chapter 10 motivation for youth’s treatment scale...

Chapter 10

Motivation for Youth’s Treatment Scale

(MYTS)

Background

Purpose The Motivation for Youth’s Treatment Scale (MYTS) is a measure of the intrinsic aspects of treatment motivation. In treatment, youth often come extrinsically motivated; indeed, some suggest that the therapeutic process often includes efforts toward transforming this external motivation into the internal sources of motivation required to sustain treatment involvement and improve outcomes (Breda & Heflinger, 2004; McMurran, Theodosi, & Sellen, 2006). The MYTS specifically asks youth to report how they think about their problems, readiness for treatment, and desire towards help. Adult caregivers are asked to report on how they perceive the youth’s problems, and their own readiness for change and desire for help.

Theory Motivation has been identified as a predictor of seeking and staying in services (DeLeon, Melnick, Kressel, & Jainchill, 1994; Ryan, Plant, & O’Malley, 1995; Prochaska, DiClemente, & Norcross, 1992; and Simpson, 2001), as well as better treatment outcomes in the field of adolescent substance abuse (Breda & Heflinger, 2004), with equal promise in the field of child and adolescent mental health. Conceptualizations of motivation often identify two broad components: extrinsic and intrinsic motivation. External sources of motivation can come from parents or legal authorities who exert pressure on the individual to seek or stay in treatment. Intrinsic motivation reflects the respondent’s own problem recognition, desire for help, and treatment readiness, dimensions that have been found to be important for treatment involvement and outcome (Simpson, 2001). There are currently several motivation measures in use with various adult and youth populations including offenders, substance abusers, and clinical populations. For example, the University of Rhode Island Change Assessment (URICA; McConnaughy, DiClemente, Prochaska, & Velicer, 1989; McConnaughy, Prochaska, & Velicer, 1983) asks respondents to indicate the degree to which they agree or disagree with 32 statements (McConnaughy et al., 1983; 1989). The URICA has four subscales comprised of eight items each that assess the four stages of change: Precontemplation, Contemplation, Action, and Maintenance (Prochaska et al., 1992). The URICA has been used with adult and youth (McMurran et al., 2006). However, the validity of the stage model, which the URICA is based on has recently been subject to dispute (West, 2005; Casey, Day, & Howells, 2005).

Peabody Treatment Progress Battery 2007.1

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The Treatment Motivation Questionnaire (TMQ; Ryan et al., 1995) is a 26-item measure that consists of four subscales (Internal Motivation, External Motivation, Help Seeking, and Confidence in Treatment). This measure requires respondents to indicate the degree to which each of the statements is true or not true of them on a seven-point scale. The TMQ has been shown to predict treatment engagement, attendance, and outcomes in adults and youth with alcohol problems. The Treatment Entry Questionnaire (TEQ; Wild, 2006) is a 20-item measure based on 10 of the items from the Treatment Motivation Questionnaire described above. The additional items were included by the author in an effort to discriminate between introjected (e.g., guilt), identified (e.g., identification with and commitment to treatment goals), and external motivation. The TEQ has been used with success with a sample of adults in a substance abuse program. The Circumstances, Motivation, Readiness, and Suitability Scale (CMRS; DeLeon et al., 1994) has an 18-item adolescent form that is appropriate for use with youth. On a five point Likert-type scale, this measure assesses external motivation (the Circumstances subscale), internal motivation (the Motivation subscale), the perception that the youth needs treatment (Readiness subscale), and the youth’s perception that residential treatment is suitable. A modified version of the CMRS (the CMR), that does not include one item from the Motivation subscale and drops the whole Suitability subscale has been tested in a sample of youth receiving treatment for substance abuse (Breda & Heflinger, 2004). There are few measures assessing caregiver motivation to participate in a youth’s treatment. Indeed, currently only one, other than the MYTS, has been identified, the Parent Motivation Inventory (PMI; Nock & Photos, 2006). The 25-item PMI assesses three dimensions: caregiver desire for change in the youth, caregiver willingness to change their behaviors to help their child change, and caregiver’s perceived ability to enact the needed change and has been examined in a sample of caregivers of youth with emotional and behavioral disorders. There is, however, no parallel youth form for the PMI, precluding the possibility of making any comparisons between the two.

