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Follow-up Interview

YOURS Follow-up Interview
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Questions marked with an * are required Exit Survey
 
 
* STUDY ID NUMBER
   
 
 
 
* PARTICIPANT INITIALS
   
 
 
 
* INTERVIEWER INITIALS
   
 
 
 
* DATE OF INTERVIEW
MonthDayYear
  
 
 
 
INTERVIEWER INSTRUCTIONS:
1. Sections in a single box are read to Participant by Interviewer.
2. Sections in a double box are instructions for the Interviewer. Do not read these to the Participant.
 
 
 
Interviewer:  We will go through a number of questions today about various topics. Please answer each question as openly and honestly as possible. If you do not feel comfortable giving an answer to a particular question or item, you may skip it and we will move to the next one. You may also end the interview, or take a break at any time. Your answers will never be shared with probation or parole officials, other probationers or parolees, and anyone outside of the study personnel. All of your answers will be kept strictly confidential. For some questions, we will use this RESPONSE CARD. [Provide RESPONSE CARD to participant.] I will show you which option to use when responding to the various questions.

Do you have any questions before we begin?
 
 
 
DEMOGRAPHIC QUESTIONS
 
 
Interviewer: We will first go through some basic questions about your background.
 
 
 
D_01. How old are you? _____(age in years)
   
 
 
 
D_02. Has your marital status changed since your baseline interview?
 
Yes
 
No
 
Refused to answer
 
 
 
D_02a. What is your current marital status?
 
Married
 
Remarried
 
Widowed
 
Separated
 
Divorced
 
Never married
 
Refused to answer
 
 
 
D_03. Are you currently living with your partner?
 
Yes
 
No
 
Refused to answer
 
 
 
D_04. Usual living arrangements since your baseline interview? Choose arrangements most representative of the last 6 months. If there is an even split in time between these arrangements, choose the most recent arrangement. (Choose one)
 
With sexual partner and children
 
With sexual partner alone
 
With children alone
 
With parents
 
With family
 
With friends
 
Alone
 
Controlled environment
 
No stable arrangement
 
Refused to answer
 
 
 
D_07. Do you have any children?
 
Yes
 
No
 
Refused to answer
 
 
 
D_07a. How many children (including biological, step, and adopted) do you have? (99- refused to answer) ____# of children
   
 
 
 
D_07b. How many of them are under the age of 18? (99-refused to answer)
   
 
 
 
D_07c. How many lived with you for the majority of the time since your baseline interview? (99-refused to answer)
   
 
 
 
D_07d. How many received financial support from you for the majority of the time since your baseline interview? (99-refused to answer)
   
 
 
 
D_07e. How many of your children went into foster care since your baseline interview? (99-refused to answer)
   
 
 
D_08 Since your baseline interview, please check any of the following places in which you stated at least one night. Interviewer, if the client reported not staying in place, mark the number of days as zero.
30 days=1 month
60 days= 2 months
90 days=3 months
120 days= 4 months
150 days= 5 months
180 days= 6 months
Stayed at place for at least one night# of days stayed since baseline interview
Homeless (living on the street, in a park, etc.)
Shelter
Transitional (Time-limited) Single Room Occupancy Hotel
Permanent Single Room Occupancy Hotel
HIV/AIDS Housing/ Group Home
Drug Treatment Facility
Other Healthcare Residential Facility or Institution
Staying with family/ friends
Rent an apartment/ house (alone or with others)
In my own home
Jail
Prison
Halfway House
Other (please specify below)
 
 
 
D_08a. Specify other place you have lived since your baseline interview
   
 
 
 
D_09a. Since the time of your baseline interview, did you consider yourself to be homeless?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
 
D_10. What is you current employment status? (Check one)
 
NOT EMPLOYED AND NOT LOOKING FOR WORK
 
NOT EMPLOYED AND LOOKING FOR WORK
 
EMPLOYED 32 HOURS OR MORE A WEEK
 
EMPLOYED PART-TIME (____HRS A WEEK ON AVERAGE)
 
RETIRED
 
DISABLED
 
Other
 
 
 
 
D_11. Are you currently a gang member?
 
Yes
 
No
 
Refused to Answer
 
 
 
D_12.Did anyone abuse you physically since the time of your baseline interview? Caused you physical harm.
 
Yes
 
No
 
Refused to Answer
 
 
 
D_13. Did anyone abuse you sexually since the time of your baseline interview? Forced sexual advances/acts.
 
Yes
 
No
 
Refused to Answer
 
 
 
Progress Rating
 
 
SP_01. On a scale from 1 to 10, how would you rate your overall progress on housing since your baseline interview?
1- Negative 2 3 4 5- About the same 6 7 8 9 10- Positive 99-N/A
Overall progress on housing
 
 
SP_02. On a scale of 1 to 10, how would you rate your progress on obtaining any educational requirements since your baseline interview?
1- Negative 2 3 4 5- About the same 6 7 8 9 10- Positive 99-N/A
Overall progress on educational requirements
 
 
SP_03. On a scale from 1 to 10, how would you rate your progress in dealing with leisure time or recreational activities since your baseline interview?
1- Negative 2 3 4 5- About the same 6 7 8 9 10- Positive 99-N/A
Overall progress on leisure time or recreational activities
 
 
 
ADDICTION SEVERITY INDEX LITE - CF
 
 
Interviewer: Now I’m going to ask you about three potential problem areas: Medical, Employment/Support Status, and Alcohol/Drug, and Family/Social. Remember, all information you tell me is confidential. If you are uncomfortable giving an answer, then tell me you do not want to answer. Please do not give inaccurate information
 
 
 
MEDICAL STATUS
 
 
 
ASI_MS01. How many times in your life have you been hospitalized for medical problems?Interviewer: For ASI_MS01 include O.D.s and D.T.s. Exclude detox, alcohol/drug, psychiatric treatment, and childbirth (if no complications). Enter the number of overnight hospitalizations for medical problems.
   
 
 
 
ASI_MS02. Do you have any chronic medical problems which continue to interfere with your life?

