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Phoenix/New Freedom Programs

A Road Not Taken:A Substance Abuse Program That Works!

In 2007, Phoenix/New Freedom programs worked closely with Dr. Daniel Selling (currentlyExecutive Director of Mental Health and Director of Substance Abuse Treatment for CorrectionalHealth Services, City of New York) to create a substance abuse program for use in New YorkCity Jails, particularly Riker’s Island (a daily inmate population of around 14,000).

Program HistoryIn December of 2007, the program, called A Road Not Taken, was initially implemented in two unitsat Riker’s Island.

In 2008, drug court judges began to note that inmates who completed the program were not beingre-arrested as frequently as those who did not receive the programming. In May of that year, theprogram was officially partnered with the drug courts, and judges began sentencing offenders directlyinto the program.

By December of 2011, the program was expanded to multiple units-- 3 male general population, 1 male Mentally Ill/Chemically Addicted unit, and 2 female general population units.

The ProgramNew Freedom’s A Road Not Taken is a workbook-based group model based on: • The Transtheoretical Model of Change• Cognitive Behavioral Therapy• Motivational Interviewing

The program includes:1. Case management2. Individual counseling3. Daily curriculum (group) counseling

Program Evaluation ResultsThe results of the program evaluation were highly significant! A 41.67% reduction in multiple re-arrests, and a significant 23% reduction of recidivism for those experiencing a longer length ofstay (more than 41 days) in the program.

A New Freedom • ©1998 - 2014 A.R. Phoenix Resources, Inc • www.newfreedomprograms.com

A Road Not Taken Evaluation Results

Counselors gathered data at intake and at discharge. Data was regularly reported to programadministrators. Separate reports were quality-checked and compiled, then linked to DOC databasesfor incarceration history.

An evaluation sample was taken of 785 clients, who were all released by November 28, 2010.

.

Multiple arrests upon release: The jail population is typically characterized by frequent re-arrests. One year later, the analystslooked at the number of times clients in the evaluation sample were re-arrested in that 1 yearperiod:

• Pre: The average number of arrests for the year prior to the jail sentence in which A RoadNot Taken enrollment occurred was 1.2 times

• Post: The average number of arrests for the year following that jail sentence was .75

This means the average number of re-arrests per client significantly reduced from 1.2to .751 – a reduction of 41.67%*.

This reduction in arrests is a significant outcome for this high-risk population.

*Statistically significant: P-value < .001%

Recidivism:Then the analysts looked at the percentage of clients arrested at least once during the 1 yearperiod following discharge:

• Pre: The percentage of clients arrested during the year prior to the jail sentence in whichARNT enrollment occurred was 57%

• Post: The percentage of clients arrested during the year following that jail sentence was43%

The percentage of clients arrested in a 1 yr period significantly decreased from 57% to43% — a difference of 14%*.

*Statistically significant: P-value < .001%


ConclusionIn October of 2012, the research presented here was selected to be presented at the AmericanPublic Health Association 140th Annual Meeting and Expo in San Francisco. The session,called “Residential substance abuse treatment in the New York City jail system”, outlined theresearch outlined above. You can read a full description of the session here: https://apha.confex.com/apha/140am/webprogram/Paper266905.html

Also presented at that meeting were the preliminary results of data from a parallel New FreedomMental Health program called Beyond The Bridge. You can read about it here:https://apha.confex.com/apha/140am/webprogram/Paper268314.html

As this is a short-stay jail population, the positive outcomes presented here are especially significant. This accomplishment is even more significant when one looks at the positive differences experiencedwhen the dosage was increased.

Notice the 23% recidivism drop to 32% for those who received the program for morethan 41 days. For an adult jail population, this is an unusual and noteworthy result.

For more information about A Road Not Taken, Beyond The Bridge, or any of our multitude ofevidence-based resources for both adult and juvenile populations, please contact us at: 212-462-3055, or visit our websites at:

www.newfreedomprograms.com/www.phoenixcurriculum.com/www.gangprograms.com/www.insightandoutlook.com/

Length of Stay:Finally, the analysts examined the effect of length of stay in the program. The average length ofstay was 41 days. So the evaluation sample was divided into those staying under 41 days and thosestaying over 41 days.

• Those in the program under 41 days saw a significant reduction in re-incarceration, from1.26 to .982– a difference of 22%

• Those in the program over 41 days saw a significant reduction in re-incarceration, from1.15 to .523– a difference of 55%

• Those under 41 days saw no significant reduction in recidivism from 58% to 53%• Those over 41 days saw a significant reduction in recidivism from 55% to 32%– a

difference of 23%


Core Program

Stage 1 Preparation For Treatment: Pre-contemplation

Page 1 Pre1 What am I doing here? (3-6 program hours) ▶

Page 33 Pre3a,d Treatment readiness activities (3 program hours) ▶

Page 52 SD1 Introduction to Self-Discovery (3 program hours) ▶

Stage 2 Self-Discovery: Pre-contemplation to contemplation

Page 76 SD7a-b My life so far (4 program hours) ▶

Page 133 SD2 What went wrong? (9 program hours) ▶

Page 165 SD5 Understanding your dependencies (8 program hours) ▶

Page 209 SD6 Reasons to change (6 program hours) ▶

Page 243 SD11 What’s going on in my life? (7 program hours) ▶

Page 269 F5 Shame (6 program hours) ▶

Page 302 F11 Are you an “excitement junkie”? (1-2 program hours) ▶

Page 316 SA1 Self-awareness: preventing relapse by increasing your ▶ sensitivity to cues, patterns or cycles (5 program hours)

Page 341 CC9 Denial (1 program hour) ▶

Stage 3 Returning Home: Preparation for community reintegration

Page 351 RH6 Making positive steps to take control of your life (5 program hours) ▶

Page 381 RH5 If you “lapse” (5 program hours) ▶

30 RH7 Avoiding the negative (5 program hours) ▶

Page 453 RH14 Getting close to getting out (2 program hours) ▶

SuPPlemental reSourCeS

Page 466 AODA MI 1-4 Motivational Interviewing Resources ▶

Page 606 Competency Checklists ▶

Page 618 Fidelity Monitoring Checklist ▶

Page 620 Logic Model ▶

a road not taken

Phoenix/new Freedom ProgramS SubStanCe abuSe Program


A Road Not Taken: LM

Logic Model

A New Freedom • ©1998 - 2014 A.R. Phoenix Resources, Inc • www.newfreedomprograms.com • Page 620

New Freedom Curriculum TARGET POPULATIONS/ STRATEGIES/ IMMEDIATE INTERMEDIATE FINAL THEORY ACTIVITIES OUTCOMES OUTCOMES OUTCOMES

Training of Program Facilitators Focus on Underlying theory of chance Facilitator as instrument of resiliency building Facilitator as change agent Preparing program staff to deliver each intervention

component

Pre-Contemplation (residents are unwilling to change, unaware, resistant, or in severe denial) • Activities – using MET/MI techniques, group contact,

and brief workbooks and materials -- to engage residents, enhance motivation and receptiveness

Contemplation (residents participate, but there is still some denial and/or resistance) • Activities – using MET/MI and CBT techniques,

group contact, workbooks and materials -- to increase self-awareness and emotional recognition; realistic assessment of current lifestyle; identify values, goals, and risk factors

Preparation (target population participates, uses program materials, and talks, although some resistance remains) • Activities – using MET/CBT techniques, group

contact, workbooks and materials -- aimed to identify what needs to be changed in the offender’s life; testing new ideas and learning new skill sets; understanding thinking and behavioral issues

Action (target population actively pursues new and can address significant issues and feelings) • Activities – using CBT and social learning/relapse

prevention, group contact, workbooks and materials: practice new skills; actively change negative behavioral patterns; address issues and techniques for building self-efficacy and healthy relationships

Maintenance and Aftercare (target population prepares to return to the community, remain honest and continue to practice new skills) • Prepare, review, and revise detailed post-release

relapse prevention plans; implement pro-actively • Develop action plans dealing with risk factors, family,

friends, and linking with protective factors at release

BOX 1: See Appendix for Details • Staff begins to build trust, and identify and reduce

resistance to the programming • Target population identifies life goals and current

feelings • Initial steps to engage in individual and group

counseling through guided self-disclosure

BOX 2: See Appendix for Details • Active participation in programming • Target population is aware of feelings • Target population identifies costs and

consequences (for self and others) of “old behaviors”

• Target population identify alternative life options

Box 3: See Appendix for Details • Target population demonstrates insight into

behavior • Identifies and begin to address specific issues

relating to past behaviors, including underlying thoughts and feelings, triggers, symptoms/cues

• Learning and demonstrating basic coping, interpersonal and communication skills

BOX 4: See Appendix for Details • Target population demonstrates repeatedly

successful coping with variations on their highest risk situations

• Demonstrate competence in a range of specific coping, assertion, refusal, resistance, resiliency, violence avoidance, and self-management skills.