History of Development The first drafts of the motivation scales evaluated as part of the psychometric study (see Chapter 2) contained 15 items for the youth version and 13 items for the adult caregiver version including several items assessing extrinsic motivation. The psychometric study sample was randomly divided into two sections using a SAS program that utilized a replicable random seed. One group served as the learning sample that was used to evaluate the characteristics of the scales and reduce the number of items while the second group was used as the validity sample. In deciding which items to delete, six main criteria were used: (a) general psychometric quality of an item, (b) the similarity of an item in its difficulty measurement score to another item (indicates redundancy), (c) the similarity of an item in its wording to another item (an important factor in respondent compliance), (d) the relationship of the item to the general factor structure, and (e) the theoretical properties of each item. In addition, the initial analyses clearly revealed


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extrinsic treatment motivation is not represented by one clear construct that could be assessed using a psychometric scale. Clients are either motivated by a court order or by the school. Considering these findings and the issue that intrinsic motivation is the more critical factor for youth treatment (some external motivational factor especially at the beginning of treatment can typically be assumed with youth) the extrinsic motivation items were deleted. The psychometric properties and the validity of these final versions were established based on the validity sample.

Structure The youth version (10 items) assesses the youth’s problem recognition, the desire for help, and readiness to be and participate in treatment. The adult caregiver version (nine items) assesses the adult caregiver’s motivation to participate in the youth’s treatment in regard to problem recognition and readiness to participate. It also includes one item that refers to desire for help (this item does not contribute to either of the subscale scores described below). Response options range from one (Strongly Disagree) to five (Strongly Agree) on a five-point Likert-type scale. The MYTS-Youth Total Score provides an overall assessment of motivation as well as three subscale scores: Problem Recognition (four items), Desire for Help (three items), and Treatment Readiness (three items). Scores for the adult version include the MYTS-Adult Caregiver Total Score as well as two subscale scores: Problem Recognition (three items) and Treatment Readiness (five items). All scale scores represent the mean of items (either the total number or a select subgroup) and range from one (low motivation) to five (high motivation). The analyses presented in this chapter required 85% of the items to have valid answers. Please note that the psychometric analyses of the MYTS-Youth presented here are based on only nine items that were identified during the initial psychometric evaluation using the randomly selected learning sample. However, when using the MYTS-Youth, we recommend adding a tenth item: “I need help with problems”. This item is included in the available version of the MYTS. We currently do not have any psychometric information available on this item. All nine items of the MYTS-Adult Caregiver are included in all analyses. Also, note that the descriptive information is based on the complete psychometric sample while all other psychometric information is based on the randomly selected validity sample. See Chapter 2 for more details on the psychometric sample and test development procedures.

Administration The MYTS is available in two versions, one to be completed by the youth and one to be completed by the adult caregiver. As presented in Table 10.1, the MYTS may be administered during intake and treatment phases. The suggested frequency of administration is every other week or at least once a month.


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Table 10.1 Administration of MYTS by Phase Intake Treatment Discharge Follow-Up

Y A C Y A C Y A C Y A C ■ ■ ■ ■

Y = Youth (age 11-18); A = Adult Caregiver; C = Clinician Recommended Frequency: Every two weeks or at least once a month The suggested administration schedule of all the measures in the Peabody Treatment Progress Battery is presented in Appendix A. All PTPB measures with self-scoring tables can be found in Appendix B: Measures and Self-Scoring Forms.

Description

Basic Descriptives The descriptive statistics for the youth and adult versions of the MYTS appear in Tables 10.2 and 10.3.

Table 10.2 Descriptive Statistics for MYTS Summary Scores MYTS N Mean Std

Dev Skewness Kurtosis Min Max

Youth Total Score 513 3.26 0.77 -0.24 0.19 1 5

Problem Recognition 505 2.71 1.07 0.07 -0.80 1 5

Treatment Readiness 508 3.50 1.03 -0.42 -0.31 1 5

Adult Caregiver Total Score 429 3.75 0.64 -0.48 1.02 1 5

Problem Recognition 420 3.06 1.06 -0.32 -0.65 1 5

Treatment Readiness 421 4.02 0.64 -0.93 2.43 1 5 Note: Data represented in this table reflect the nine item version of the MYTS-Youth and the nine item MYTS-Adult Caregiver, and is based on the complete psychometric sample.

The correlations among the MYTS subscales suggest related but distinct constructs. The correlation of the problem recognition and treatment readiness subscales of the youth version is r = 0.36, while the same correlation in the adult version is r = 0.40. Because insufficient information is available on the desire for help subscale of the youth version, no correlation with this subscale is reported at this time.