A chronic medical condition is a serious physical condition that requires regular care (i.e., medication, dietary restriction) preventing full advantage of their abilities.
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_MS03. Please specify chronic medical problems
   
 
 
 
ASI_MS04. Are you taking any prescribed medication on a regular basis for a physical problem?

This includes medication prescribed by a MD for medical conditions; not psychiatric medicines. Include medicines prescribed whether or not you are currently taking them.
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_MS04a. Please specify any prescribed medicine.
   
 
 
 
ASI_MS05. Do you receive a pension for a physical disability? Include Workers' compensation, do not include psychiatric disability.
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_MS05a. Please specify pension for a physical disability.
   
 
 
 
ASI_MS06. How many days have you experienced medical problems in the past 30 days? Do not include ailments directly caused by drugs/alcohol. Include flu, colds, etc. Include serious ailments related to drugs/alcohol, which would continue even if the patient were abstinent (e.g., cirrhosis of liver, abscesses from needles, etc.). (99- refused to answer)
 
 
 
ASI_MS07. How troubled or bother have you been by these medical problems in the past 30 days?
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
Refused to answer
 
 
 
ASI_MS08. How important to you now is treatment for these medical problems? Refers to the need for new or additional medical treatment by the patient.
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
Refused to answer
 
 
Interviewer: Is the above information significantly distorted by:
Yes No
ASI_MS10. Patient's misrepresentation?
ASI_MS11. Patient's inability to understand?
 
 
ASI_MS12. MEDICAL Comments
   
 
 
 
PSYCHIATRIC STATUS
 
 
 
PY1. How many times have you been treated for any psychological or emotional problems in a hospital or inpatient setting? (99-Refused to answer)
   
 
 
 
PY2. How many times have you been treated for any psychological or emotional problems as an outpatient or private patient? Do not include substance abuse, employment, or family counseling. Treatment episode = a series of more or less continuous visits or treatment days, not the number of visits or treatment days. Enter diagnosis in comments if known.(99-refused to answer)
   
 
 
 
PY2_s. Diagnosis comments. If none, write Not Applicable.
   
 
 
 
PY3. Do you receive a pension for a psychiatric disability?
 
Yes
 
No
 
Refused to answer
 
 
 
PY4a. In the last 30 days, was there a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced serious depression? Sadness, hopelessness, loss of interest, difficulty with daily functioning.
 
Yes
 
No
 
Refused to answer
 
 
 
PY4b. In your life, was there a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced serious depression? Sadness, hopelessness, loss of interest, difficulty with daily functioning.
 
Yes
 
No
 
Refused to answer
 
 
 
PY5a. In the last 30 days, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced serious anxiety or tension? Uptight, unreasonably worried, inability to feel relaxed
 
Yes
 
No
 
Refused to answer
 
 
 
PY5b. In your life, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced serious anxiety or tension? Uptight, unreasonably worried, inability to feel relaxed
 
Yes
 
No
 
Refused to answer
 
 
 
PY6a. In the last 30 days, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced hallucinations? Saw things/heard voices that others didn't see/hear
 
Yes
 
No
 
Refused to answer
 
 
 
PY6b. In your life, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced hallucinations? Saw things/heard voices that others didn't see/hear
 
Yes
 
No
 
Refused to answer
 
 
 
PY7a. In the last 30 days, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced trouble understanding, concentrating or remembering?
 
Yes
 
No
 
Refused to answer
 
 
 
PY7b. In your life, have you had a significant period of time (that was not a direct result of drug/alcohol use) during which you experienced trouble understanding, concentrating or remembering?
 
Yes
 
No
 
Refused to answer
 
 
 
PY8a. In the last 30 days, have you had a significant period of time during which you experienced trouble controlling violent behavior including episodes or rage or violence? Patient can be under the influence of alcohol/drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
PY8b. In your life, have you had a significant period of time during which you experienced trouble controlling violent behavior including episodes or rage or violence? Patient can be under the influence of alcohol/drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
PY9a. In the last 30 days, have you had a significant period of time during which you experienced serious thoughts of suicide? Patient seriously considered a plan for taking his or her life. Patient can be under the influence of alcohol/drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
The client has indicated they are suicidal. You must cease the interview and contact the appropriate crisis number below.
If in Pittsburgh, PA, then call the re:solve Crisis Network at: 888- 796-8226
If in Baltimore, MD, then call Baltimore Crisis Hotline at 410-433-5175.
 
 
 
PY9b. In your life, have you had a significant period of time during which you experienced serious thoughts of suicide? Patient seriously considered a plan for taking his or her life. Patient can be under the influence of alcohol/drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
PY10a. In the last 30 days, have you attempted suicide? Include actual suicidal gestures or attempts. Patient can be under the influence of alcohol or drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
The client has indicated they are suicidal. You must cease the interview and contact the appropriate crisis number below.
If in Pittsburgh, PA, then call the re:solve Crisis Network at: 888- 796-8226
If in Baltimore, MD, then call Baltimore Crisis Hotline at 410-433-5175
 
 
 
PY10b. In your life, have you attempted suicide? Include actual suicidal gestures or attempts. Patient can be under the influence of alcohol or drugs.
 
Yes
 
No
 
Refused to answer
 
 
 
PY11a. In the last 30 days, have you been prescribed medication for any psychological or emotional problems? Prescribed for the patient by a physician. Record "Yes" if a medication was prescribed even if the patient is not taking it.
 
Yes
 
No
 
Refused to answer
 
 
 
PY11b. In your life, have you been prescribed medication for any psychological or emotional problems? Prescribed for the patient by a physician. Record "Yes" if a medication was prescribed even if the patient is not taking it.
 
Yes
 
No
 
Refused to answer
 
 
 
PY12. How many days in the last 30 days did you experience these psychological or emotional problems? Refers to problems noted in previous questions
 
 
 
PY13. How much were you troubled or bothered by these psychological or emotional problems in the last 30 days? Patient should be rating the problem days from previous question. (Choose one)
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
Refused to answer
 
 
 
PY14. How important to you now is treatment for these psychological problems? (Choose one)
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
Refused to answer
 
 
Interviewer: Is the above information significantly distorted by:
Yes No
PY22. Patient's misrepresentation?
PY23. Patient's inability to understand?
 
