high-risk situations (Sklar & Turner, 1999). The tool’s eight questions each capture one of the high-risk situations identified by Marlatt and Gordon in 1985. The DTCQ-8 has separate questionnaires, one for alcohol use, and one for other drug use.
The Eight Categories:
The eight high-risk situations that Marlatt and Gordon identified (1985) as high-risk for relapse fall into two major classes of situations: (i) personal states; and (ii) situations involving other people.
The category “personal states” refers to internal states, both physical and emotional (thoughts and feelings). It includes five situations:
- Unpleasant emotions.
- Physical discomfort.
- Pleasant emotions.
- Testing personal control.
- Urges and temptations.
The other category, “Situations involving other people,” refers to challenging situations that involve others:
- Conflict with others.
- Social pressure to drink.
- Pleasant times with others.
The DTCQ-8 was developed out of the DTCQ, an original 50 item measure (Annis & Martin, 1985), which has strong evidence for the situation-specificity of efficacy beliefs. An 8-factor model was developed in 1997 by Sklar and Turner. All eight subscales of the DTCQ-8 were shown to have good reliability (alphas .79 to .95). Extensive convergent and discriminant validity analyses for the DTCQ-8 and its subscales in relation to ADS, DAST, OES, DRIE, SCQ, SCL-90R, BDI, HS, and SOCRATES substantiate that the DTCQ-8 is a promising tool for clinical application and further research.
How to Use the Tool
High self-efficacy is related to positive outcomes. The more confident someone is that she can cope with a high-risk situation, the more likely she will succeed in avoiding relapse and additional consequences. In fact, improved self-efficacy is a positive outcome of treatment.
This tool gives the clinician an opportunity to discuss the client’s individualized risk of relapse. Many clients have never connected a relapse or risk of relapse with a particular situation or set of circumstances. They believe the relapse “just happened.” For many clients, the value of this tool is that they can now see that in some situations they are relatively safe, while in other situations they are at much greater risk to use.
The tool is also particularly helpful to the clinician, especially in working with clients who have not developed the skill of analyzing their thoughts, feelings and behaviour. With this tool, not only can clinicians identify a personalized profile of high-risk situations for the individual client, but can also record the client’s level of confidence in each risk situation. The questionnaire yields rich clinical information about the risk of relapse that the counsellor can then discuss with the client.
I would be able to resist the urge to drink heavily:
Each item, representing a “situation”, is scored from 0 to 100. Remember that a higher score means more confidence for the client. Thus, high scores (80 and above) indicate that the client believes he can cope in these situations. Low scores (0 to 20) indicate that the client believes that the situation would likely put him at risk of relapse. A global self-efficacy score can be calculated by taking the average of all of the situations.
Annis, H.M. & Martin, G. (1985). Drug-Taking Confidence Questionnaire. Toronto, Canada: Addiction Research Foundation, CAMH.