Quartiles Quartiles for the MYTS are presented in Table 10.3. High scores are those in the top quarter, with low scores in the bottom quarter. For the MYTS - Youth Total Score, a score greater than 3.9 is considered high, whereas a score less than 2.9 considered low.


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For the MYTS-Adult Caregiver Total Score, a score greater than 4.1 is considered high, whereas a score less than 3.3 is considered low. To aid interpretation, the quartiles were used to create low, medium, and high scores and percentile ranks based on comparison to the psychometric sample. This information is presented in the last section of this chapter.

Table 10.3 MYTS Quartiles Quartile MYTS-Youth

Total Score MYTS–Adult Caregiver

Total Score 100% Max 5.0 5.0 75% Q3 3.9 4.1 50% Median 3.4 3.6 25% Q1 2.9 3.3 0% Min 1.0 1.0 Note: Data represented in this table reflect the nine item version of the MYTS-Youth and the nine item MYTS-Adult Caregiver.

Evidence of Reliability

Reliability Coefficients The Cronbach’s alpha internal consistency reliability for the MYTS is presented in Table 10.5.

Table 10.5 Cronbach’s Alphas for the MYTS Scale Unstandardized

Alpha Standardized

Alpha MYTS-Youth 0.82 0.82

Problem Recognition 0.78 0.78

Treatment Readiness 0.81 0.82

MYTS-Adult Caregiver 0.78 0.81

Problem Recognition 0.75 0.75

Treatment Readiness 0.68 0.74 Note: Data represented in this table reflect the nine item version of the MYTS-Youth and the nine item version of the MYTS-Adult Caregiver.

The internal consistency reliability as measured by the unstandardized coefficient alpha of the MYTS-Adult Caregiver was slightly less than the commonly accepted criterion of 0.80. Several alphas for the subscales are also below 0.80. If a test’s reliability is below 0.80, it may be too short to measure individuals accurately. Because in this case the coefficient alphas were close to the 0.80 mark (except for the one for treatment readiness in the adult caregiver version) no further action was taken. However, the somewhat lower internal reliability, especially for the adult version, should be taken into account when interpreting relationships with these scales and subscales


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Comprehensive Item Psychometrics Tables 10.6 and 10.7 present the comprehensive item psychometrics. Shaded cells indicate that a criterion was out of the range of sought values, as described previously in Table 2.2 in chapter two. Only items with two or more shaded cells are considered problematic. The last item in Table 10.6 (“Want to make positive changes”) has three characteristics (the mean, the item-total correlation, and the item discrimination value) that are either below or above the cut-off criteria as indicated by the shading. However, these values are close to the respective cut-off values. In addition, we expect that the addition of the new item, which is part of the same construct (Help) as this item, will improve the integration of this item into the total motivation scale.

Table 10.6 Comprehensive Item Analysis for the MYTS-Youth

Con

stru

ct

Item

N

Mea

n

St D

ev

Kur

tosi

s

Item

-Tot

al

Mea

sure

Infit

Out

fit

Dis

crim

inat

ion

Problem Behavior making life worse 265 2.54 1.25 -1.02 0.41 0.79 1.18 1.22 0.69

Problem Behavior causing problems 269 2.68 1.37 -1.25 0.57 0.65 0.96 0.93 1.19

Problem Feelings causing problems 268 2.70 1.32 -1.07 0.53 0.63 0.99 1.01 1.01

Problem Feeling are bothering me 268 2.93 1.32 -1.09 0.46 0.40 1.14 1.16 0.77

Readiness Staying because is want to 266 3.21 1.32 -1.08 0.49 0.10 1.13 1.16 0.79

Readiness Staying in counseling seems good 268 3.60 1.21 -0.36 0.65 -0.34 0.79 0.76 1.34

Help Want solutions for problems 269 3.65 1.19 -0.21 0.55 -0.39 0.93 0.97 1.07

Readiness Life will get better with counseling 268 3.71 1.1 0.06 0.60 -0.48 0.76 0.74 1.28

Help Want to make positive changes 269 4.28 0.93 2.13 0.36 -1.36 1.22 1.25 0.79

Note: Items listed in ascending order by item difficulty (Measure). Data represented in this table reflect the nine item version of the MYTS-Youth


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Table 10.7 Comprehensive Item Analysis for the MYTS-Adult Caregiver C

onst

ruct

Item

N

Mea

n

St D

ev

Kur

tosi

s

Item

-Tot

al

Mea

sure

Infit

Out

fit

Dis

crim

inat

ion

Readiness My participation important 192 4.39 0.81 3.68 0.62 -1.26 0.79 0.66 1.22

