Psychometric properties of the decisional balance for patient choice in substance abuse treatment

In the context of patient-centered care and the increasing number of evidence-based substance abuse treatments, outpatient substance abuse treatment programs are poised to provide patients with a menu of options. Not all patients will be ready for such an open choice field in substance abuse treatment and they will undoubtedly differ on how they weigh the risks and benefits of having autonomy to choose their own treatment. Given the lack of an existing valid measure to assess this decision making process, this study sought to establish a measure to assess the relative weight that patients give to the pros and cons of choosing their own substance abuse treatment. Construct validity of the Decisional Balance for Patient Choice in Substance Abuse Treatment was assessed in a sample of 231 outpatients using confirmatory factor analysis. As another validity aspect, the use of decisional balance across a continuum of choice options also was investigated. The model fit was acceptable (CFI = 0.904). Internal consistency of the measure was established. The final 22-item measure revealed sound psychometric properties, but further testing is warranted.