• Evidence of self-efficacy in counseling

BOXES 5 & 6: See Appendix for Details • Demonstrated understanding of and active

participation in programming • Development of post-release, recidivism, and

relapse prevention plans • Commitment to post-release plans

Staff demonstrates understanding of underlying concepts and is prepared to deliver intervention programming with high fidelity

• Target population internalizes program messages

• Target population recognizes the negative consequences associated with deviant peer involvement

• Target population stays committed to prosocial behavior

• Target population utilizes their new assertion, refusal, resistance, and resiliency skills, and generalize them across situations

• Decrease in violence and substance use in residential facility

• Target population follow their action plans

• Decreased prevalence and incidence of recidivism

• Decreased prevalence and incidence of post-release substance use

• Increased compliance with drug testing

• Decreased post-release infractions of probation regulations and requirements

• Active participation in post-release treatment/ counseling/support groups activities as required

Structured and monitored substance abuse

interventions based on cognitive-behavioral,

motivational enhancement, and social learning philosophies will reduce the resistance to behavioral change and

decrease antisocial behaviors, including substance use and

abuse

Increase in resiliency factors targeted by program, including: • Specific coping skills for

relapse prevention • Anger management skills • Life skills • Impulse management • Environmental controls • Problem solving/self-regulation • Skills for dealing with thoughts,

cravings, and feelings • Communication skills • Substance abuse education • Goal setting skills • Develop personal safety nets • Victim empathy • Gender/cultural identity • Employability skills • Recreation/leisure time skills • Family involvement

A New Freedom • ©1998 - 2014 A.R. Phoenix Resources, Inc • www.newfreedomprograms.com • 21

A Road Not Taken: CC

Competency Checklists


A Road Not TakenCompetency Checklists

Participant :

Outcomes Rating(A-B-C)

Date Initials Comments

RATING SCALE: A = Excels: demonstrates comprehension and competency with tools, concepts, or skills,

demonstrates insightB = Basic comprehension: demonstrates basic familiarity, not thorough competence with tools,

concepts, or skillsC = Little to no comprehension: demonstrates a lack of comprehension of tools, concepts or

skills

Stage 1: Preparation For Treatment - Pre-contemplation

Pre1: What amI doing here?

List three (3) temptations, influences,pressures, or models you had fordrinking or drug use.

List at least two (2) other behaviorsbesides alcohol or other drugs youhave used to help cope.

List four (4) examples ofconsequences of your pastbehaviors.

Pre3a,d:Treatmentreadinessactivities

Identify personal goals (Finish thissentence: What I want most in life....)

Identify specific feelings or concerns:(Finish this sentence: My lowest daysare....)

Identify life-changing events (What isone event in your life that has made abig difference?)




SD1:Introductionto Self-Discovery

Name three (3) specific “costs” orbad consequences of your oldpatterns of behavior.

Identify 1-2 specific areas ofresistance. (Identify one or two areaswhere you don’t want to change, orwhere you might find it hard tochange.)

Stage 2: Self-Discovery

SD7: My lifeso far

Identify issues and risk factors.

Provide information on substancesused or abused.

Identify risk factors for violence andcriminal behavior.

Complete initial action plan toaddress dysfunctionalbehaviors.

SD2: Whatwent wrong?

Identify current burdens andvulnerabilities. (Name three specificareas where you are still“vulnerable.”)

List three specific “triggers” and howyou feel when they happen.

Identify ineffective coping skills (Listthree bad or harmful things you havedone in the past when you feltuncomfortable, vulnerable, or atrisk.)




SD5:Understandingyourdependencies

Admit harmful dependencies (Listthree addictions,dependencies, or other dysfunctionalbehaviors).

Describe how emotional discomforthas led to specific harmful behaviors -past and present. (Give twoexamples.)

Describe current harmful behaviors.

Describe replacement of onedependency with another.

(Optional) Identify areas ofdiscomfort relating to past harm;identify issues relating to trust andintimacy.

Describe frequency, intensity andduration of chronic problems bycompleting chart on past and presentlevels of discomfort.

List three (3 ) things you can do rightnow to keep from falling back intoyour old behaviors.




SD6: Reasonsto change

Identify consequences for self andothers of specific dependencies,compulsive, harmful or addictivebehaviors.

Name two (2) things you did whichharmed people in your family orother people you know.

Name two (2 ) things you did whichharmed other people.

Identify current thinking about thesebehaviors.

Examine readiness for change. (Howdo you feel about those behaviorstoday?)

Explain specific reasons (motivation)to consider changing from pastpatterns of dependencies.

Explain barriers or obstacles he/sheperceives to changing. (What barriersor obstacles are in the way of makingthe positive changes you need tomake in your life? Describe whatyou are doing to remove thosebarriers.)




SD11: What’sgoing on in mylife?

List three (3) words to describe howyou are feeling today.

List three (3) temptations, influences,pressures or models you had fordrinking or drug use.

List at least two other behavior youused to help cope.

Identify four (4) costs orconsequences of your drinking ordrug use.

Describe the role drugs or alcoholplayed in your being here.

Evaluate your current level of alcoholor other drug use.

Explain your understanding of howalcohol or other drugs can beharmful to you.

Identify readiness for change. Indicateassessment of current stage of change

‘ pre-contemplation‘ contemplation‘ preparation‘ action‘ maintenance




F5: Shame Complete an assessment of shameand low self-esteem issues.

Use selected vocabulary to describeshame in specific situations.

Identify sources of shame (Describetwo issues which have caused you tofeel shame in the past - and whichcould cause you problems today).

Identify personal triggers for feelingshame.

List most frequent symptoms or cuesof feeling shame.

Identify the cost or consequences ofshame in your life (Give one exampleof a link between shame andsubstance abuse in your life).

Evaluate feeling of shame today,compared with feelings just prior tolast relapse.

Explain current understanding ofshame and low self-esteem.

Complete a current assessment oftroublesome feelings.

F11: Are youan “excitementjunkie?”

Identify the relationship between highrisk behavior and substance abuse.




SA1: Selfawareness:preventingrelapse byincreasingyour sensitivityto cues,patterns orcycles

Describe current status or progressof your recovery.

List five common dependencies oraddictions.

List three which have caused you realproblems in the past.

List two dependencies or addictionsthat you want to change.

FD7: Denial Give one example of denial in yourlife.

What did others see that you didn’t?

Stage 3: Returning Home

RH6: Makingpositive stepsto take controlof your

Make initial list of possible membersof safety net of supportive people.

Evaluate that list and select 5-7people who will be asked toparticipate.

List accessible counselors andprograms with addresses and phonenumbers.

Make a list of the appropriatesupport groups, including day/time ofmeeting, location, and contact phonenumber.