Readiness Counseling good idea 192 4.52 0.64 3.81 0.62 -0.97 0.82 0.8 1.19

Readiness Without counseling life worse 192 3.32 1.21 -0.75 0.61 -0.88 0.94 0.86 1.10

Readiness Willing to make changes for child 192 4.26 0.84 4.11 0.63 -0.56 0.76 0.79 1.20

Help Want help finding solutions 192 4.42 0.74 5.14 0.63 -0.56 0.76 0.79 1.20

Readiness My decision re: child’s counseling 190 3.65 1.21 -0.58 0.59 0.49 1.23 1.30 0.66

Problem Child’s behavior causing problems 191 3.31 1.38 -1.02 0.59 0.91 1.39 1.44 0.74

Problem Troubled by how child feels 190 3.25 1.30 -1.12 0.65 0.98 1.02 1.16 1.02

Problem Child’s behavior making life worse 190 2.53 1.21 -0.85 0.63 1.85 1.13 1.09 0.65

Note: Items listed in ascending order by item difficulty (Measure). Data represented in this table reflect the nine item version of the MYTS-Adult Caregiver.


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Standard Errors of Measurement For the MYTS-Youth Total Score, the standard error of measurement (SEM) is 0.34 points. With 95% confidence, we can say the true score is between approximately ±2 SEMS, or 0.67 points on a one to five point scale. The SEM for the MYTS-Adult Caregiver Total Score is 0.30 points. With 95% confidence, we can say the true score is between approximately ±2 SEMS, or 0.59 points on a one to five point scale.

Reliable Change Index The reliable change threshold is 0.55 points with 75% confidence for the MYTS-Youth Total Score, and gives us 75% confidence that a difference of more than 0.55 points is not due to chance. For the MYTS-Adult Caregiver Total Score, the reliable change index (RCI) is 0.49 points, and gives us 75% confidence that a difference of more than 0.40 points is not due to chance. The RCIs for subscale scores are as follows for the youth (Problem Recognition = 0.82, Treatment Readiness = 0.73) and the adult caregiver (Problem Recognition = 0.86, Treatment Readiness = 0.59). For both versions of the MYTS, if the change is in a positive direction (i.e., increase in score value), it represents an increase in reported motivation, while a change in the negative direction indicates a reduction in perceived motivation.

Test-Retest Reliability Not available at this time.

Evidence of Validity

Scree Plot Scree plots for the youth and adult caregiver versions of the MYTS were very similar as shown in Figure 10.2. These exploratory factor analyses suggest more than one-factor for the MYTS, which is accordance with the theory. The final factor structure was tested using confirmatory factor analysis (CFA).


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1 2 3 4 5 6 7 8 9

Eig

enva

lue

0

1

2

3

4

Youth Adult

1

2

3

Figure 10.2 Scree Plot of Eigenvalues for MYTS

Confirmatory Factor Analysis: Youth The factor structure of the MYTS-Youth was first evaluated using confirmatory analysis for the randomly selected half of the psychometric sample that was used for testing purposes. The results of these initial analyses indicated that a three factor model represents the data best, which corresponds with the theory and the results of exploratory factor analysis. The three factors are problem recognition, desire for help, and treatment readiness. The three-factor model was then confirmed using the validity sample. For comparison purposes we also included a one-factor model at this final stage. The results of this analysis, presented in Table 10.8, indicate a good fit of the three-factor model with the data. Clearly, the fit for the three-factor model is superior to the one of the one-factor model as the values for the CFI, the GFI, and the RMSEA as well as the significant chi square difference test indicate. The factor loadings on each of the three factors were generally high, ranging from 0.55 to 0.86.


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Table 10.8 Evaluation of the MYTS-Youth Factor Structure Scale χ2 df χ2 / df χ2 diff Bentler

CFI Joreskog

GFI RMSEA

MYTS-Youth One-Factor Model 296.37 28 9.62 0.68 0.77 0.19

MYTS-Youth Three-Factor Model 80.79 25 3.23 215.58 0.93 0.93 0.09

For the CFI and GFI, values greater than 0.90 indicate good fit between a model and the data. For the RMSEA, a value of 0.05 indicates close fit, 0.08 fair fit, and 0.10 marginal fit (Browne & Cudeck, 1993). Data represented in this table reflect the nine item version of the MYTS-Youth.

