CM-EA TAM Form

Contingency Management for Emerging Adults-Therapist Adherence Measure - Please check off one response (Never, Rarely, Often, Almost Always) that best answers the question about the work you and the CM-EA provider have worked on together. Some questions may not apply to you at this time so you will be able to skip those questions. Please follow the instructions in the survey for skipping questions.

Month(Required)

Client ID(Required)

Provider Name(Required)

1. My provider explained what an ABC Assessment is and why it is used.(Required)

Never / Not Yet

Rarely

Often

Almost Always

2. My provider helped me think of relapses as "learning opportunities" rather than "failures."(Required)

Never / Not Yet

Rarely

Often

Almost Always

3. My provider talked with me about situations that might cause or "trigger" me to use drugs.(Required)

Never / Not Yet

Rarely

Often

Almost Always

4. My provider conducted an ABC Assessment of my drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

5. In the ABC Assessment, my provider made sure that "Behaviors" included things I did to obtain drugs.(Required)

Never / Not Yet

Rarely

Often

Almost Always

6. In the ABC Assessment, my provider made sure that "Consequences" included both the positive and negative consequences of my drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

7. My provider made sure that I completed an ABC Assessment on my own.(Required)

Never / Not Yet

Rarely

Often

Almost Always

8. My provider used a contract that focused on stopping drug use in exchange for rewards.(Required)

Never / Not Yet

Rarely

Often

Almost Always

9. My provider identified my Most Valued Privilege (that is, a privilege that I would work really hard to get).(Required)

Never / Not Yet

Rarely

Often

Almost Always

10. My provider worked with me to identify rewards for myself(Required)

Never / Not Yet

Rarely

Often

Almost Always

11. My provider made sure that rewards included a balance between vouchers (such as gift cards) that my provider provided and privileges that I, or my social network, provided.(Required)

Never / Not Yet

Rarely

Often

Almost Always

12. My provider made sure that any rewards I could earn or that would be withheld would motivate me to stop using drugs.(Required)

Never / Not Yet

Rarely

Often

Almost Always

13. My provider helped me focus on rewarding abstinence rather than focusing on punishment for drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

14. My provider used a tracking system, to track my draws from the Fishbowl.(Required)

Never / Not Yet

Rarely

Often

Almost Always

15. My provider tested me for drug use using a drug screen.(Required)

Never / Not Yet

Rarely

Often

Almost Always

16. My provider made sure that I, or my support person, tested me for drug use using a drug screen.(Required)

Never / Not Yet

Rarely

Often

Almost Always

17. My provider made sure that an ABC Assessment was completed after each drug screen, regardless of whether the result was positive or negative.(Required)

Never / Not Yet

Rarely

Often

Almost Always

18. My provider made sure that I could access or withhold the Most Valued Privilege based on my drug screen results.(Required)

Never / Not Yet

Rarely

Often

Almost Always

19. My provider made sure that positive or negative consequences were given based on the results of my drug screen.(Required)

Never / Not Yet

Rarely

Often

Almost Always

20. My provider made sure the drug screens were administered frequently enough to catch drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

21. My provider made sure the drug screens were administered randomly (at times I was not expecting it).(Required)

Never / Not Yet

Rarely

Often

Almost Always

22. My provider made sure that drug screens were administered at times when I was more likely to use drugs.(Required)

Never / Not Yet

Rarely

Often

Almost Always

23. My provider worked with me on a Self-Management Plan regarding my drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

25. My provider made sure that my Self-Management Plan was based on information I had provided in ABC Assessments.(Required)

Never / Not Yet

Rarely

Often

Almost Always

26. My provider helped me think of ways to rearrange my environment to help me avoid situations that might cause or "trigger" drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

27. My provider helped me think of ways to avoid situations that might cause or "trigger" drug use.(Required)

Never / Not Yet

Rarely

Often

Almost Always

28. My provider made sure that the drug avoidance strategies were best suited for my unique circumstances, peer group, and personality.(Required)

Never / Not Yet

Rarely

Often

Almost Always

29. My provider helped me think of the costs and benefits of different drug avoidance strategies.(Required)

Never / Not Yet

Rarely

Often

Almost Always

30. My provider helped me practice drug avoidance strategies.(Required)

Never / Not Yet

Rarely

Often

Almost Always

31. My provider helped me think of ways to refuse drugs.(Required)

Never / Not Yet

Rarely

Often

Almost Always

32. My provider made sure that the drug refusal strategies were best suited for my unique circumstances, peer group, and personality.(Required)

Never / Not Yet

Rarely

Often

Almost Always

33. My provider helped me think of the costs and benefits of different drug refusal strategies.(Required)

Never / Not Yet

Rarely

Often

Almost Always

34. My provider helped me child practice drug refusal strategies.(Required)

Never / Not Yet

Rarely

Often

Almost Always

Provider Login

ARENA, Training for Evidence-Based Programs

Quick Links