Identify steps to deal effectively withadvance planning for the highest risktimes of the week. List groups andactivities which will be attendedduring those times.




RH6 Cont. Explain why the members of your“safety net” and counselors need toknow some of the issues underlyingyour past problems. (For example,why they need to know about areasof vulnerability, triggers, areas of“stinking thinking,” high risksituations, troublesome feelings, cuesthat you are at increasing risk ofrelapse, etc.)

Explain, in writing, what the safetynet members and/or counselors willneed to know about his recovery.List:

3 problems3 areas of vulnerability3 specific triggers3 areas of stinking thinking3 high risk situations3 feelings which have beenmost troublesome3 cues that you are atincreasing risk of relapse

What you are asking them to dowhen they notice those cues.

What you are asking them to do ifthey find you resistant or at theactual point of relapse.




RH5: If you“lapse”

List three (3) common “lapses.”

Identify four (4) specific “high risk”situations you will need to avoid.

Identify three (3) things you can do ifyou catch yourself in a “lapse” (aboutto relapse).

List two (2) safe things you can doafter saying “no” to temptation.

Identify three (3) consequences foryou if you fail to maintain yourrecovery.

Describe your personal “thoughtstopping” technique.

RH7: Avoidingthe negative

List the three (3) dependencies oraddictions which are the most likelyor dangerous for you.

List three (3) people at home or inyour community who are likely toput you at high risk. Explain how youcan avoid being around those people.If you can’t avoid those people,explain how you expect to handlebeing with them so you can stay inrecovery.

List three (3) places in yourcommunity which put you at highrisk. Explain how you can avoidbeing in those places.




RH7 Cont. List three (3) high risk things orsituations you plan to avoid. Explainhow you will successfully avoid them.

List three (3) safe people you canspend time with, and three (3) safeplaces you can go to.

RH14: Gettingclose to gettingout

Address common thoughts, feelings,and temptations in the last fewweeks before going home.


A Road Not Taken: FMC

Fidelity Monitoring Checklist


PHOENIX/NEW FREEDOM RESOURCES FIDELITY MONITORING CHECKLIST

Observer Name & Title: _____________________________________________________________________Report Date: ________________Facility Name: _______________________________________________________________________________Group Session Date: _______________ Session Time: Morning _________ Afternoon _________Facilitator Name & Title: ____________________________________________________________________Co-Facilitator Name & Title: __________________________________________________________________

Lesson(s) Covered Today

_____________________________________________________________________________________________

Please indicate below your opinion of how well the Facilitator or Co-Facilitator (if applicable) did the following intoday’s lesson: (Circle the number that corresponds to your rating.)

Mechanics of the Lesson Not atall

Needs someimprovement

Adequate VeryWell

Excellent

1. Covered all parts of the lesson 1 2 3 4 5

2. Facilitated discussion of What Do You Think or other session opener or closer(if applicable)

1 2 3 4 5

3. Gave feedback on role play (if applicable)

1 2 3 4 5

4. Explained key vocabulary 1 2 3 4 5

5. Adhered to time allocation for each lessonelement

1 2 3 4 5

6. Collected all data, competency checks, orother forms in lesson (if applicable)

1 2 3 4 5

7. Completed behaviorally-stated objectives oflesson

1 2 3 4 5

8. Reviewed/Assigned homework (ifapplicable)

1 2 3 4 5

9. Fully explained key concepts (such asinternal and external risk factors, symptomsand triggers, etc.)

1 2 3 4 5

Please rate the Facilitator or Co-Facilitator (if applicable): (Circle the number that corresponds to your rating.)

Experiential Component of the Lesson Poor Needs someimprovement

Adequate Good Excellent

1. Preparation: materials ready, lesson well-planned, knowledge of material

1 2 3 4 5

2. Enthusiasm: Conveyed enthusiasm and abelief in the material presented

1 2 3 4 5

3. Comfort level: comfortable teaching lesson 1 2 3 4 5

4. Objectivity: presented factually, withoutmoralizing, offering opinions, or judging

1 2 3 4 5

5. Clarity: covered content clearly 1 2 3 4 5

6. Simplicity: no unnecessary complications;used terms participants understand

1 2 3 4 5


7. Pacing: not too rushed, not too slow 1 2 3 4 5

8. Engagement: presented in interesting way; involved participants; engaged non-participants

1 2 3 4 5

9. Platform Skills: body language, tone ofvoice, facial expression, eye contact, did nottalk too much

1 2 3 4 5

10. Behavior Management Issues: howsuccessfully handled, if applicable

1 2 3 4 5

11. Understanding: checked forunderstanding; asked open-ended questions

1 2 3 4 5

12. Homework assignment: explicitly-statedand not rushed

Skills Component of Lesson (if applicable) Poor Needs someimprovement


1. Modeled skill for participants 1 2 3 4 5

2. Reviewed previous skill practice (ifapplicable)

1 2 3 4 5

3. Had participants practice skill multiple times 1 2 3 4 5

Motivational Interviewing Component ofLesson (if applicable)

Poor Needs someimprovement


1. Demonstrated use of MI skills and elicitedchange talk

1 2 3 4 5

2. Used provided tools to elicit change talk 1 2 3 4 5

3. Overtly linked content of lesson to makinglife changes

1 2 3 4 5

4. Addressed issues and obstacles relating toconfidence and importance of making generaland specific life changes

1 2 3 4 5

Recommendations/Further Actions


Self-Discovery (SD2)

What Went Wrong?


SAMPLE

Lesson Planning Support

Workbook

What Went Wrong? (SD2)

Series

Self-Discovery

Time Needed

9-10 hours

Purpose and Background Information

This is a critical workbook, with the objective of helping identify underlying issues and areas of vulnerability. As this happens, it helps increase participants’ readiness for change.

Most problem behaviors don’t “just happen.” They are not the total cause of the youths’ current problems. Instead, they are an outcome of a series of experiences, thoughts, feelings, and behaviors. “What went wrong?,” is an important question, for the answers point to areas needing attention in order to prevent future problems. In most cases, the answer to that question is a complex one, and perhaps even unprovable. Nonetheless, it is important to understand that “who we are today” is a result of the past, and our future can be different if we make certain changes today.

This workbook uses a series of checklists and exercises to identify common problems. In many cases, the problems can be traced to other people (family members, for example). Staff should be careful to avoid placing too much emphasis on blaming past experiences, or other people, for today’s behaviors. If that were the case, we would not be responsible for much of our behavior today. The emphasis can better be put on identifying current vulnerability (or weakness) as a result of past experiences and challenging the youth to overcome that weakness. Very few people want to remain weak or helpless in the face of the past and current problems.

This workbook will help participants identify areas for further attention, especially issues which may still put them at risk. These concerns may be identified and discussed individually or in group counseling. This understanding is an important building block in self-discovery and making lasting changes. More important, this process contributes to the “contemplation “ stage of making changes (the Prochaska model).


SAMPLE


Staff Preparation

Please review the workbook and the material in this packet. As you consider the needs and personalities of the people you will be helping, you may place a greater emphasis on certain sections of the workbook. It may help to talk your plans over with others who have used this material or with your supervisor.

Content Areas/Use of This Book

This is a critical workbook which:

identifies underlying issues•

identifies areas of vulnerability•

Behavioral Objectives

Using workbook materials provided, youth will :

identify current burdens and vulnerabilities•

identify areas needing further attention in continuing recovery•

identify current risk factors: vulnerabilities, triggers, and ineffective •coping skills

identify specific areas of vulnerability•

identify specific triggers•

identify specific areas of failure in past coping•

identify specific areas of vulnerability (complete checklist, and •describe the “top three”)


SAMPLE

Wh at We nt Wro n g?

This workbook will help you to identify areas in your life that set you up for problems. These are your weaknesses and “vulnerabilities.” Knowing these things is important.