Confirmatory Factor Analysis: Adult-Caregiver Parallel to the youth version, the factor structure of the MYTS-Adult Caregiver was first evaluated using confirmatory analysis for the randomly selected half of the psychometric sample that was used for testing purposes. The results of these initial analyses indicated that a two-factor model represents the data best, although the fit was not as good as the three-factor model for the youth version. The two factors are problem recognition and treatment readiness. The two-factor model was then confirmed using the validity sample. For comparison purposes we also included a one-factor model at this final stage. The results of this analysis, presented in Table 10.9, indicate a satisfactory fit of the two-factor model with the data using the CFI and GFI as criteria. The RMSEA value is slightly above the recommended 0.08. Sensitivity analyses confirmed, however, that the two-factor model is the one with the best fit and is clearly superior to the one-factor model as shown in Table 10.9. The factor loading of one of the items was somewhat low (0.25) while all other items have satisfactory or high loading ranging from 0.43 to 0.83. These results of the CFA suggest that, while the factor structure of the MYTS-Adult Caregiver is detectable within the current data, it is not as clear as the structure of the MYTS-Youth. Future investigations will have to show if the two-factor structure for the MYTS-Adult Caregiver represents the best model of treatment motivation for adult caregivers.

Table 10.9 Evaluation of the MYTS-Adult Caregiver Factor Structure Sample χ2 df χ2 /

df χ2 diff Bentler CFI

Joreskog GFI RMSEA

MYTS-Adult Caregiver One-Factor Model

265.54 27 9.83 0.72 0.76 0.20

MYTS-Adult Caregiver Two-Factor Model

107.28 26 4.13 158.26 0.90 0.91 0.12

For the CFI and GFI, values greater than 0.90 indicate good fit between a model and the data. For the RMSEA, a value of 0.05 indicates close fit, 0.08 fair fit, and 0.10 marginal fit (Browne & Cudeck, 1993). Data represented in this table reflect the nine item version of the MYTS-Adult Caregiver .


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Scoring the MYTS

Scoring Use the self-scoring tables (Table 10.10 or Table 10.11) to calculate the MYTS Total Score for the youth and adult caregiver versions respectively. Enter the value for the responses in fields A-J. Calculate the total score by adding the scores and then dividing the sum by the number of items (10 or 9). Separate columns in the tables indicate items included in subscale scores for ease of calculation. Note that for the adult caregiver version, item five (G in the table) contributes to the total score but is not included in either subscale score. There are no reverse coded items in the MYTS. Self-scoring tables are also available in Appendix B: Measures and Self-Scoring Forms. Use the scoring form in the case where measures are fully completed (100% response rate). Otherwise, in cases with missing data, scoring can be done by computing the mean of completed items. Determining when too much missing data occurs for computing summary scores is at the discretion of the user. The analyses presented in this chapter required 85% of the items to have valid answers.

Table 10.10 MYTS-Youth Self-Scoring Form Values for Responses

Item

Not

at a

ll

Onl

y a

little

Som

ewha

t

Qui

te a

bit

Tota

lly Enter value for

selected responses here and calculate scores as instructed

1 1 2 3 4 5 A 2 1 2 3 4 5 B 3 1 2 3 4 5 C

4 1 2 3 4 5 D 5 1 2 3 4 5 E

6 1 2 3 4 5 F 7 1 2 3 4 5 G 8 1 2 3 4 5

H 9 1 2 3 4 5 I

10 1 2 3 4 5 J Sum of A, B, C, and J: K

K / 4: L Sum of D, E, and I: M

M / 3: N

Sum of F, G, and H: O O / 3: P

Sum of L, N, and P: Q

Q / 3: R MYTS-Youth Total Score = R MYTS-Youth Problem Recognition Subscale Score = L MYTS-Youth Desire for Help Subscale Score = N MYTS-Youth Treatment Readiness Subscale Score = O


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Table 10.11 MYTS-Adult Caregiver Self-Scoring Form Values for Responses

Item N

ot a

t all

Onl

y a

little

Som

ewha

t

Qui

te a

bit

Tota

lly

Enter value for selected responses here and calculate scores as instructed

01 1 2 3 4 5 A 02 1 2 3 4 5 B 03 1 2 3 4 5 C

Sum of A-C: D D / 3: E

04 1 2 3 4 5 F 05 1 2 3 4 5 G 06 1 2 3 4 5 H 07 1 2 3 4 5 I 08 1 2 3 4 5 J 09 1 2 3 4 5 K

Sum of F, H - K: L

L / 5: M Sum of E, G, M: N

N / 3: O MYTS-Adult Caregiver Total Score = O MYTS-Adult Caregiver Problem Recognition Subscale Score = E MYTS-Adult Caregiver Treatment Readiness Subscale Score = M

