ASI-MV Worksheets & Handouts

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ASI-MVWORKSHEETS & HANDOUTSAddictionsRelapse PreventionRP-1 Preventing Relapse QuizHO-1 What is Addiction?RP-2 How Well Are You Preventing Relapse?HO-2 Points for the Family to Remember(Pre-recovery)RP-3 Stages of RecoveryRP-4 Relapse Prevention Self AssessmentHO-3 Points for the Family to Remember(Post-recovery)RP-5 Treatment Attitudes QuestionnaireHO-4 DenialRP-6 Negative Behaviors in TreatmentHO-5 Myths of AddictionRP-7 Recovery Behaviors FormHO-6 Ten Things You Should Know AboutAlcohol and AlcoholismRP-8 High Risk Situations for RelapseRP-9 My High Risk SituationsContinuing CareRP-10 Some Common Recovery DilemmasCC-1 Self-Care AssessmentRP-11 My Recovery DilemmasCC-2 Self-Care Goals WorksheetRP-12 Managing Cravings: Tricks and ToolsCC-3 Feelings Management StrategiesRP-13 My Craving TriggersCC-4 Feeling Skills HandoutRP-14 Protracted WithdrawalCC-5 Assertiveness SkillsRP-15 Abstinence Violation EffectCC-6 Learning To Say “No”RP-16 Seemingly Irrelevant DecisionsCC-7 Unrealistic ThinkingRP-17 My Relapse AttitudesCC-8 What is Depression and Anxiety?RP-18 Managing My Relapse ThinkingCC-9 Support Network SurveyRP-19 Think Your Way Out of UsingCC-10 RelaxationRP-20 Assessing Your LifestyleEmploymentRP-21 Leisure Activity ExerciseE-1 The Ready-for Work ChecklistRP-22 Social Survival ManualE-2 The Right Job ChecklistRP-23 Safe and Dangerous ContactsE-3 Thinking About A More Open RecoveryE-4 Making Work Work For YouResourcesR-1 General Resources for Help and Info 2007 Inflexxion, Inc. Newton, MA

RP-1PREVENTING RELAPSE QUIZ1. Relapse begins when you use alcohol and or drugs.TRUEFALSE2. People relapse because they fail to use willpower.TRUEFALSE3. The primary causes of relapse are negative events in the person’s life.TRUEFALSE4. Relapse is sudden and unpredictable.TRUEFALSE5. All recovering persons experience equally strong tendencies toward relapse.TRUEFALSE6. Relapse involves a conscious and voluntary choice to use.TRUEFALSE7. Withdrawal from a substance (i.e. cocaine, opiates) is complete within 1-2 days.TRUEFALSE8. The only way to help a chronic relapser is to hope for a spiritual awakening.TRUEFALSE9. The substance user with a long history of relapse will usually be unable to recover.TRUEFALSE10. People relapse because they haven’t “hit bottom” yet.TRUEFALSEAdapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-2HOW WELL ARE YOU PREVENTING RELAPSE?1. Have you set goals related to staying clean? What will staying clean allow you to accomplish?2. Assess your alcohol and/or substance abuse practices:a) what stimuli set you off? (money, people, paraphernalia, etc.)b) who in your work/home/social environments use alcohol and/or drugs?c) what is the availability of alcohol and drugs in your environment?d) what is the availability of money to obtain alcohol and drugs? Will you be receiving any significant sum ofmoney in the near future?3. Have you reviewed all of your high-risk situations with peers and staff?4. Do you have plans for all anticipated high-risk situations?5. Have you discussed the feelings of loss or deprivation that accompany getting straight? Do you feel cheatedbecause you can’t use drugs?6. Are you aware of how you justify your alcohol and/or drug use?7. Are you aware of ways that you have tried to control your usage?8. Are you prepared for the highs and lows of recovery?9. Have you taken steps to limit the availability of alcohol and/or other substances?10. Have you told all important people in your life about your addiction(s)?11. Do you expect treatment to be a “cure” or “magical” solution?12. How do you “test” yourself in recovery?13. How will you limit exposure to people who use drugs or drink?14. Are you aware of how you make the “chain” of decisions that lead to opiate use?15. Have you examined past relapses? Do you see them as mistakes, failures, or episodes of weakness?16. What personality traits do you have that may interfere with recovery?17. Do you feel entitled to use drugs or drink?18. How well can you keep track of how you are feeling?19. How well do you solve problems? Do you jump at the first apparent solution?20. Do you assume that if you don’t have cravings in treatment that you won’t have them after treatment?21. Do you see craving as something that has a life of its own, something out of your control?22. What lifestyle changes have you made? Do you need to change the way you structure things?23. Do you seek out help or wait for it to come to you?24. What are your plans to reduce complications or crises in your life?Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-3STAGES OF RECOVERY1. Abstinence (0-6 months)a)b)c)d)Focus is on avoiding substance usageTasks are specific and concrete—changes in behavior are readily observedResults are seen relatively quickly—less crises in lifeChange in daily routine occupies most of one’s attention2. Lifestyle Change (6-18 months)a) Focus is on relapse preventionb) Tasks involve decisions about relationships, residence, leisure, job, and familyc) Results take somewhat longer because these changes are more involved and may directlyaffect other peopled) Building a long-term foundation occupies most of one’s attention3. Self-Knowledge (greater than 18 months)a) Focus is on long-term issues—trauma, psychological disorders, personality issues,unresolved conflictsb) Tasks are more involved and require significant time-investment, such as psychotherapyc) Results are less specific because they involve internal changed) Understanding one’s life occupies most of one’s attention4. Spirituality (lifetime)a) Focus is on “Who am I?”—the meaning of life, purpose or mission in life, long-term goals, asense of priorities, knowing one’s place in the world, a sense of why one is here on earthb) Tasks are very involved—for some it may involve religion, for others it means finding amentor, for all it means much self-reflectionc) Results take a lifetime—these questions are ongoingd) Gaining a sense of identity occupies most of attentionRemember: 1. These stages are not forced—you do not decide which stage you are in.2. These stages are gradual—you may not notice that you are in a new stageuntil someone tells you3. Each stage builds on the last stage—you cannot jump ahead without buildinga good foundation4. Different people get “stuck” at different stages—you can learn from someonewhose recovery is more advanced than yours 2007 Inflexxion, Inc. Newton, MA

RP-4RELAPSE PREVENTION SELF ASSESSMENTWhat specific behaviors and other warning signs preceded your most recent relapse?How much time elapsed between the time you noticed warning signs and the time you actuallyused drugs and/or alcohol?Where did your relapse occur and who were you with at the time?What attitudes, feelings, and behaviors preceded this episode of drug and/or alcohol use?What could you have done differently to prevent this relapse from occurring?Using the following scale, honestly rate your current motivation for doing what is necessary toprevent another relapse?12345678910Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-5TREATMENT ATTITUDES QUESTIONNAIRE1. How many times have you received inpatient treatment for addiction?If this is your first treatment, go to Question 62. What was effective about past treatments?3. What was ineffective about past treatments?4. Which treatment suggestions did you follow?5. Which treatment suggestions did you ignore?6. Have you attended N.A. or A.A. meetings?- If yes, what was effective about the meetings?- What was ineffective about the meetings?7. Please answer the following questions True (T) or False (F):I expect treatment to require much work on my partI get annoyed when people say that I need treatmentI expect long-term benefit from treatmentIf I refused treatment, I would feel guiltyI need support to help me remain clean and soberWhen I finish treatment, most of my problems will be solvedI can handle my problems myselfAs long as I’m clean, everything should fall into placeMy addiction is caused by negative events in my lifeI don’t see the benefit of talking about my problemsI object to the idea of attending a lot of meetingsAnyone faced with my problems would use or drinkMy family and friends support my treatmentI don’t trust people enough to open up about myselfI need to change my lifestyle to remain clean and soberI am willing to change my daily schedule to include aftercareI am willing to take direction from others with my recoveryI tend to get defensive when people give me feedbackAdapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-6NEGATIVE BEHAVIORS IN TREATMENTIntimidator—uses anger to drive people awayIntellectual—mistakes knowledge for understandingVictim—blames negative events for addictionBlamer—blames other people for addictionPlaying Dumb—“I don’t understand”Avoider—tries to keep a low profileSocialite—keeps a high profile, but is superficialN.A. / A.A. Expert—speaks in slogans, but doesn’t get personalCon Man—thinks he (or she) is fooling peopleClose Minded—“I know what I have to do”Magic Bullet—“I know what caused my addiction”“Yeah, But”—“That’s a good idea, but it won’t work”Deflector—tries to focus attention away from selfLip Service—agrees to follow through, but never doesController—tries to control the course of treatmentRabble-Rouser—tries to turn patients against staffSuspicious—“What will you do with this information?”Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-7RECOVERY BEHAVIORS FORMFrom the list of negative treatment behaviors (see RP-6), list 3 you believe you display. For eachone, list 3 positive actions you can take to improve it.For example:- Negative Treatment Behavior — Avoider; this person tries to keep a low profile- Positive Recovery Actions:1. Make an effort to introduce myself to new people2. Begin talking in groups, even if it means starting slowly3. Try to understand why I am trying to keep a low profile (i.e., am I scared, don’t knowwhat I am supposed to be doing in treatment; because I don’t really want to be intreatment; because I’m ashamed of having relapsed?) Talk to a staff member aboutthe reasons for my negative behavior.1. Negative Treatment Behavior:Positive Recovery Actions:2. Negative Treatment Behavior:Positive Recovery Actions:3. Negative Treatment Behavior:Positive Recovery Actions:Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-8HIGH RISK SITUATIONS FOR RELAPSENegative EmotionsRelapse sometimes occurs when you are feeling emotionally upset and you want to usedrugs/alcohol to change the way you are feeling. You may want to use to cope with fear,frustration, anger, sadness, anxiety, tension, boredom, depression, loneliness, or guilt.Negative Physical/Physiological StatesRelapse sometimes occurs because of difficulty dealing with negative physical states and youwant to use drugs/alcohol to change the way you feel physically. These negative physicalstates could be associated with prior drug/alcohol use, like feeling shaky and sick, or havingdifficulty sleeping. Other negative physical states are independent of previous substance use,such as pain, illness, injury, fatigue, or headache.Enhancement of Positive EmotionsRelapse sometimes occurs when you are feeling good and want to feel even better. You mightuse to increase feelings of pleasure, freedom, or sexual excitement. These relapses are oftenconnected to special events like a birthday, holiday, or vacation. It can be tempting to make aspecial exception and give yourself permission “just this one time.”Testing Personal ControlDuring a period of recovery, you may be tempted to test your recovery. You might begin toquestion whether you are really an addict. You may decide to use once just to see if you areable to stop, or test your willpower by putting yourself in a tempting situation.Giving In to Temptation or UrgesTemptations or urges to use often happen when you are in the presence of drugs or in thepresence of something that reminds you of drugs, like scenes in a movie. There also might betimes when you have urges to use that seem to come “out of the blue.”Coping with ConflictRelapse sometimes occurs when you have difficulty coping with a conflict with another person,such as a friend, family member, or co-worker. You might experience feelings like frustration,jealousy, or anger stemming from an argument, disagreement, or a fight. This category alsoincludes other emotions that are directly connected to an interaction with another person, suchas anxiety, tension, worry, concern, or fear.Social PressureYou may experience pressure to use in social situations. Sometimes the pressure is direct, likewhen another person verbally encourages you to use. Other times that pressure is moreindirect, such as when you are in a situation where you are watching other people use.Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-9MY HIGH RISK SITUATIONSReferring to High Risk Situations for Relapse (handout RP-8), list three (3) situations that put you athigh risk for relapse. For each situation, give a specific example of a risky situation you haveexperienced in the past. Then list 3 coping skills you could use to handle that situation.Example: High Risk Situation — ConflictExample: I always feel like getting high when I fight with my boyfriendCoping Skills:1. Take a walk to clear my head2. Remind myself of the negative consequences of getting high3. Write in my journal about my feelings1. High Risk Situation:Example:Coping Skills:2. High Risk Situation:Example:Coping Skills:3. High Risk Situation:Example:Coping Skills:Adapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-10SOME COMMON RECOVERY DILEMMASÖ Your dealer wants the money that you owe himÖ Your spouse asks you why you need to attend so many NA/AA meetingsÖ Your mother wonders how you got “this way”Ö Your friends invite you to a party saying that you can just drinkÖ Your friends offer you marijuana, saying that your “real” problem is cocaineÖ You feel that you are missing out on “where the action