If you are like most people, you don’t like to think of yourself as weak or “helpless.” You don’t like to feel vulnerable. Yet it is likely that you were weak. You were unable to stop your addictive or harmful behavior.

P a r t 1

Your treatment starts when you admit you need to change some parts of your life.

It is not enough simply to agree that you need to stop drinking or drugging, hurting other people, stealing, or acting out sexually. In fact, these behaviors that hurt you and hurt others are really the result of a deeper and more hidden problem.

You may have acted out, for example, to help deal with hidden problems and the pain that they cause you. You will need to learn new ways to cope. But first you will need to fix the hidden problems.

When you do this, your life will be very different. You’ll be in less pain, and you will be less anxious.

Have you had troubles in coping? � ⃞ Yes ⃞ No

Have you failed in many of your past efforts to change? � ⃞ Yes ⃞ No

Has your life been out of control? � ⃞ Yes ⃞ No

It’s important to admit your problems. It is the first step in treatment. Unless you do, you are likely to fail again for the same reasons.

A good place to start is to identify those areas where you are most easily “set off.” These are the areas where you most often feel uncomfortable.

You may be vulnerable (or “weak”) if you were hurt. “Hurt” can be an injury to your body or emotional damage. We call this kind of hurt “trauma.” Traumas are damage. It means you were hurt, wounded, or badly scared. Examples of trauma are being in an accident, being around violence, or being abused.


SAMPLE

These experiences can leave us emotionally wounded for a long time—even a lifetime. We may find ourselves fearful, angry, or unable to trust. A first step is to identify those situations. This workbook will help you start the healing process.

Did you find ways to “medicate” your discomfort or emotional pain?

You will also learn more about how you began to use the behaviors that have harmed you and others. You will understand your life better. As you learn “what went wrong” you will understand that you are not alone. Others have had very similar problems. Many people like you have learned how to live a happy and healthy life. You are not permanently “broken.” You can change. You can have a better and happier future!

This program can help you:

face your weaknesses �become stronger �become more comfortable with your life �become proud of yourself �

This process has two parts:

First, you will complete worksheets and activities which will help you learn more 1. about yourself.

Second, you will discuss your answers with counselors and friends who care enough to 2. support you in having a good life. They can help you in making the changes you need.

Self-discovery starts by paying attention to your thinking, feelings, and behaviors today.

A good place to start is to begin to pay careful attention to how you are thinking and feeling.

You can also identify the specific people, places, and things that have the most impact on your feelings and behavior. When something makes us feel a certain way, we call it a “trigger” to that feeling.

Example: You had a bicycle accident at a certain spot, and were badly hurt. Later, when you pass that spot, it might remind you of the accident. You might remember the pain. Seeing the place where you were hurt is a “trigger” to sad feelings.

Knowing your “triggers” will help you to identify your most sensitive or troublesome areas and start the process of getting stronger. This is a big part of your recovery.


SAMPLE

P a r t 2

Start to pay attention to your triggers.

Sometimes, there is a big trigger. It is so painful or powerful that we fall apart. This could be a breakup with a friend or lover, the death of someone close, or failure at school or in a job.

Sometimes, these big events don’t lead to problems. We may be strong, or our family and friends may quickly support us. If a family member dies, for example, other people may come to our aid. Sometimes, this help can reduce our pain, although we felt hurt.

It is more common, however, for the trigger to be small. It may not seem powerful enough to push us back into our “old” problem behavior.

You may have missed seeing how this trigger brought you close to problems. �You were not aware of how these things “set you up” for your problem behaviors. �

When we have big problems, others notice, and can offer help. They may not notice the smaller triggers. This is especially true if we have kept our lives secret from others. We need friends who know the “real” us. We also need to spend time with our support group or a “safety net” of counselors and other helpers.


SAMPLE

Small problems add up—and “set you up” for triggers!

You may have been at high risk for some time without being aware of how close you were. Each day, things happen, both large and small. These can become triggers that affect you if you are already vulnerable.

Let’s look at how this happens. To illustrate, think of a hiker going for a walk with a backpack. While he’s hiking along, carrying the load in his pack, he’s “coping.” However, if his load becomes too heavy, or he becomes tired or weaker, he can no longer cope and may even collapse. This collapse, can come suddenly, or build up over time.

Each stressful event—if you are vulnerable to it and do not address it—adds something new to the backpack.

This stress is largely useless to us. It’s as if the hiker is carrying a heavy load of rocks or stones. Some problems we have been carrying in that pack have been there for many years.

Some events and problems are only mildly stressful. They only add a little. Other events add a lot. If you are hungry, in pain, tired, sick, or under stress, your load may become even harder to bear.

You’ve been carrying many burdens around with you.

Most of us forget, however, that there is a lot already in the backpack. We have:

vulnerabilities or weaknesses ⃞trauma, wounds, or “hurt” ⃞unhealthy secrets ⃞losses and grief ⃞problems in our life which make us feel angry ⃞problems in our life which make us fearful, or anxious, ⃞problems in our life which make us feel guilty or shameful. ⃞we feel unlovable (perhaps others have not treated us with the love we needed) ⃞we don’t feel worthwhile ⃞we don’t feel very smart or very capable ⃞we don’t feel very good about our bodies ⃞we don’t feel good about our physical abilities ⃞


SAMPLE

we have failed in the past. ⃞we have had problems in school, in finding a job, or in keeping a job ⃞we have had money troubles ⃞we have had family problems, or problems in relationships, ⃞we have given in to temptations ⃞

These issues are dangerous. They add to our load. Our feelings can add to our burdens. Anger, hurt, sadness, worry, or loneliness are heavy burdens, too.

We can be at high risk and not know it.

Our load can become too heavy. At that point, it doesn’t take much to overload it to the point where we collapse. We feel pain or our temptations become too much.

The bad news: If we have poor coping skills, we are likely to experience more problems. It’s all we know how to do.

The good news: If we develop effective coping skills, we can reduce our load anytime!

Activity

Look at the list of burdens on pages 5 and 6. Place a check (“✔”) next to any you have carried. Then think about how uncomfortable these burdens have been. Would you like to “lighten your load?”

READINESS RULERHow ready are you to deal with these burdens?

(not ready to deal with them) (somewhat ready to deal with them) (ready to deal with them)1 2 3 4 5 6 7 8 9 10


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P a r t 3

Key questions in self-discovery.

Many of us would like to believe that there is an easy answer. All we have to do is to just say “no” to ourselves or others. Why can’t it be that simple?

Promises are not enough. There is no shortcut or simple solution.

We must learn how to help ourselves. Do you want to become stronger? If so, you need to make serious changes. This involves work. Treatment isn’t easy. If it were, few of us would have problems.

One of the best things you can do is to stop and think things over before you act. It will frequently prevent you from making a poor or dangerous decision.

You can also learn a powerful skill called “thought stopping.” It may prevent you from making a mistake.

When you stop to think things over, it may also give you time to think.

Will your actions hurt others? �Will you be hurting yourself? �

“I’ve wanted to stop. Why hasn’t willpower been enough?”

“What about self-control? Why isn’t it enough just to stop and think before I act?”


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Sometimes we fool ourselves into thinking that things are fine, when underneath all the old problems are still there.

Were things “going well” for you before? Sometimes we feel good on the surface. We have money, people to spend time with, and things to do. Things look pretty good. If we stay busy enough, we may even forget—for a while—the things which are troubling us. In fact, if we do start to feel bad, we can quickly get involved in something which will take our minds off our troubles.

It’s easy to become “too self-confident.” You may forget that you have a problem which will never disappear completely.

When you are in treatment, your problems will be fewer. They will also be less powerful. You can have a better life, but you must keep looking for the warning signs that your problems are coming back. You should notice when your load is getting heavier.