 
 
EMPLOYMENT/ SUPPORT STATUS
 
 
ASI_ES01.  Education completed: GED = 12 years, note in comments. Include formal education only.
# Years of education completed# Months of education completed
Number of years and months of education completed
 
 
 
ASI_ES01A. What was the highest grade or level of school you have completed or the highest degree you have received?
 
Middle school (junior high school) or less
 
Some high school, no diploma
 
High school graduate/GED or equivalent
 
Junior (2-Year) College
 
Technical/trade/vocational school
 
Some college (4-year college or university)
 
College graduate (4-year college or university)
 
Don't Know
 
Refused to answer
 
 
 
ASI_ES01B. Did you participate in any GED or any type of vocational/ technical training degree while you were on supervision?
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_ES01C. Have you completed a vocational or technical training program while on supervision?
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_ES01D. Did you complete your GED while on supervision?
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_ES01E. Are you currently working on your GED or any type of vocational/ technical training degree?
 
Yes
 
No
 
Refused to answer
 
 
ASI_ES02. How many months and years of training or technical education have you completed? Formal, organized training only. For military training, only include training that can be used in civilian life (i.e., electronics, computers).
# Months# Years
Number of months and years of training or technical education completed
 
 
 
ASI_ES04. Do you have a valid driver's license? Valid license; not suspended/revoked
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_ES04A. Is your license restricted?
 
Yes
 
No
 
Refused to answer
 
 
 
ASI_ES05. Do you have an automobile available for use? Does not require ownership, only requires availability on a regular basis
 
Yes
 
No
 
Refused to answer
 
 
ASI_ES06. How long was your longest full-time job? Full-time = 35+ hours weekly; does not necessarily mean most recent job.
# Years# Months
Years and Months of longest full-time job
 
 
 
ASI_ES07. Usual (or last) occupation? (Choose one)
 
Higher execs, major professionals, owner of large businesses
 
Business managers of medium sized businesses, or other skilled professional, such as nurses, opticians, pharmacists, social workers, teachers
 
Administrative personnel, managers, minor professionals, owners/proprietors of small businesses (bakery, car dealership, engraving business, plumbing business, florist, decorator, actor, reporter, travel agent)
 
Clerical and sales, technicians, small businesses (bank teller, bookkeeper, clerk, draftsperson, timekeeper, secretary)
 
Skilled Manual- usually having had training (baker, barber, brakeperson, chef, electrician, fireman, machinist, mechanic)
 
Semi-skilled hospital aide, painter, bartender, bus driver, cutter, cook, drill press, waiter
 
Unskilled (attendant, janitor, construction helper, porter, unspecified labor)
 
Homemaker
 
Student, disabled, no occupation
 
Refuse to answer
 
 
 
ASI_ES09. Does someone contribute the majority of your support, eg other household member takes care of bills, or you receive gifts from family members?
 
Yes
 
No
 
Refuse to answer
 
 
 
ASI_ES10. Usual employment patter, past 3 years? 

Answer should represent the majority of the last 3 years, not just the most recent selection. If there are equal times for more than one category, select that which best represents the current situation. (Choose one)
 
Full time (35+ hours)
 
Part time (regular hours)
 
Part time (irregular hours)
 
Student
 
Military Service
 
Retired/Disability
 
Unemployed
 
In controlled environment (has been continuously in prison)
 
Refuse to answer
 
 
 
ASI_ES11. How many days were you paid for working in the last 30 days? Include "under-the-table" work, paid sick days, and vacation
 
 
 
ASI_ES11A. How many days, weeks, or months, were you paid for working since your baseline interview? Include "under-the-table" work, paid sick days, and vacation.

# of days paid for working since the baseline interview
 
 
# of weeks paid for working since the baseline interview
 
 
# of months paid for working since the baseline interview
 
 
How much money did you receive from the following sources in the last 30 days and since the time of your baseline interview?
Last 30 days Since your baseline interview
ASI_ES12. Employment Net or "take home" pay, include any "under the table" money
ASI_ES13. Unemployment compensatin
ASI_ES14. Welfare Include food stamps, transportation money provided by an agency to go to and from treatment
ASI_ES15.Pension, benefits, or social security Include disability, pensions, retirement, veteran's benefits, SSI, & workers' compensation
ASI_ES16. Mate, family, or friends Money for personal expenses (i.e., clothing); Include unreliable sources of income (e.g., gambling). Record cash payments only, include windfalls (unexpected), money from loans, legal gambling, inheritance, tax returns, etc.
ASI_ES17. Illegal Cash obtained from drug dealing, stealing, fencing stolen goods, illegal gambling. Do not attempt to convert drugs exchanged to a dollar value
 
 
 
ES19. How many days have you experienced employment problems in the past 30 days?

Include inability to find work, if they are actively looking for work, or problems with present job in which that job is jeopardized.
 
 
 
ES19A. How many days have you experienced employment problems since the time of your baseline Interview?

Include inability to find work, if they are actively looking for work, or problems with present job in which that job is jeopardized.
 
 
 
ES20. How troubled or bothered have you been by these employment problems? If the patient has been incarcerated or detained during the past 30 days, they cannot have employment problems. In that case, code NA.
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
NA
 
 
 
ES21. How important to you now is counseling for these employment problems? Stress help in finding or preparing a job, not giving them a job
 
Not at all
 
Slightly
 
Moderately
 
Considerably
 
Extremely
 
 
 
ASI_ES22 EMPLOYMENT/ SUPPORT Comments
   
 
 
Interviewer: Is the above information significantly distorted by:
Yes No
ASI_ES23. Patient’s misrepresentation?
ASI_ES24. Patient’s inability to understand?
 