is”Ö You wonder how you will get to sleep without a substanceÖ You wonder how you will deal with your sadness, loneliness, or anxiety without drugsand/or alcoholÖ You wonder how you will be able to talk with people without a being highÖ You wonder “what is normal”Ö You wonder how you will handle physical pain without substancesÖ A friend drops by for a “visit” with drugs and/or alcoholÖ A family member ridicules you for being a “holy roller” because you attend NA/AA meetingsÖ You cannot figure out how you will walk down your street without running into people withdrugs or alcoholÖ You feel lost because you have to give up activities connected to drug/alcohol useÖ You don’t know how you will cope with your stressful jobÖ A friend reminds you of the “good times”Ö You feel guilty about stealing or conning people for money to get drugsÖ You feel like a failure because of your past relapsesÖ You wonder about your personality as a clean and sober personÖ You have not had sex without chemicals in years—now what do you doAdapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-11MY RECOVERY DILEMMASReferring to Some Common Recovery Dilemmas (handout RP-10), choose a recovery dilemmaand write out your responses to the following 6 points:1.2.3.4.5.6.Give an example of a specific situation that is a risk to your recovery.Give an example of an old coping strategy for dealing with this situation.Identify the consequences of this old behavior.Describe the outcome you want in recovery.Describe the benefits you anticipate will come from this new behavior.Describe your new strategy for achieving the outcome you want.Recovery Dilemma:1. Risky Situation2. Old Coping Strategy3. Consequences4. Desired Outcome5. Anticipated Benefits of New Behavior6. New StrategyAdapted from: Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R. (2003), Time-Effective Treatment: A Best Practices Manual forSubstance Abuse Professionals. Center City, MN: Hazelden Foundation. 2007 Inflexxion, Inc. Newton, MA

RP-12MANAGING CRAVINGS: TRICKS AND TOOLSThere may be people, places, and situations that you should avoid so as not to put yourself at risk forrelapse. There is no way to avoid all high-risk people or situations, but you can be aware of yourpersonal triggers and avoid them as much as possible. Early recovery is not the time for you to “test”yourself by purposely putting yourself in risky situations. If you know ahead of time that you will be in asituation that might be risky, develop a plan so that you can cope with cravings if they develop.If you find yourself in a situation that is triggering a craving — LEAVE; you may have to make somepolite excuse, but your recovery has to come first.Find someone supportive to talk to about how you feel — a sponsor or other friends in recovery. Ifyou call someone and they are not available, keep calling until you reach someone. Alwayshave phone numbers available in case of an emergency.Attend a self-help meeting, such as A.A., C.A., or N.A. You will not use drugs/alcohol during thetime you are there.Distract yourself by doing something active—exercising, playing with your children, washing thedishes or the car, taking a shower, taking a drive in the country, mowing the lawn, reading abook. Or go somewhere where neither drugs or alcohol is available—a movie, a museum, or aconcert.Write down what you are feeling or thinking in a journal. Describe your craving and the situationin which it occurred. Track the outcome by reporting the coping strategies you used—this mayhelp you see a pattern.Remember that cravings are ALWAYS temporary—they don’t have to lead to using. Rememberthat using will solve none of your problems—remember the negative consequences of yourdrug/alcohol use.Powerful but infrequent triggers such as the loss of a loved one, can trigger old habits in anotherwise solid recovery. In times of crisis, use the recovery tools that have been working foryou all along.Put off the decision to use drugs/alcohol, even for fifteen minutes at a time. Remember that urgesare like waves—they crest and then recede—ride them out.Remove all alcohol, drugs, and paraphernalia from your home—they can keep craving alive.If you have a using/drinking dream, remind yourself that it is normal—they will eventually go away.Write it down and talk about it; th

_ My addiction is caused by negative events in my life _ I don’t see the benefit of talking about my problems _ I object to the idea of attending a lot of meetings _ Anyone faced with my problems would use or drink _ My family and friends support my treatment _ I don’t trust people enough to open up about myself

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