Did you notice the warning signs? � ⃞ Yes ⃞ No

Did you feel under pressure? � ⃞ Yes ⃞ No

Some people have a problem with success. Just when they are about to achieve something, or to make something good happen in their lives, they seem to find a way to mess it up. They quit school just before graduating, get in trouble at work, don’t finish a job—just when it’s about done, or mess up a relationship just as it starts to become something special. These people, underneath, may feel that they don’t “deserve” this happiness or success. Their low self-worth prevents them from getting what they have earned.

Has this ever happened to you? � ⃞ Yes ⃞ No

“Why did things get worse when things were going so well?”

“Just when things are going good, I always seem to mess it up.”


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This is especially important for people in treatment. They manage to stay on the right track for several months. Just when they are due to receive some recognition for their success, they fall back to their old behaviors.

Has this ever happened to you? � ⃞ Yes ⃞ No

It’s tough to try to handle our problems without safe friends or counselors who are aware of our past weaknesses. People who are “isolated” or alone have no one to give them a “reality check” on their thinking, their feelings, or their behavior.

“I’m worried about you today. You look all stressed-out! Can I help?” �“You know those guys you’re hanging with are bad news. Why don’t you come with �me to see a movie tonight instead?”

To avoid more problems in the future, you’ll need to learn new skills to help yourself and have others available to help you.

P a r t 4

Others can really help.

Counselors, groups, and safe and supportive friends can help. They can help reduce the load we are carrying in a variety of ways.

They can:

alert us when we are using “Negative Thinking” �think through our choices with us �be sensitive to our feelings and alert us when they think we are at risk �give us “reality checks” �listen: take time to pay attention to us and our problems �help us resolve issues and make decisions �comfort us �help us to see that our problems aren’t insurmountable �help us divide our big problems into smaller ones—which we can handle �help carry our load when we need it �

“Why do I need to have other people involved in my life? What’s wrong with trying to handle it on my own?”


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A key point is that these people can’t help you if you don’t include them. You must be open to them. It’s best to invite them to help you before you really need their help. They can help you stop problems before they get serious.

When a friend asks you how you are doing, it’s easy to answer, “Fine!” Even when you are hurting. Perhaps you don’t want to appear weak, or that you don’t have everything under control. You may not want to be a burden to someone else, or to add to their problems.

Your real friends may be truly interested in how you are doing. As friends, they may want to help. After all, that’s a major part of friendship.

Are you glad to help a friend with his or her burdens, but are you too proud to ask for help yourself? ⃞ Yes ⃞ No

What would you say to a friend who you felt needed help with his or her burdens?

Group Counseling

Group counseling can help.

There are several reasons for working with others to learn about ourselves.

You learn that you are like others. This can be comforting to you. You’re not 1. alone in your problems and in your suffering. Others know how you feel.

You learn that other people succeed in handling problems similar to 2. yours.

Others can help us see ourselves better.3. We can learn from what we see in them.4. Finally, we can learn from group experiences how to work with others. We 5. can start learning how safe people can help us have a good life. We can start the process of working with a counselor.


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P a r t 5

Self-Review

Have you reached a point in your treatment where you have begun to make changes? Look at the chart below. Place a check (“✔”) in the appropriate column after each statement.

Statement Still True Or Have You Changed?

I’m not always aware when I am at risk. ⃞ This is still true ⃞ I’ve changed

I’m not always aware of what to do when I am at risk. ⃞ This is still true ⃞ I’ve changed

I do not have safe friends or counselors. ⃞ This is still true ⃞ I’ve changed

I am pretty much alone. I have very few truly close friends. ⃞ This is still true ⃞ I’ve changed

I have been keeping “bad secrets.” ⃞ This is still true ⃞ I’ve changed

There is nobody who can give me a truly honest “reality check.” ⃞ This is still true ⃞ I’ve changed

I have not “coped’ well with temptation or stress. ⃞ This is still true ⃞ I’ve changed

If you identified any areas as “still true of me” these are areas where you need to continue to work in your treatment.

If you haven’t addressed the underlying issues in your life, and if you do not address new problems as they occur, your load becomes heavier. As this builds up, you may not be able to cope.


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P a r t 6

Learn to be aware when you are emotionally exhausted or “tired”

When you are tired, you make more mistakes.

You pay less attention to how you are feeling. You may be less aware that you are “setting yourself up” for danger. Yet if you spend time with a counselor or a friend, your chances improve. You both may notice that you are “stressed-out” or “burned out”—before it’s too late.

This outlet also gives you a safe place to express your anger, say stupid things, cry, or talk about your problems. This makes recovery more likely. It’s a simple and safe answer to protect you when your load gets heavy.

Note

Your load will get heavy sometimes. Don’t be afraid of this. It happens to all of us. With new skills, you can handle it! And, you don’t have to handle it alone. That’s what friends and counselors are for.

Eventually, there are two major steps you can take to reduce your load. Here are some specific steps you can take:

SteP 1

Identify the issues you have been carrying around with you. Examine your past.

Do you feel discomfort when you think about certain things in your life? � ⃞ Yes ⃞ No

Do certain things make you very sad? � ⃞ Yes ⃞ No

Are you still angry about certain things? � ⃞ Yes ⃞ No

Do you still feel guilty? � ⃞ Yes ⃞ No

Do you worry about certain things? Do you still have some “bad” secrets? Have you �been hurt or abused? ⃞ Yes ⃞ No

Do you sometimes feel not very good, smart, or worthwhile? � ⃞ Yes ⃞ No

Do you sometimes feel unlovable? � ⃞ Yes ⃞ No

As you address these issues, your load will become lighter.


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Every time you face or “fix” some of these issues, it’s as if you reached into that backpack and removed a heavy stone.

You can even say to yourself, “I don’t need to carry that around with me any more!” In time, you can empty nearly all these old issues, and your everyday life will reflect your new freedom.

What are 1-2 issues you can start to “unload” right now? (Answer below.)

SteP 2

Make it a point to identify how you are feeling and what you are doing each day.

Talk over how you feel with your counselor or safe friends. If you notice the clues that something is troubling you, then take the time to identify exactly what is going on.

What clues or symptoms have you noticed recently? List 2-3 below:

Are you concerned about your family or relationships? List 1-2 concerns below:

Sometimes you can’t do much about these concerns right away. If you can’t do much, then set them aside. Worrying won’t help. Instead, focus on the things you can do something about.


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P a r t 7

Get on with life, as a stronger and happier person.

Having a totally empty “backpack” is probably impossible. There will always be something in it.

We will always have a few things to deal with. Everyone does. And that’s okay as long as you handle them well. In treatment, you’ll succeed.

Treatment also means that you have greater joy and peace in your life.

Carrying a lighter “load” helps you cope better with life. You can also take steps to lighten your load. That’s what groups, counseling, and friends are for. When you talk things out, you’re emptying the pack, little by little.

The new coping skills you will learn in this program will give you the tools to make this task easier.

“aren’t Some PeoPle uncomfortable With thiS ProceSS?”

Some people find it hard to let go of the load in their backpack. It’s become a major part of them.

You may even hope that your burdens will cause others to feel sorry for you. Usually this doesn’t work for very long. In time, people “catch on” when we “use” them. Avoid “using” others. It’s a form of “Negative Thinking.” And it’s a sign that you are still weak.

Facing your issues may be painful, but it’s much more painful to carry these problems further. Unless you change, you run the risk of doing even more damage to your life and to other people. Take the risk and face your past. As your load becomes lighter, life will be better.


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P a r t 8

Look at the whole range of “risk factors”

The following table of various types of problem areas may be helpful in identifying where you are still at risk—where you are still vulnerable. “Vulnerabilities” leave you “set up” for your specific triggers, and if you have not learned to cope effectively, your cycle may repeat itself often.

As you review the lists below, place a check (“✔”) next to all those items that describe you.

Vulnerabilities Triggers Ineffective Coping Skills

I don’t feel very ⃞lovable.

