Focus area: Warning signs of relapse

Overview: The Advanced Warning of Relapse (AWARE) Questionnaire was designed as a measure of the warning signs of relapse, as described by Gorski (Gorski & Miller, 1982). In a prospective study of relapse following outpatient treatment for alcohol abuse or dependence, the AWARE was found to be a good predictor of the occurrence of relapse (r = .42, p < .001).

Total number of items: Twenty eight

Administration: Self-report

Standardized cadence: Two months

Estimated completion time: Five to seven minutes

Supported subscales: None

Age range: 18+

Scoring and interpretation: The higher the score, the more warning signs of relapse are being reported by the client. The range of scores is from 28 (lowest possible score) to 196 (highest possible score). The following table shows the probability of heavy drinking (not just a slip) during the next two months, based on our prospective study of relapse in the first year after treatment (Miller & Harris, 2000).

Reliability/Validity: Confirmatory factor analysis revealed a single, internally consistent, 25-item factor that demonstrated convergent validity and predicted subsequent relapse alone and when controlling for other important relapse risk predictors (Kelly et al., 2011)

Additional information: The AWARE scale may be a useful and efficient clinical tool for assessing short-term relapse risk among young people and, thus, could serve to enhance the effectiveness of relapse prevention efforts. This instrument was developed through research funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA, contract ADM 281-91-0006).