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These user manuals are for the latest version of CARS. Visit the resources archive to view user manuals for previous versions of CARS.

CARS-5 User Manual (Windows Edition)

CARS-5 User Manual (macOS Edition)

To view quick guides, select the type of installation you have, then select the tab for the quick guide you would like to view, and then select the thumbnail to view or download a PDF of the quick guide.

These quick guides are for the latest version of CARS. Visit the resources archive to view quick guides for previous versions of CARS.

CARS-5 Quick Guides

Installing/Updating CARS

Q: After installing CARS I get the message, “Your site is not registered with the CARS Tool.” I already registered on the website.A: Website registration is separate from site registration (we understand, it is a bit confusing). Website registration helps the CARS Team keep track of users and notify users about updates and bug fixes. Site registration happens within the CARS tool. Site registration tailors the user experience and enables data sharing with the Division on Addiction.
Q: What if my virus software prevents me from downloading the CARS executable file from the website?A: CARS is completely safe to download and use. If you have issues downloading the CARS executable file, try downloading the zip file. The zip file is available as a separate link below the download button for Windows and Mac OS.
Q: I don’t see a confirmation email in my inbox.A: Emails from CARS may take up to 5 minutes to send. Make sure you have entered the correct email address, and check your spam folder. If you are still not receiving an email, your home network may not be allowing the validation email to send. Try connecting to a different network or using a mobile hotspot, then send the validation code again.

If you have tried these solutions and do not see a confirmation email, please contact us.
Q: Why am I being asked to save an update to CARS in a new directory?A: Your current version of CARS may still be running. Exit the program and attempt to install the update again. If you continue to experience issues with updating CARS, please contact us.
Q: After setting up a network configuration, the program will not open on a second computer.A: In a networked configuration, the main networked computer must to be running CARS for the secondary networked computer to be able to open CARS. If this is not possible, consider using multiple standalone configurations instead.

Logging In/Passwords

Q: I’m trying to log in as the administrator, but CARS won’t accept the username and password that I made on the website.A: CARS comes with a default administrator username and password that is separate from the login information for the CARS website. The default administrator username and password can be found in the “Setting Up CARS” section of the User Manual. After entering the default administrator credentials, you can change the administrator password. The default administrator username cannot be changed.
Q: I forgot the username/password for a CARS user account.A:
CARS 1.05 users: Click here for instructions on how to recover your password.

CARS-5 users: See “Password Recovery” in Quick Guides (click the “Quick Guides" tab above).
Q: How is the administrator different from other users?A: The administrator is a special CARS account for administrative functions. The administrator cannot conduct sessions.

Data

Q: When should I back up my data? How do I back up my data?A: When updating or reinstalling CARS, CARS will automatically back up your data. This backup data can be restored to your new installation.

Important Note: CARS-5 is not backwards-compatible with older versions of CARS. You will not be able to restore backup data from CARS 1.5 or earlier onto your installation of CARS-5. You will only be able to restore backup data that was generated using CARS-5 or later.

Additionally, we recommend that you back up your data on a regular basis. For detailed steps on how to backup and restore data, see the “Backing Up Data” and “Restoring Data” sections of the User Manual.

Conducting Sessions

Q: When trying to start a session, I receive the message, “No assigned modules.”A: You are logged in as the administrator. The administrator cannot run assessments. Log out of the administrator account, select New CARS Session again, and log in with a different user account.
Q: How do I go back to previous questions?A: Because of the complexity of the skip logic in the tool, CARS does not allow users to return to previous questions in a session or change their answers.
Q: A client is refusing to answer a question. What should I do?A: There are “Don’t Know” and “Refuse” response options for many questions in CARS. These can be selected under the “Answer” tab during sessions. “Don’t Know” and “Refuse” response options should be used sparingly; when possible, encourage a client to answer the question to the best of their ability.