I don’t feel ⃞very capable or worthwhile.

I am ⃞uncomfortable with myself physically.

Certain triggers ⃞hit me where I am weakest.

I haven’t been ⃞aware that I was at risk.

I didn’t know what ⃞to do at that point.

I didn’t think ⃞any coping skills would help me.1

I have felt guilty ⃞or ashamed.

I had some “bad” ⃞secrets.

I have a lot of ⃞stress in my life.

I was neglected or ⃞abused.

I usually fail. ⃞I often expect to ⃞fail.

There’s not much ⃞hope for me.

I had family ⃞problems.

I lived around ⃞danger.

There were crises ⃞in my life.

I was around ⃞temptation.

I usually “want it ⃞now!”

When I’m in pain, ⃞I try to fix it fast.


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Vulnerabilities Triggers Ineffective Coping Skills

I was abused. ⃞I was neglected. ⃞I was afraid. ⃞

My “Negative ⃞Thinking” sometimes causes me problems.

I expect the worst. ⃞

I have had few ⃞safe friends or counselors who have been aware of my past problems.

I felt like a failure. ⃞ I sometimes ⃞handle my feelings poorly.

I am pretty much ⃞alone in life.

I have nobody to ⃞give me “reality checks.”

I have not spent ⃞much time looking carefully at my life.

I sometimes think ⃞about returning to my old harmful behaviors.

I sometimes just ⃞can’t control myself.

I have some ⃞physical concerns.

I sometimes act ⃞without thinking about the effect on others.

My life is a ⃞constant series of crises.

I live in a bad area ⃞or neighborhood

I am around ⃞temptation

There is no hope ⃞living where I do

I have family ⃞members that use

I am around ⃞temptation

The only ones ⃞close to me are in the same boat as me

What three (3) items in this list have caused you the greatest troubles in the past? (Go back �over the items you checked, and circle them).

Think about the people who have known you best (family members, friends, and counselors). �Which items would they suggest having caused you the most trouble? (Mark two or three items which others have noticed.)

The items you marked in this list have put you at greatest risk for harmful behavior. Knowing your “risk factors” is a critical step in self-discovery.A New Freedom • ©1998 - 2014 A.R. Phoenix Resources, Inc • www.newfreedomprograms.com • Page 150

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P a r t 9

Why have I had problems? What happened in my life that resulted in my difficulties?

SteP one: look for your vulnerabilitieS

Where were you weakest? (Complete the table below.)

Vulnerabilities How Might This Apply To Me?

1 I have never felt very capable, smart, or worthwhile.

2 I have never felt very capable, smart, or worthwhile.

3 Sometimes I have created my own problems through “Negative Thinking.”

4 When I haven’t felt “right,” I have usually used the same ways of “coping.” These ways have actually hurt me.


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5 I still have some painful issues in my life.

Examples: death, neglect, abuse, a parent’s drinking, bad secrets, or violence.

6 I have learned to deal with my problems by avoiding them. I pretend to myself that they don’t bother me.

7 I’ve failed before, and I’m not very confident.

8 There are problems in my family (like mental health problems or trauma).

9 I’m emotionally or physically weak. I should be stronger.

Review the list above and notice how these issues have led to problems in your life. �As you work to address each of these issues, they may no longer cause you so many �problems.


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SteP tWo: look for the SPecific triggerS that directly affect you and lead to your ProblemS

Did your life include events that moved you closer to acting out?


1 A trigger hit me where I was weak.

Examples:

I didn’t feel very lovable. I 1. often felt abandoned as a child. When I was rejected in a relationship, it was a trigger.

One of my parents died.2. I had worries about 3. my family, and then someone made a remark that made me mad.

I didn’t feel very smart, 4. and then a teacher made a remark.

I wish I had a better body. 5. When someone calls me a wimp, it hurts.

2 I experienced a very powerful

or painful trigger.

examples: accidents, street violence, abuse


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3 I had a lot of stress in my life—for a long time.

examples: family violence, abuse, being afraid, living in a dangerous place, worrying about family members

4 I became sick, or began acting out in harmful ways that triggered other problems.

examPleS

Substance use or cravings

Just as you can reduce the problems caused by your vulnerabilities, you can also reduce the impact of your triggers. Other workbooks in this program will show you:

how to avoid certain triggers, �how to change your thinking to reduce the impact of triggers, �how to reduce anxiety and stress in your life, so triggers have less impact, �how to become a less angry person, so you are less vulnerable to your old anger �triggers, and

how to become less sensitive to certain triggers that make you anxious. �


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SteP three: look for your feelingS of failure and Poor WayS of coPing

Look for feelings of failure and poor ways of coping, which allow our problems to continue. Did you know what to do?

Complete the table below.

Poor “Coping” How Does This Apply To Me?

I resorted to old behavior because: I did not know I was at risk, until it was too late. I did not know any “good” coping skills.

I didn’t think I could use any of the “good” coping skills I knew about.2

I had failed before. The last failure made me feel worse. It somehow “set me up” for more problems. I had many problems. These kept me “off-balance” and unable to manage my life.


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Poor “Coping” How Does This Apply To Me?

I had hidden my problems from safe friends or counselors. They could have helped me with my problems. I had bad coping habits. I did the same things every time. It was easy to return to the same harmful behaviors. I was helpless and desperate. I tried, but my life was out of control.

When I was in pain or not comfortable, I usually didn’t wait. I just did what I needed to get “quick relief.” This put me at risk for more problems.

I expected bad things to happen. I expected to fail.

Review the list of problem areas above. The patterns of poor coping are mostly behaviors you learned somewhere.

Just as you once learned them, you can “unlearn” them and replace them with “good” coping skills. The workbooks that follow will help you.


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Part 10

“ h o W d i d t h i S h a P P e n t o m e ? ”

For many of us, these “failures” started when we are younger. There are many ways in which we experience it:

“Is this the best you can do?” ⃞“This report card is a disaster.” ⃞“You’re just like your father; no good.” ⃞“I don’t love you.” ⃞

“I don’t want you on my team.” ⃞“You’re hopeless.” “You’re stupid.” ⃞“You’ll never amount to anything.” ⃞“You can’t live with us anymore.” ⃞

“You’re not as good as your brother in sports.” ⃞“Some people are meant for college; you’re not.” ⃞

Which of the above sound familiar? Mark them with a check (“✔”).

What other “failure” messages did you hear when you were younger? (Name at least two.)

What “failure” messages have you heard recently? Check (“✔”) those that sound familiar.

“You don’t have what it takes.” ⃞“Your brother can do it, why can’t you?” ⃞“Your family is so ashamed of you.” ⃞“You have wasted your life.” ⃞

“Look at the mess you made.” ⃞“You can hardly read.” ⃞“You let us down.” ⃞“We don’t want you around.” ⃞

“You’ve got a criminal record. I can’t hire you.” ⃞“You’ve made a mess of everything.” ⃞

Others you have heard:


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do you feel you have been a “failure?”

What caused you to begin to have doubts about yourself? �When did those doubts start? �

If you began to feel less worthwhile or loved when you were younger, you may still feel that way today. The pain and anger of being mistreated may still be there—under the surface—and you may still be vulnerable.

Our self-esteem is based on what we think about ourselves.

Do you feel lovable? �Do you feel capable or worthwhile? �Or, do you have some doubts? �

These doubts cause people to feel angry, sad, or worried. These feelings lead to addictions and harmful or “problem” behaviors.

If you don’t face these feelings, how might this impact your future?

If you do take the steps to face these feelings, how may that impact your future and your chances of a good life?


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P a r t 1 1

What if you don’t think you are very “loveable?”