 
 
Progress
 
 
SP_04. On a scale from 1 to 10 how would you rate your overall progress on employment since your baseline interview?
1- Negative 2 3 4 5- About the Same 6 7 8 9 10-Positive 99-N/A
Overall progress on employment since your baseline interview
 
 
SP_05. Using the scale from 1 to 5, indicate the degree which the following statements are true:
Never Rarely Sometimes Often Always N/A
1. I have a good relationship with my employer
2. I have difficulties getting along with co-workers on the job
3. I have an interest in making my job work
4. I find my job satisfying.
5. I value getting money from working
 
 
SP_06.  On a scale from 1 to 10, how would you rate your overall progress on personal finances since your baseline interview?
1-Negative 2 3 4 5-About the Same 6 7 8 9 10-Positive 99-N/A
Overall progress on personal finances since your baseline interview
 
 
 
ALCOHOL/DRUGS
 
 
ASI_AD1. In the last 30 days, did you use any of the following substances?
Yes No Don't Know Refused
Alcohol
Heroin
Methadone
Other Opiates (prescription pain medication)
Barbiturates
Sedatives/Hypnotics/Tranquilizers
Cocaine
Amphetamines
Cannabis
Hallucinogens
Inhalants
Other (specify)
 
 
 
Specify Other (N/A if not applicable)
   
 
 
ASI_AD2. Since the time of your baseline interview, did you use any of the following substances?
Yes No Don't Know Refused
Alcohol
Heroin
Methadone
Other Opiates (prescription pain medication)
Barbiturates
Sedatives/Hypnotics/Tranquilizers
Cocaine
Amphetamines
Cannabis
Hallucinogens
Inhalants
Other (specify)
 
 
 
Specify Other (N/A if not applicable)
   
 
 
ASI_AD3. Since the time of your baseline interview, what was the most usual or most recent route of administration:
Oral Nasal Smoking Non-IV injections IV Don't Know Refused N/A
Alcohol
Heroin
Methadone
Other Opiates (prescription pain medication)
Barbiturates
Sedatives/Hypnotics/Tranquilizers
Cocaine
Amphetamines
Cannabis
Hallucinogens
Inhalants
 
 
 
SUBSTANCE ABUSE TREATMENT QUESTIONNAIRE
 
 
Interviewer: Now I’m going to ask you some questions about your previous experiences with different treatments
 
 
 
SATX_01. Have you been told by a physician since the time of your baseline interview that you have a problem with drugs (e.g. heroin, prescription pain pills, cocaine, crack, methamphetamine, amphetamine, PCP, mushrooms, LSD, marijuana, benzos, etc.)?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_02. Have you received treatment for problems with drugs in the since the time of your baseline interview?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_02A. How many times were you treated for problems with drugs since the time of your baseline interview? (99-refused to answer) ____# of of times
   
 
 
 
SATX_03. Have you received treatment for drugs in an outpatient setting since the time of your baseline interview?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_03A. How many times did you receive treatment for drugs in an outpatient setting since the time of your baseline interview? (99-refused to answer)
   
 
 
 
SATX_04. Have you ever had to be detoxed off of drugs in an inpatient setting since the time of your baseline interview?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_04A. How many times did you receive treatment for drugs in an inpatient setting since the time of your baseline interview? (99-refused to answer)
   
 
 
 
SATX_05. Have you received treatment for drugs in another setting since the time of your baseline interview? (Check all that apply)
 
No, did not receive treatment for drugs in another setting
 
Residential
 
Jail
 
Prison
 
Community Corrections
 
Refused to answer
 
Other
 

 
 
 
SATX_06. For what drugs did you receive treatment? (Check all that apply)
 
Heroin
 
Prescription pain pills
 
Powder cocaine
 
Crack
 
Methamphetamine
 
Amphetamine
 
PCP
 
Mushrooms
 
LSD
 
Other hallucinogens
 
Ecstasy
 
Marijuana
 
Benzos
 
Don’t Know
 
Refused to answer
 
Other
 

 
 
 
SATX_07. Since the time of your baseline interview, has a doctor prescribed medications to treat your drug addiction (e.g., methadone, suboxone, subutex, naltrexone, vivitrol)?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_08 Are you currently being prescribed medications to treat your drug addiction (e.g., methadone, suboxone, subutex, naltrexone, vivitrol)?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_08a. What medication are you currently being prescribed for your drug addiction?
 
Methadone
 
Buprenorphine (Suboxone, Subutex)
 
Naltrexone (oral/ReVia)
 
Naltrexone (depot/injection, Vivitrol)
 
Refused to answer
 
Other
 
 
 
 
SATX_09. Since the time of your baseline interview, have you been told by a physician that you have a problem with alcohol?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_10. Have you received treatment for problems with alcohol since the time of your baseline interview (e.g., medication assisted treatment, support groups (AA) and detox)?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_10a. How many times were you treated for problems with alcohol since the time of your baseline interview? (99-refused to answer) _____# of time times
   
 
 
 
SATX_11. Since the time of your baseline interview, have you ever received treatment for alcohol in an outpatient setting?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_11A. How many times did you receive treatment for alcohol in an outpatient setting since the time of your baseline interview? (99-refused to answer)
   
 
 
 
SATX_12. Since the time of your baseline interview, have you ever had to be detoxed off of alcohol in an inpatient setting?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_12A. How many times did you receive treatment for alcohol in an inpatient setting since the time of your baseline interview? (99-refused to answer)
   
 
 
 
SATX_13. Since your baseline interview, have you received treatment for alcohol in another setting? (Check all that apply)
 
No, did not receive treatment for alcohol in another setting
 
Residential
 
Jail
 
Prison
 
Community Corrections
 
Refused to answer
 
Other
 

 
 
 
SATX_14. Since the time of your baseline interview have you been prescribed medications to treat your alcohol addiction?
 
Yes
 
No
 
Refused to Answer
 
 
 
SATX_14A. What medications were you prescribed since the time of your baseline interview to treat your alcohol addiction? (check all that apply)
 
Acamprosate (Campral)
 
Disulfiram (Antabuse)
 
Librium (Benzodiazepine)
 
Naltrexone (oral/ReVia)
 
Naltrexone (depot/injection, Vivitrol)
 
Don’t know
 
Refused to Answer
 
Other
 

 
 
 
SATX_15 Are you currently being prescribed medications to treat your alcohol addiction?
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_15A. What medications are you currently being prescribed to treat you alcohol addiction? (Check all that apply)
 
Acamprosate (Campral)
 
Disulfiram (Antabuse)
 
Librium (Benzodiazepine)
 
Naltrexone (oral/ReVia)
 
Naltrexone (depot/injection
 
Refused to answer
 
Other
 

 
 
 
SATX_16. Have you gone to self-help meetings like AA, NA, CA since the time of your baseline interview? (Include non-12-step groups such as Rational Recovery, SOS, and SMART)
 
Yes
 
No
 
Refused to answer
 
 
 
SATX_16A. About how many meetings have you attended since your baseline interview?
 