If a question appears inside a grid, select the corresponding row in the grid before choosing Don’t Know or Refused. If a question consists of multiple parts, select the target section before choosing Don’t Know or Refused. Visual cues will appear to indicate that Don’t Know (yellow highlight) or Refused (red highlight) has been selected.
Q: Can clients complete CARS assessments remotely?A: There is currently no way to complete CARS assessments remotely. We are hoping to develop this feature in future versions of CARS. It is possible to administer CARS via video call (e.g., Skype) or over the phone, but we strongly encourage in-person administration.
Q: How can I view all of the questions in a module?A: PDF versions of CARS modules are available here.
Q: Is there a printable version of the assessment?A: PDF versions of CARS modules are available here. However, the CARS assessment implements complex skip logic and algorithms, and we do not recommend administering sessions using PDFs alone.
Q: When I enable the Depression or Mania module, the other turns on automatically.A: The Depression and Mania modules must be enabled at the same time in order to fully assess for symptoms of depression and bipolar disorder.
Q: When I try to reload a saved session, I'm stuck with the "Loading saved session" message.A: This might have resulted from trying to reload a saved session while signed in as the administrator. Quit CARS, then sign into a non-administrator account to reload the session. If the problem persists, please contact us.

Reports

Q: Why aren’t any referrals appearing on the generated reports?A: Diagnostic reports show referral sites that are matched to a client’s zip code. The default referral database is empty. To use this feature, users must add information about known mental health, substance use, and emergency treatment referrals in their area to the referral database.

For detailed information about how to add referrals, see “Adding Referral Information” and “Looking Up and Modifying Referrals” in the Quick Guides (click the "Quick Guides" tab above).
Q: Why do I see referral agencies that I have not entered on diagnostic reports?A: There are a small number of referral agencies that are pre-entered into the CARS referral database. These agencies were identified during our national pilot testing phase in 2016.
Q: A client received a diagnoses for a disorder. Does this mean they definitely have the disorder?A: In CARS, a “diagnosis” means that the client reported symptoms that satisfy all or some criteria for a given disorder. It is not a final diagnostic determination. Further evaluation is needed to determine whether problems reported are sufficient to qualify as a disorder.
Q: How specifically is [disorder] diagnosed in CARS?A: Please contact us with questions about specific diagnoses in CARS.

Other

Q: How much will CARS cost to implement at my site?A: CARS is free to download and use.
Q: What changes were made from CARS v1.05 to CARS-5?A: See the New in CARS-5 page for more information.
Q: Why is it called CARS-5?A: CARS stands for “Computerized Assessment and Referral System.” The latest CARS assessment is based on diagnostic criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. Hence, CARS-5.
Q: How is CARS-5 different from previous versions of CARS?A: CARS-5 is a significant update from previous CARS versions. There are many major changes to diagnoses, security, and overall functionality. We will soon upload documents to our website summarizing changes made between CARS 1.05 and CARS-5. For more detailed explanations of specific module changes, please contact us.
Q: What qualifications are needed to administer CARS?A: CARS is designed to be administered by anyone, no qualifications necessary. However, we highly recommend reading the User Manual and running practice sessions to familiarize yourself with the program before working with clients.
Q: Is CARS clinically validated?A: See Validation of CARS for more information.
Q: Does CARS come in languages other than English?A: CARS-5 includes Spanish options for the CARS Screener and Self-Administered Screener. The full CARS assessment is currently only available in English.
Q: Is the CARS assessment the same for males and females?A: CARS can be administered to anyone regardless of gender identity, and does not differentiate based on gender. CARS allows clients to identify as cisgender, transgender, or gender nonbinary. CARS also has an option for clients who prefer not to provide their gender.
Q: Does CARS have terms of use or an end-user license agreement?A: Currently there is no license agreement for CARS. We encourage users to use CARS as they see fit for their needs.
Q: Can children/adolescents be assessed with CARS?A: CARS can be used with adolescents, but CARS is currently developed specifically for adults aged 18 and older. We recommend using an alternative assessment method created specifically for adolescents.

Using CARS will be a learning process for both staff members and clients. As you familiarize yourself with CARS and incorporate it into your work, the efficiency of the tool depends on your clients’ and your own comfort level with the new process. Here we present tips for interviewing with CARS to help you prepare and anticipate difficult interview situations.