You are not alone. But you don’t have to feel this way. It’s something you can “fix.” Many people have felt that they are not very lovable. It’s very common. Feeling unlovable can be a major part of such problems as:

sick relationships ⃞allowing others to abuse us ⃞eating too much ⃞

eating disorders ⃞sexual “acting out” ⃞committing crimes. ⃞

Nor is it something you are “born with.” Sad experiences may have “taught” you that you are unlovable and even that your life is supposed to be unhappy. If you were abused, abandoned, or neglected as a child, you may have come to believe there was something about you that made you unlovable.

We fear that we have something very “wrong” with us. We become afraid to let others know us as we really are. We fear that if they knew us, they, too, would reject us. It leads to the same sad result. If you believe others won’t love you, you may begin to avoid letting others get to know you as you really are. If you try to be something you are not, it doesn’t matter if others like that image—it’s not you. Again, you feel unloved.

you may be Paying a big “Price” for theSe feelingS

The fear of being unlovable can lead to many behaviors:

we don’t let others get close to us ⃞we try to “buy” friends ⃞we try to please people ⃞we choose friends who are even more “messed-up” than we are ⃞we “show-off,” brag or “build ourselves up” in front of others ⃞we tell lies to get attention ⃞we tell lies to make ourselves look better ⃞we commit crimes just to be accepted by our peers ⃞we may even just act angry to hold others at a distance ⃞

Have you ever done any of the above? Place a check (“✔”) next to any you have done.


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Part 12

v u l n e r a b i l i t i e S c h e c k l i S t S

The checklists on the next pages may remind you of certain areas you would probably rather not think about - your weaknesses (or vulnerabilities). It’s important to go over these areas several times, however. When you find yourself feeling uncomfortable, or even angry, about a statement, it’s important to be honest with yourself. This may be an area that has led to problems for you in the past. Knowing about it now can lead to healthy answers.

Place a check (“✔”) in the boxes below which apply to you.

not feeling ver y “caPable” or WorthWhile

I sometimes don’t feel good about myself. ⃞I haven’t felt smart enough. I felt stupid. ⃞I feel bad about my poor grades in school or lack of education. ⃞I have never had a good job. ⃞At times, I haven’t felt strong enough (or athletic enough). ⃞It seemed like I could never please my mother or father. ⃞I felt I was “no good” or not “good enough.” ⃞At times I felt I couldn’t do a job right. ⃞I couldn’t keep a job. ⃞I have let people down. ⃞I felt I couldn’t be trusted. ⃞I felt I was not brave enough. ⃞I have some feelings of guilt about my family. If I had somehow done things ⃞differently we would have been better off.

People trusted me and I hurt them or let them down. ⃞I have not been a good parent. ⃞There are things I should have done. ⃞I couldn’t measure up to others in my family. ⃞


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iSSueS With “lovableneSS”

Someone abandoned or deserted me. ⃞I sometimes felt I couldn’t measure up to others in my family and they were ⃞disappointed in me.

I’m not able to love others. ⃞I haven’t experienced much love in my life. I wonder if I’m lovable. ⃞I sometimes feel guilt or shame. ⃞There have been times when I haven’t fit in or felt acceptance. ⃞I have had some confusion between “love,” “affection,” and “sex.” ⃞I have thought people loved me, but all they wanted was sex. ⃞I have thought I loved someone, but all I really wanted was affection. ⃞I have some issues with unresolved grief (a loss, or death). ⃞At times I have kept shameful secrets. ⃞I have been told that I have a strong need to “control” other people. ⃞There are times when others have controlled me. ⃞I have held myself away from people. ⃞As a child, I experienced neglect or abuse (physical, sexual, or emotional). ⃞At times in my life, people have rejected me. I still have a fear of rejection. ⃞I have difficulty trusting others. ⃞I want people to like me and sometimes I try too hard. Sometimes I trust other ⃞people too much.

People have told me I don’t care about other people. ⃞I sometimes feel very angry with myself. I have many regrets. ⃞

iSSueS of PhySical aPPearance

I sometimes think I’m ugly or homely. ⃞I sometimes think I look wimpy. ⃞I think I’m too fat or overweight. ⃞It bothers me that I’m not very athletic. ⃞I think I look too skinny. ⃞I wish I were better looking. ⃞


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I’m not strong enough. ⃞I wonder if others find me attractive. ⃞I feel inadequate when compared to someone else. ⃞

other iSSueS that may affect Self-eSteem

I have fears. ⃞I have unhealthy secrets that trouble me. ⃞I worry a lot. ⃞I’m often sad. ⃞I sometimes feel that if I start crying that I’ll never be able to stop. ⃞I sometimes think about all the harm that I have done. ⃞Thinking about sex sometimes makes me uncomfortable. ⃞I have a lot of feelings of anger. ⃞I sometimes feel controlled, helpless, or powerless. ⃞I have acted in self-destructive ways, or felt suicidal. ⃞I have bad feelings or thoughts because of harm done to me. ⃞I sometimes have thoughts that disturb me. ⃞

PhySical “SetuPS” Which create vulnerability

I drink a lot of soft drinks or coffee (it contains caffeine, a powerful stimulant). ⃞I normally eat a lot of “junk food.” ⃞I usually don’t eat a lot of fruit and vegetables. ⃞I often skip meals (like breakfast). ⃞I still smoke cigarettes alot. ⃞I have a lot of physical pain or problems. ⃞I normally feel tired or “run down.” ⃞I usually don’t get enough sleep. ⃞I consider myself physically weak or in poor shape. ⃞I have poor exercise habits. ⃞


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Review the lists above and identify three areas you want to start to change and grow stronger. Pick three you want to deal with now. There will be chances later to address the others.

Three Areas Of Vulnerability I Want To Change Now

1

2

3

Share this list with your counselor and at least one other safe and supportive person. Tell them why this is important to you, and how you might begin to change.


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IMPORTANCE RULERHow important is it to you to change these vulnerabilities?

(this is not very important to me) (this is somewhat important to me) (this is very important to me)

1 2 3 4 5 6 7 8 9 10

CONFIDENCE RULERIf you tried hard, how confident are you that you would be able to make these changes?

(I don’t think I can) (I might be able to change) (I’m very confident I can do this if I try) 1 2 3 4 5 6 7 8 9 10

READINESS RULERHow ready are you to make changes in your vulnerabilities?

(not ready to change) (somewhat ready to make changes) (more ready to make a change)

1 2 3 4 5 6 7 8 9 10

Notes Marlatt, G. Alan, “Relapse Prevention: Theoretical Rational and Overview of the Model.” In 1. G.A. Marlatt and J. R. Gordon (Eds.), Relapse Prevention, Guilford Press, New York, 1985. Marlatt is credited with the development of the concept of self-efficacy.


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Self-Awareness (SA1)

Self-Awareness

Preventing Relapse by Increasing Your Sensitivity to Your Pattern or Cycle


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Workbook

Self-Awareness: Preventing Relapse by Increasing Your Sensitivity to Your Pattern or Cycle

Series

Self-Awareness

Catalog code(s)

SA1

Time Needed

5-6 hours

Purpose and Background Information

This recovery program looks at the various dependencies (alcohol or drug abuse, for example) as outcomes of a process which includes underlying vulnerabilities, difficulties in handling specific triggers or stressors, and in poor “coping” with feelings and desires. In these workbooks, each of these factors will be identified so they can be effectively addressed. Other workbooks in this program are targeted to each of these concerns.

The instructor can provide encouragement and hope at this point, “Other people have found that the techniques you are learning do work. They have worked for others, and they can work for you. There is hope, and there is a systematic way for you to address the areas you need to. These workbooks will help identify what those areas are.”

Since most people with dependencies have a pattern of behavior which has repeated itself many times, these workbooks will help them understand their thoughts and feelings earlier in their “cycle.” This means that steps for intervention (new “coping skills’) can be used to help prevent relapse.