1-5
 
6-10
 
11-25
 
26-100
 
Over 100
 
Refused to answer
 
 
 
SATX_17. What substance use programs or services did you complete since the time of your baseline interview?
   
 
 
 
SATX_18. Do you currently have medical insurance?
 
Yes
 
No
 
Refused to answer
 
 
SP07. On a scale from 1 to 10 how would you rate your progress in dealing with any alcohol or substance use issues since the time of your baseline interview?
1-Negative 2 3 4 5-About the Same 6 7 8 9 10- Positive 99-N/A
Progress in dealing with any alcohol or substance
 
 
 
CRIMINAL HISTORY QUESTIONNAIRE
 
 
Interviewer: Now I will to ask you some things about your involvement with the criminal justice system. Please remember that the information that you share with me is confidential and will not be shared with your parole officer or anyone outside of the research study. Your honesty is important and if you are unsure about some information than just give your best guess.
 
 
 
CH01. Altogether, about how many times were you arrested since the time of your baseline interview?
 
 
 
CH01A. About how many of these arrests were for things you did while using drugs or trying to get drugs?
 
 
 
CH02. Altogether, about how many times were you convicted for a crime since your baseline interview?
 
 
CH03. Since the time of the baseline interview how many times have you been arrested and charged with:
# of times arrested and charged
Shoplifting/Vandalism
Parole/Probation Violations
Drug Crimes
Forgery
Weapons Offense
Burglary/Larceny/Breaking and Entering
Robbery
Assault
Arson
Rape
Homicide/Manslaughter
Prostitution
Contempt of Court
Disorderly conduct, vagrancy, or public intoxication
Driving while intoxicated
Major diving violations (speeding, reckless driving, no license, etc.)
Other (specify)
 
 
 
Other (specify)
   
 
 
 
CH04. Were you ever incarcerated since the time of your baseline interview?
 
Yes
 
No
 
Don't Know
 
Refused to Answer
 
 
CH04b. How many days, weeks, or months were you incarcerated since the time of your baseline interview (Interviewer: if incarcerated 2 weeks or more, round this up to 1 month. List total number of months incarcerated)
length of time incarcerated
# Days Incarcerated
# Weeks Incarcerated
# Months Incarcerated
 
 
 
CH07. Did you violate probation, parole, or community supervision since your baseline interview?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
 
CH07A. Altogether, about how many times did you violate a condition of supervision since your baseline interview?
 
 
 
CH07B. If you had a parole/probation/community supervision violation, what was it for? (Check all that apply)
 
Positive urine screens
 
Curfew violation
 
Non-payment of fines/fees
 
Failure to attend treatment
 
Failure to attend counseling
 
Violate GPS/EM
 
Failure to complete community service
 
Don't know
 
Refused to answer
 
Other
 

 
 
 
CH07C. About how many of the violations were for positive urine screens? (99-refused to answer)
   
 
 
 
CH10. Have any supervision conditions been added since your baseline interview?
 
Yes
 
No
 
Refused to answer
 
 
CH10A. What condition was added? (check all that apply)
Condition was added[,]Specification
YesNo
Drug testing (specify frequency)
Drug or alcohol assessment
Drug or alcohol treatment (specify)
Mental health counseling
Fines/fees
Curfew limits
GPS/EM (specify days on)
Community service (specify)
Other (specify)
Other (specify)
Other (specify)
Refused to answer
 
 
 
CH11. Any notes/ comments on criminal history
   
 
 
 
Interviewer: Next I’m going to ask you about the times you were involved in activities within the past 30 days and since the time of your baseline interview that were against the law. That is, the number of times you committed any of the following activities regardless of arrests or violations. We are interested in activities that did and did not involve police action or action by a probation/parole officer. For each type of crime please tell me how many times you engaged in the behavior since the time of your baseline interview and during the past 30 days. If you are not comfortable answering any of the questions or feel responding to the question or item may place you at risk with your probation officer, just let me know and we can skip the question or item and move on to the next. If you do choose to skip a question or item it will not have any impact on your participation in the study.
 
 
Type of Crime by the Number Times Committed Within the Past 30 days
None 1-2 times 3-4 times 5 or more times Don't know Refused to answer
Public intoxication from alcohol or drugs
Use or possession of illegal drugs
Possession with intent to distribute
Possession of drug paraphernalia
Manufacture or growing of drugs
Sale or distribution of drugs
Forgery/Fraud (bad checks, credit card fraud)
Fencing (buying or selling stolen property)
Illegal gambling (running numbers)
Prostitution or pimping
None 1-2 times 3-4 times 5 or more times Don't know Refused to answer
Burglary/attempted burglary/breaking and entering (home, auto, business)
Shoplifting/larceny/ embezzlement
Weapons offenses
Vandalism/property damage/tagging
Probation/parole violations (Specify)_______________________
Other (Specify)__________________
 
 
 
Specify Probation/ parole violation (N/A if not applicable)
   
Specify Other (N/A if not applicable)
   
 
 
Type of Crime by the number of times committed since the Baseline Interview
None 1-2 times 3-4 times 5 or more times Don't know Refused to answer
Public intoxication from alcohol or drugs
Use or possession of illegal drugs
Possession with intent to distribute
Possession of drug paraphernalia
Manufacture or growing of drugs
Sale or distribution of drugs
Forgery/Fraud (bad checks, credit card fraud)
Fencing (buying or selling stolen property)
Illegal gambling (running numbers)
Prostitution or pimping
None 1-2 times 3-4 times 5 or more times Don't know Refused to answer
Burglary/attempted burglary/breaking and entering (home, auto, business)
Shoplifting/larceny/ embezzlement
Weapons offenses
Vandalism/property damage/tagging
Probation/parole violations (Specify)_______________________
Other (Specify)__________________
 
 
 
