Timeline Followback

Efficient and standardized measures of substance abuse and dependence are needed to assist in treatment planning, as well as to measure treatment outcomes. When assessing for substance abuse and dependence, it is imperative to employ standardized measures of alcohol and drug use frequency across an extended time, so patterns of use can be better understood. The Timeline Followback (TLFB) procedure is the most widely employed standardized measure that assesses retrospective self-report estimates of substance use. The TLFB method was originally developed in the 1970s to assess alcohol frequency. Since its original development, the TLFB has developed into an assessment measure that can be utilized in a variety of settings and formats. This procedure can also be utilized to assess the frequency of a wide variety of substances and measurable behaviors related to commonly co-occurring problems and treatment goals associated with substance abuse.

In this procedure, the assessment professional presents the substance abuser with a calendar that includes commonly experienced significant events (e.g., holidays, disastrous weather, professional sporting events, elections, accidents with mass casualties). Next the individual is instructed to record memorable personal events on their retrospective date of occurrence (e.g., anniversaries, birthdays, work-related events, funerals, arrests, celebrations, hospitalizations). These common and idiosyncratic events serve as anchor points to assist the respondent in remembering his or her substance use patterns during these time periods. The respondent is then instructed to estimate his or her daily substance use consumption for a specified time period ranging up to the past 12 months. Whenever possible, a standard drink and drug conversion chart should be utilized to assist the respondent in estimating the approximate amount of substances consumed during a particular occurrence.

If desired, the assessor can also utilize several memory aids or techniques to assist the respondent in accurately recalling substance use patterns. The interviewer can instruct the respondent to record black and white days. This technique involves querying the individual for extended periods of continuous substance use (i.e., black) and abstinence (i.e., white). Similarly, the interviewer can query for periods of heavy and light substance use. To establish boundaries on the amounts of substances used, the assessor can begin the interview by querying the respondent on the most and/or least amount of substance(s) consumed on any single day during the specified reporting period. To avoid vague quantity consumption reports (e.g., smoked a lot or a little, drank too much), the interviewer can provide more appropriate examples to assist in more accurately specifying the quantity of substances used. Additionally, when scheduling the initial assessment, the interviewer can instruct the individual to bring his or her own memory aids (e.g., appointment and schedule books, planners, diaries, calendars) to the interview.

Several versions of the TLFB procedure are currently available; these include a paper-and-pencil method, a computerized version, and a telephone [Page 903]interview. The TLFB procedure can be self-administered or administered by an assessor individually or in group formats. Administration times vary depending on the format that is utilized and the time interval that is assessed. Typical administration times are approximately 10 to 15 minutes for the 90-day TLFB and 25 minutes for the 12-month procedure. Group administration times may require more time.

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