Interpretation The MYTS assesses treatment motivation during the previous two weeks. Scores on the MYTS can fluctuate significantly from one administration to the next. Thus, it is important to see if these changes represent clinically significant change and if so, what may be the cause. It will also be important to administer the MYTS frequently so that general trends can be reliably assessed. A negative trend indicates that the youth is not highly motivated to participate in his or her treatment. The scores of the MYTS can range from one to five, where a five represents high motivation for treatment while a one indicates low motivation. The scores presented below (Table 10.12) help to judge whether a score should be considered relatively low, medium, or high. Respondents who rate their motivation as high may recognize that the youth has a problem that requires treatment. High scores may also indicate that the respondent is ready to participate in and commit to the youth’s treatment. When a youth or caregiver reports low motivation it indicates that the respondent may not recognize the youth has a problem, that the respondent does not think the youth needs treatment, or that the youth or caregiver is not willing to change in order to help the youth improve.


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Low, Medium, High Scores Based on the psychometric sample, a total score greater than 3.9 in the MYTS-Youth is considered high, which indicates that the youth reports a strong positive motivation for counseling. If the total score is less than 2.9, it is considered low, indicating that the youth’s motivation for counseling is lower than the psychometric study sample. All scores in between represent a medium level of motivation. A total score greater than 4.1 in the MYTS-Adult Caregiver is considered high, which indicates that the caregiver reports a strong positive motivation for counseling. If the total score is less than 3.3, it is considered low, indicating that the caregiver’s motivation for counseling is lower than the psychometric study sample. All scores in between represent a medium level of motivation. Total scores for the MYTS are presented in Table 10.12.

Table 10.12 MYTS Low, Medium, and High Scores Scale Low Medium High

MYTS-Youth Total < 2.9 2.9 - 3.8 > 3.9

Problem Recognition < 2.0 2.0 – 3.5 > 3.5

Treatment Readiness < 3.0 3.0 – 4.3 > 4.3

MYTS-Adult Caregiver Total < 3.3 3.3 – 4.1 > 4.1

Problem Recognition < 2.3 2.3 – 3.7 > 3.7

Treatment Readiness < 3.6 3.6 – 4.4 > 4.4 Note: Data represented in this table reflect the nine item version of the MYTS-Adult Caregiver and the nine item MYTS-Youth. At this time, low, medium, and high scores are not available for the desire for help subscale for the youth version. This subscale includes the newly added item for which no data was available at the time this manual was written. Without this additional item the subscale is only represented by two items which is not sufficient for it to be considered a scale.

Percentile Ranks Table 10.13 shows the percentile ranks of total scores for the youth and adult caregiver versions of the MYTS. For example, on the MYTS-Youth, a score of 3.25 is in the 51st percentile. This means that in the psychometric sample, 51% of youth scored 3.25 or lower and 49% scored higher.


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Table 10.13 MYTS Percentile Ranks for Total Scores

MYTS-Youth MYTS-Adult Caregiver

Score Percentile Score Percentile Score Percentile

1.00 1 3.25 51 2.78 3 1.22 1 3.33 53 2.89 8 1.33 1 3.38 56 3.00 15 1.44 2 3.44 59 3.11 23 1.56 2 3.50 62 3.13 30 1.67 3 3.56 65 3.22 36 1.78 3 3.63 67 3.33 43 1.89 4 3.67 70 3.44 46 2.00 5 3.75 72 3.56 53 2.11 7 3.78 75 3.67 61 2.22 8 3.88 77 3.78 66 2.33 11 3.89 79 3.89 75 2.44 14 4.00 83 4.00 83 2.56 17 4.11 87 4.22 86 2.67 20 4.22 90 4.33 90 2.78 23 4.33 92 2.89 28 4.44 94 3.00 34 4.56 95 3.11 40 4.67 96 3.13 43 4.78 97 3.22 47 4.89 98

5.00 99

Note: Data represented in this table reflects the nine item version of the MYTS-Adult Caregiver and the nine item MYTS-Youth

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Retrieved January 29, 2007 from http://www.ibr.tcu.edu/presentations/PDF/tpm-evidence.pdf

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