Specify Probation/ parole violation (N/A if not applicable)
   
Specify Other (N/A if not applicable)
   
 
 
 
CRIMINAL SENTIMENTS SCALE (CSS-M)
 
 
Interviewer: I will now ask you some questions about your views of the criminal justice system. Use OPTION #8 on the RESPONSE CARD to respond to each statement. A=Agree, U= Uncertain, D=Disagree
 
 
A U D
CSS1. Pretty well all laws deserve our respect
CSS2. It’s our duty to obey all laws.
CSS3. Laws are usually bad.
CSS4. The law is rotten to the core.
CSS5. You cannot respect the law because it’s there only to help a small and selfish group of people.
CSS6. All laws should be obeyed just because they are laws.
CSS7. The law does not help the average person.
CSS8. The law is good.
CSS9. Law and justice are the same thing.
CSS10. The law makes slaves out of most people for a few people on the top.
A U D
CSS11. Almost any jury can be fixed.
CSS12. You cannot get justice in court.
CSS13. Lawyers are honest.
CSS14. Prosecutors often produce fake witnesses.
CSS15. Judges are honest and kind.
CSS16. Court decisions are pretty well always fair.
CSS17. Pretty well anything can be fixed in court if you have enough money.
CSS18. A judge is a good person.
CSS19. The police are honest.
CSS20. A cop is a friend to people in need.
 
 
 
A U D
CSS21. Life would be better with fewer cops.
CSS22. The police should be paid more for their work.
CSS23. The police are as crooked as the people they arrest.
CSS24. Society would be better off if there were more police.
CSS25. The police almost never help people.
CSS26. Sometimes a person like me has to break the law to get ahead in life.
CSS27. Most successful people broke the law to get ahead in life.
CSS28. You should always obey the law, even if it keeps you from getting ahead in life.
CSS29. Its OK to break the law as long as you don’t get caught.
CSS30. Most people would commit crimes if they know they wouldn’t get caught.
A U D
CSS31. There is never a good reason to break the law.
CSS32. A hungry man has the right to steal.
CSS33. It’s OK to get around the law as long as you don’t actually break it.
CSS34. You should only obey those laws that are reasonable.
CSS35. You’re crazy to work for a living if there’s an easier way, even if it means breaking the law.
CSS36. People who have broken the law have the same sorts of ideas about life as me.
CSS37. I prefer to be with people who obey the law rather than people who break the law
CSS38. I’m more like a professional criminal than the people who break the law now and then.
CSS39. People who have been in trouble with the law are more like me than people who don’t have trouble with the law.
CSS40. I have very little in common with people who never break the law.
CSS41. No one who breaks the law can be my friend.
 
 
SP08. On a scale of 1 to 10, how would you rate your progress since the time of your baseline interview in dealing with peers that you are involved in criminal behavior?
1-Negative 2 3 4 5-About the same 6 7 8 9 10-Positive 99-N/A
Overall progress in dealing with peers that are involved in criminal behavior
 
 
 
UPPS IMPULSIVITY SCALE
 
 
Interviewer: Next I will read a number of statements that describe ways in which people act and think. For each statement, please indicate how much you agree or disagree with the statement. Use OPTION #7 on your RESPONSE CARD.
 
 
Strongly Agree Agree Some Disagree Some Strongly Disagree
UPPS_01 I have a reserved and cautious attitude toward life.
UPPS_02 I have trouble controlling my impulses.
UPPS_04 I generally like to see things through to the end.
UPPS_05 My thinking is usually careful and purposeful.
UPPS_06 I have trouble resisting my cravings (for food, cigarettes, etc.).
UPPS_08 I tend to give up easily.
UPPS_09 I am not one of those people who blurt out things without thinking.
UPPS_10 I often get involved in things I later wish I could get out of.
UPPS_12 Unfinished tasks really bother me.
UPPS_13 I like to stop and think things over before I do them.
Strongly Agree Agree Some Disagree Some Strongly Disagree
UPPS_14 When I feel bad, I will often do things I later regret in order to make myself feel better now.
UPPS_16 Once I get going on something I hate to stop.
UPPS_17 I don't like to start a project until I know exactly how to proceed.
UPPS_18 Sometimes when I feel bad, I can’t seem to stop what I am doing even though it is making me feel worse.
UPPS_20 I concentrate easily.
UPPS_22 I finish what I start.
UPPS_23 I tend to value and follow a rational, "sensible" approach to things.
UPPS_24 When I am upset I often act without thinking.
UPPS_26 I am able to pace myself so as to get things done on time.
UPPS_27 I usually make up my mind through careful reasoning.
Strongly Agree Agree Some Disagree Some Strongly Disagree
UPPS_28 When I feel rejected, I will often say things that I later regret.
UPPS_30 I am a person who always gets the job done.
UPPS_31 I am a cautious person.
UPPS_32 It is hard for me to resist acting on my feelings.
UPPS_34 I almost always finish projects that I start.
UPPS_35 Before I get into a new situation I like to find out what to expect from it.
UPPS_36 I often make matters worse because I act without thinking when I am upset.
UPPS_38 Sometimes there are so many little things to be done that I just ignore them all.
UPPS_39 I usually think carefully before doing anything.
UPPS_40 Before making up my mind, I consider all the advantages and disadvantages.
UPPS_41 In the heat of an argument, I will often say things that I later regret.
UPPS_43 I always keep my feelings under control.
UPPS_45 Sometimes I do impulsive things that I later regret.
 
 
SP09. How would you rate your progress in setting limits or dealing with impulsive behavior since the time of your baseline interview?
1-Negative 2 3 4 5-About the same 6 7 8 9 10-Positive 99-N/A
Overall progress in setting limits or dealing with impulsive behavior
 
 
 
SITUATIONAL MOTIVATION SCALE
 
 
Interviewer: Using the below scale, tell me which response best describes the reason why you engaged in the workbook activity.
 
