Title : Stages of change and recovery engagement: Evidence from URICA assessments in residential treatment
Abstract:
Substance use recovery among adolescents and emerging adults is a dynamic process that involves changes in motivation, behavior, and the ability to sustain recovery over time. This study utilized the URICA (University of Rhode Island Change Assessment) tool to examine readiness for change and recovery maintenance among youth participating in Intensive Residential Treatment (IRT) programs in Georgia. Data was collected from adolescents and emerging adults receiving treatment across multiple IRT sites and included baseline, reassessment, discharge, and post-discharge URICA measures. Baseline analyses focused on readiness for change classifications, while follow-up analyses examined Action and Maintenance subscale scores to better understand engagement in recovery and challenges sustaining behavioral change.
Findings indicated that many youth entered treatment in early stages of change, with a substantial proportion demonstrating precontemplation or contemplation level readiness at intake. Over time, participants generally showed increased Action scores, suggesting greater engagement in recovery-oriented behaviors. However, Maintenance scores remained elevated for many youth, indicating continued difficulty sustaining recovery and avoiding relapse-related thoughts or behaviors. Site-level variation also emerged, highlighting potential differences in treatment engagement and recovery progression across programs.
These findings demonstrate the value of URICA as a practical assessment tool for understanding motivation, recovery readiness, and sustained behavioral change among adolescents and emerging adults in residential substance use treatment settings. Incorporating stage-of-change assessments into program evaluation may help providers tailor interventions, identify youth needing additional recovery supports, and improve long-term treatment outcomes.