General CARS Interviewing Tips

  • We encourage users to conduct practice interviews with fellow staff members before interviewing clients to familiarize themselves with the program.
  • Like other mental health assessments, CARS can take a considerable amount of time to complete. If you think your client is becoming anxious or tired, consider taking a break.
  • Remember that, even with computer assistance, the assessment process is a conversation. You should be able to converse naturally and comfortably with clients and deviate from the planned interview sequence if a question or answer needs additional clarification or further discussion (e.g., suicidality, abuse, danger to others, etc). The computer’s job is to make data collection easier and more efficient. It should not dominate the interview.
  • CARS produces a diagnostic report for each individual who completes the assessment. Reports are meant to be shared with clients. After completing an assessment, review the issues identified in the report and discuss next steps. Clients should receive a copy of their report as well.

Answering Client Questions

The use of CARS will be new to your clients, and some might express hesitation, discomfort, or even resistance to participate in a computerized interview. Some clients might not understand the technology, others might feel paranoia or anxiety about the use of a computer, and others might just find the presence of a computer too distracting.

Therefore, it is useful to anticipate questions that clients might ask about CARS. Below is a list of potential client questions. If you have experienced other questions or situations when using CARS that you think other CARS users should know about, please share them with us at info@CARStrainingcenter.org.

Q: What is this?A: This is a computerized clinical interview. It helps us work together to identify any emotional or mental health concerns you may have.
Q: Why are you using a computer?A: The computer helps guide our conversation. A lot of research shows that assessments are most effective when using guided interviews like this one.

Note: You can show them the screen if they want to see it.
Q: How long will this take?A: It is different for different people. [If using the CARS Screener] About 20 to 50 minutes. [If using CARS] Between 20 minutes and 2 hours. The average time is about an hour. You may take a break at any point in the interview if you need one.

Note: Modules & Timing contains time estimates for the CARS Screener and for each CARS module.
Q: Who will see my answers?A: Only staff who are associated with your case will be entitled to see your responses and know they are yours. If you would like this information shared with someone else, let us know.
Q: Who made CARS?A: CARS was developed by a research team in Boston, the Division on Addiction. Their research focuses on addiction and other mental disorders.

Sensitive CARS Interview Questions

Below are examples of sensitive questions in CARS. Be prepared to ask them.

Note: These questions are taken from CARS-5. Older CARS versions may contain different wordings of these questions.

Mental Health

  • Have you ever had a time in your life lasting several days or longer when most of the day you felt sad, empty or depressed?
  • Have you ever had an attack of anger when all of a sudden you lost control and hit or tried to hurt a person or animal?
  • Was there ever a time in your life when you had a great deal of concern about or strongly feared being too fat or overweight?
  • Did you ever see a vision that other people could not see, or hear voices that other people could not hear?
  • Have you ever had an extremely stressful or upsetting experience which continued to bother you or affect your life for a period of time?

Substance Use

  • Was there ever a time in your life when your drug use frequently interfered with your work or responsibilities at school, on a job, or at home?
  • Have you driven after drinking any alcohol during the past 12 months?
  • How often have you used heroin during the past 12 months?

Suicidal Ideation

  • Have you ever seriously thought about committing suicide?
  • Are you currently thinking about committing suicide?
  • Do you currently have a plan for committing suicide?
  • Have you taken any steps toward completing your plan?
  • Did you ever think that it would be better if you were dead?

Bugs are any issues with the CARS software that cause it to crash, operate incorrectly, or produce incorrect output. If you think you have found a bug, you can help improve CARS by reporting it in the form below.

Reporting a bug is separate from help requests. If you have a specific question about using CARS or need to contact us, click the “Contact Us” tab.

Many questions about using CARS can be answered by reviewing the CARS User Manual, Quick Guides, and Frequently Asked Questions. You can view these resources by clicking the tabs above.

If you still have unanswered questions or suggestions for improving CARS, please contact us directly.