 
Corresponds not at all Corresponds very little Corresponds a little Corresponds moderately Corresponds enough Corresponds a lot Corresponds exactly
Because I think that this activity was interesting.
Because I was doing it for my own good.
Because I was supposed to do it.
There may be good reasons to do this activity, but personally I don’t see any.
Because I thought that this activity was pleasant.
Because I thought that this activity was good for me.
Because it was something that I have to do.
I did this activity but I am not sure if it is worth it.
Because the activity was fun.
By personal decision.
Corresponds not at all Corresponds very little Corresponds a little Corresponds moderately Corresponds enough Corresponds a lot Corresponds exactly
Because I didn’t have any choice.
I don’t know; I don’t see what the activity brings me.
Because I felt good when doing the activity.
Because I believed that this activity was important for me.
Because I feel that I had to do it.
I did the activity, but I am not sure it is a good thing to pursue it.
 
 
 
TCU PSYForm
 
 
Interviewer: For the next set of questions you will tell me how strongly you agree or disagree with each statement. Use the response options in OPTION #5 on the RESPONSE CARD. Remember, if you do not feel comfortable giving an answer to a question we can skip it.
 
 
Disagree Strongly Disagree Uncertain Agree Agree Strongly
DM01. You consider how your actions will affect others.
DM02. You plan ahead.
DM03. You think about probable results of your actions.
DM04. You think about what causes your current problems.
DM05. You think of several different ways to solve a problem.
DM06. You have trouble making decisions
DM07. You make good decisions.
DM08. You make decisions without thinking about consequences.
DM09. You analyze problems by looking at all the choices.
 
 
 
ICS
 
 
 
Interviewer: The next questions ask about your current relationship and your desired relationship with different people. For each question there are six pictures to choose from. We will circle the picture that best describes your relationship with these people. There are no right or wrong answers, choose whichever picture you think best describes your relationship.
 
 
 
QUESTION 1. SELF AND PERSON YOU ARE CLOSEST WITH
 
 
Interviewer: These questions ask about someone you feel close to—someone who is important or special to you. Closeness means different things to different people. Answer in the way that makes most sense to you.
 
 
ICS01. Who is this person to you? For example, your mother? Your cousin?
   
 
 
 
ICS02 Which picture best describes your current relationship with the person you’re closest with. The S = Self. The P = the Person you’re closest with. Relationship means different things to different people. Answer in the way that makes most sense to you.
 
 
 
ICS03 Which picture best describes your desired relationship with the person you’re closest with. The S = Self. The P = the Person you’re closest with.
 
 
 
QUESTION 2. SELF AND COMMUNITY
 
 
Interviewer: These questions ask about your relationship with the people in your community.
 
 
 
ICS04 Which picture that best describes your current relationship with people in your community. S = Self; PL = People in the Community
 
 
 
ICS05 Circle the picture that best describes your desired relationship with people in your community. S = Self; PL = People in Criminal Community.
 
 
 
QUESTION 3. SELF AND FAMILY
 
 
Interviewer: These questions are about all of your family members.
 
 
 
ICS06 Which picture best describes your current relationship with all of your family members. S = Self; F = Family members
 
 
 
ICS07 Which picture best describes your desired relationship with all of your family members. S = Self; F = Family members
 
 
 
QUESTION 4. SELF AND PROBATION/PAROLE OFFICER
 
 
Interviewer: The next two questions are about your relationship with your probation/parole officer.
 
 
 
ICS08 Which picture best describes your current relationship with your probation/parole officer. S = Self; P = Probation officer.
 
 
 
ICS09 Which picture best describes your desired relationship with the your probation/parole officer. S = Self; P = Probation officer.
 
 
 
Interviewer: To respond to the next set of questions you will use Option #6 on the RESPONSE CARD. On the scale of 1 to 5 indicate the degree to which you agree with the statements.
 
 
 
Strongly Disagree Disagree Neutral Agree Strongly Agree
ID01 I think I act like someone who is involved in the criminal justice system
ID02 I focus on the future after I am off of supervision.
ID03 I see myself a new person with new opportunities.
ID04 I tell my supervising officer that the supervision experience is beneficial.
ID05 I believe I am a different person who is more positive.
ID06 I set out clearly what I is expected to achieve.
ID07 I accepted the challenges before me in being crime-free.
ID08 I accepted positive feedback on how I can improve my situation.
ID09 I follow through on things that I said I will do.
ID10 I think before I act.
ID11 I will be successful given my behavior.
ID12 My family or support system has been helpful in my supervision process.
ID13 I always have bad luck which results in obstacles to success.
ID14 My supervising officer trusts my word.
ID15 I believe I have a lot of obstacles standing in my way to be successful on supervision.
 
 
 
Strongly Disagree Disagree Neutral Agree Strongly Agree
REL01. I get along with others.
REL02. I have someone to depend upon.
REL03. I talk positively about the person(s) I live with.
REL04. I have concern about how well others are doing.
REL05. I had a major fight or disagreement with someone in my network.
REL06. I live with others that drink or uses drugs.
REL07. I live with someone who is also on probation, parole, or just out of jail/prison.
REL08. I rely on others to deal with problems.
REL09. I work hard on my relationship with others.
REL10. I get blamed or fussed at about things others do or did.
REL11. I frequently have disagreements with others.
REL12. I had big arguments or fights lately.
REL13. I depend on friends from prison more than family or peers not involved in the justice system.
REL14. I value my friends’ viewpoints more than others.
REL15. I work hard at keeping positive relationships with my social network.
 
 
 
ATTITUDES TOWARD SUPERVISION
 
 
Interviewer: The next set of questions asks you about your attitudes toward supervision. To respond to the next set of questions you will use Option #6 on the RESPONSE CARD. On the scale of 1 to 5 indicate the degree to which you agree with the statements.
 
 
 
Strongly Disagree Disagree Neutral Agree Strongly Agree
ATP01. I respond to suggestions made by my supervising officer.
ATP02. I resent working on attitude or motivation.
ATP03. I do not trust the parole/probation or re-entry system.
ATP04. I am self-centered.
ATP05. I want something, I expect others to deliver it .
ATP06. I am not interested in finding a way to “set things right” with anyone for the crime I committed or for being in prison.
ATP07. I think the future is unpredictable and I should not plan for anything.
ATP08. I do not take responsibility for his crime.
ATP09. I enjoy life, even the little things.
ATP10. I think I can make up for the crime by doing something good.
Strongly Disagree Disagree Neutral Agree Strongly Agree
ATP11. I do not owe anything to anyone else.
ATP12. I do not like taking risks.
ATP13. I have bad luck.
ATP14. I am trying and working on the plan.
ATP15. I think that supervision is a waste of time.
ATP16. I have good control over my behavior.
ATP17. I blame others for my behavior.
ATP18. I am always looking for ways to get the respect that I am due.
ATP19. I have a good plan in place to make up transgressions to my loved ones.
ATP10. I think that people in authority are looking out for my best interest.
ATP11. I believe that I can change.
ATP12. I think I deserves more than other people.
ATP13. I am always focusing on today, not the future.
ATP14. I am concerned about the people around me.
ATP15. I do not want to be a criminal anymore.
 
 
 
SP10 Are there any other issues you have made progress on since you have been on supervision that you would like to indicate?
 
Yes
 
No
 
Refused to answer
 
Not applicable
 
 
 
SP10a. If yes, please specify
   
 
 
SP11. If yes, on a scale from 1 to 10 how would you rate your progress on this issue since the time of your baseline interview?
1- Negative 2 3 4 5-About the same 6 7 8 9 10-Positive 99-N/A
Overall progress on other issues
 
 
SP12. How would you rate your overall progress on supervision?
1- Negative 2 3 4 5-About the same 6 7 8 9 10-Positive 99-N/A
Overall progress on supervision
 
 
 
ORIENTATION OF SOCIAL SUPPORT QUESTIONS (OSS) AND SOCIAL NETWORK QUESTIONNAIRE (SNQ)
 
 
 
We are now going to ask you a few questions about the people in your network. People in your network include those important people in your life, whom you meet regularly or infrequently and can trust and seek help from. This can include your spouse, significant other or domestic partner, parents or parental figures, siblings, friends, or roommates and acquaintances.
 
 
OSS1. Think through your day-to-day activities and the people you see from when you wake up until you go to sleep. Also think about the important people in your life, who you meet regularly or infrequently and can trust and seek help from. In any given day identify how often you see the following individuals.
Daily Weekly Monthly A few times a year Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS1A. Other relative specify
   
OSS1B. Other individual specify
   
 
 
OSS2: Who are the people in your network accept you as you are? These are the people who accept both your best and worst points and who make you feel good about yourself.
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
OSS3: Who are the people in your network most willing to help you or do favors for you including provide financial help.
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
DRUG USE
 
 
 
OSS4. Is there anyone in your network who objects to drug use by you or by others?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS4A. Who are the people in your network who object to drug use by you or by others?
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS4B. How frequently do you see the people who are in your network who object to drug use by you or by others?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS5. Since the time of your baseline interview, did you use drugs with people in your network?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS5A. Since the time of your baseline interview, did you use drugs with any of the following people?
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS5B. How frequently do you see the people who are in your network who use drugs?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS5C. Of the people who are in your network, what percent do you think use drugs?
 
0% (None)
 
1% to 25 % (A little)
 
25% - 50% (some- less than half)
 
50%-75% (more than half)
 
75%-99% (quite a bit- more than half but not all)
 
100% (All)
 
Don't Know
 
Refused to answer
 
 
 
ALCOHOL
 
 
OSS6. Is there anyone in your network who objects to alcohol use by you or by others?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS6.A: Who are the people in your network who object to alcohol use by you or by others?
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS6B. How frequently do you see the people who are in your network who object to alcohol use by you or by others?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS7. Since the time of your baseline interview, did you drink with people in your network?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS7A. Since the time of your baseline interview, did you drink with any of the following people?
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS7B. How frequently do you think the people in your network drink alcohol?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS7.C: How frequently do you see the people who are in your network who drink alcohol?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
CRIMINAL ACTIVITY
 
 
 
OSS8. Is there anyone in your network who objects to criminal activity by you or by others?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS8.A: Who are the people in your network who object to criminal activity by you or by others?
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS8.B: How frequently do you see the people who are in your network who object to criminal activity by you or by others?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS9. Is there anyone in your network who engages in criminal activities?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS9.A: Who are the people in your network who engage in criminal activities?
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS9B. How frequently do you see the people who are in your network who engage in criminal activities?
 
Never
 
Rarely
 
Sometimes
 
Often
 
Very Often
 
Don't Know
 
Refused to answer
 
 
 
OSS10. Since the time of your baseline interview, did you engage in criminal activities with the people in your network?
 
Yes
 
No
 
Don't know
 
Refused to answer
 
 
OSS10.A. Since the time of your baseline interview, who did you engage in criminal activities with?
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS11. From your knowledge, has anyone in your network been arrested or had problems with the law for any reason since the time of your baseline interview?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS11.A. Since the time of your baseline interview, who in your network was arrested or had problems with the law?
Yes No Don't Know Refused N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS12. From your knowledge, has anyone in your network traded or sold drugs in the last 6 months?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS12.A. Since the time of your baseline interview, who in your network traded or sold drugs?
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
 
OSS13. From your knowledge, is anyone in your network under community supervision currently? (e.g. probation, parole, pretrial supervision)
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS13.A. Please identify who in your network is
currently under community supervision
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Other (Specify)
 
 
 
OSS14. From your knowledge, is anyone in your network currently working regularly on a job?
 
Yes
 
No
 
Don't Know
 
Refused to answer
 
 
OSS14.A. Please identify who in your network is currently working regularly on a job
Yes No Don't Know Refused to answer N/A
Partner or Spouse
Ex-Partner or Spouse
Child
Sister
Brother
Mother
Father
Other Relative
Friend
Roommate
Business Acquaintance (someone you trade sex with or sell drugs with)
Other Acquaintance
Probation/Supervising Officer
Other (Specify)
 
 
SP13. On a scale of 1 to 10, how would you rate your progress since the time of your baseline interview with regard to your family and relationships?
1- Negative 2 3 4 5- About the same 6 7 8 9 10-Positive 99-N/A
Overall progress with regard to family and relationships
 
 
 
Any additional information regarding the interview:
   
 
 
 
Interviewer: That is the end of our interview. Thank you for your participation. We really value your time and cooperation.