This series of two workbooks (SA1 & SA2) is among the most critical parts of the program, and your role as instructor will be among the most demanding. The materials cover the most important aspects of self-understanding, and may be uncomfortable for certain people. Their discomfort may appear on the form of trying to get you”off track,” (divert your attention from the material), debate


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the meaning of certain words, or put the focus of attention on someone else (including you). When this happens, suggest that another time and place be set aside to address that concern, and return to the material.

A helpful adjunct to these workbooks is “A guide to using your new coping skills” (PT6). This workbook identifies helpful coping skills at each stage of the relapse “cycle.”

Suggestions for Presentation

Prepare the room. If possible, arrange the seats so that all participants 1. face each other (around a table, or with chairs in a circle, for example).

At the start of each session take a minute to review what was discussed 2. most recently. This will help participants to remember issues, concerns, or concepts.

Before starting this workbook, explain how this links to other workbooks 3. or parts of your program. If you are unfamiliar with this area, refer to the material in each workbook, or the Counselor ’s Manual.

Check for understanding regularly. You can do this by asking simple 4. questions (“What does this mean to you?” “How does this apply in your life?” “Since you now know this information, what can you do differently?”). Try to avoid questions with “yes” or “no” answers. For example, avoid asking: “Does everyone understand this? “Is this clear to you?”

Review each session at the end. Plan ahead to allow enough time to do 5. this. A few brief comments on what was covered or discussed can be very valuable.

If possible, assign each section to be done beforehand. It makes more 6. sense to use the time you have together to talk things over then it does to have participants reading or writing!

During the session, and at the end of the workbook, link these activities 7. to the future— a lifetime of recovery. You may suggest that they save key issues or activities as a helpful reminder for future reference


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Techniques

With this workbook, it may be especially helpful to encourage discussion, perhaps by selecting certain questions or issues from the activity and asking each participant to respond.

Objective

At the conclusion of these workbooks, the participants will have identified links and patterns of vulnerability, thinking, feelings, and behavior as part of an increased understanding of past patterns of dependency and relapse.

This understanding will also include past problems and issues which still need to be addressed. It is hoped that this will increase motivation to learn new cognitive skills and new (behavioral) coping skills

A list of specific behavioral objectives is attached.

Content Areas/Use of This Book

This workbook:

explains concepts and vocabulary of recovery•

identifies links and patterns of vulnerability, thinking, feelings, and behavior•

develops understanding of past pattern of dependency and relapse •

Behavioral Objectives

Participant will:

use checklist provided to identify current status or progress of recovery•

use checklist provided to identify past dependencies and related harmful •behaviors

list those dependencies or harmful behaviors he/she wants to change—•and those he/she does not choose to change

identify daily routines and habits which may also be harmful•


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Self-awareness: preventing relapse by increasing your sensitivity toyour pattern or cycle

1 Your life probably has certain patterns that occur again-and-again

Most people have developed certain patterns in their lives. It becomes convenient todo certain things the same way every time. When you get up in the morning, do youusually do the same things - in pretty much the same order? Most of us do. The waywe eat our breakfast, go to work or school, answer the phone, and even brush ourteeth may not change much from day-to-day.

This is not necessarily bad. These patterns provide a sense of stability and order thatcan be helpful and comforting. When you know where you'll always find your keys asyou race out of the house, Is a big help! There really is no problem with many of ourrituals or habits.

Sometimes these patterns can cause you problems

Your difficulties occur when your patterns become harmful to you or others. Many ofus continue to use the same harmful behaviors again-and-again, in spite of the damagethat they are causing.

Have you usually responded to uncomfortable feelings and triggers with the same sortsof behaviors? Many people will use drugs or alcohol to help them deal withuncomfortable feelings. They found that these substances made them feel better. Infact, they began to use these substances regularly - and more often. Their substanceabuse became a pattern.

Did you use the same substances over-and-over? yes ‘ no ‘

Did you use them more often? yes ‘ no ‘

Did you use them as often as you could? yes ‘ no ‘

Did you use them on certain days of the week (like weekends)? yes ‘ no ‘

Did you use them pretty much every day? yes ‘ no ‘

Did you use them at similar times of the day? yes ‘ no ‘

If you answered “yes” to some of the questions above, then your substance use hasdeveloped into a pattern.


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Most people who abuse drugs or alcohol have a pattern. Of course, they don’t intendfor this to happen. They use drugs because of the good feelings they get, or to helpthem “cope.” They don’t intend for this to become a habit or addiction. And, theydon’t think a lot about the bad things which might happen.

Some of these “bad things” include:

‘ The high cost of buying drugs.

‘ What you might have to do in order to get the drugs.

‘ Having to commit crimes to pay for the drugs.

‘ What other people might do to you while you are under the influence of alcoholor other drugs.

‘ Being around dangerous people.

‘ Risking your health (getting a disease like AIDS by sharing needles).

‘ Having dangerous or unprotected sex (also a big risk for your health).

‘ Hurting your relationships with your family.

‘ Hurting your relationship with certain friends.

‘ Hurting other people, or putting them at risk. For example, you might commit acrime, or drive a car when you are under the influence of alcohol or otherdrugs.

‘ Problems with the law.

‘ Ending up in jail or prison. The loss of your freedom.

Look at the list above. Have you “paid a high price” for your substance abuse? yes ‘ no ‘

Many people with patterns of substance abuse, addictions or dependencies finally facethese issues. They want to quit. These “coping” choices are “costing” too much. But“just saying “no’” doesn’t work. It’s very hard to stop on your own.


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The “good news” is that you can get help. This workbook is part of that process. Youwill learn better ways to “cope” with life’s problems and your feelings. You can reallyhave a good and happy life.

A first step is to get to know more about yourself. This means you will look at theways you have thought about things - and why some things make you feel bad oruncomfortable. Being angry, afraid, or lonely, for example, is uncomfortable, and manypeople use drugs or alcohol to help handle those feelings. This program will help youhandle those feelings better - without needing to use alcohol or drugs. This process iscalled “relapse prevention.”

The process of "relapse prevention" starts by becoming sensitive to these patterns

This workbook will help you to understand your problem "cycle," the pattern of specificthoughts, feelings and behaviors that leads up to and immediately follows yourinappropriate behaviors. Most of us have a pattern that has occurred repeatedly. Ourproblems and feelings have led us to the same sorts of behaviors, including ouraddictions, again-and-again. Knowing this, you will have a powerful tool, a first steptoward interrupting your cycle before problems occur.

Learn from your past

You can look at your past to see where you have been hurt. Look for areas where youhave been weak or vulnerable.

Do you want to be hurt again in the same way? Do you want to remain weak orvulnerable? Most people would say “no.” These are parts of your life where you havebeen at greatest risk. The triggers and temptations of your past will probably be yourtriggers and temptations in the future!

Your best defenses to handle your risks are:

! to know what your risks are,

! to prepare yourself to "see them coming" whenever possible,

! and to know what to do when they occur.


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If you take these steps, your "highest risks" can become very manageable. How readyare you to take these steps?

READINESS RULER

(not ready) (somewhat ready) (very ready)

1 2 3 4 5 6 7 8 9 10

You probably will experience fewer "high risk" situations because of this work. That'sthe "good news." The "bad news" is that it only takes one mistake for you to relapse. That's why a relapse prevention program is so important.

2 The Basics of Relapse Prevention

“How can I have a good life?”

“How can I reduce my chances of relapse?”

To answer those questions, you'll need to start by answering this one:

"Where (or when) am I at greatest risk for relapse?"

You're always at risk when you are around temptation, of course. With your newcoping skills and self-discipline, you should be better able to handle it than before. Youare also at high risk when you experience uncomfortable feelings and don't handle themwell. At that point, it's only a short step to returning to harmful behaviors.

The following may help explain why you have those uncomfortable feelings. Your risk is greatest when these three factors are present:

1 You are vulnerable to a set of specific triggers.

You don't feel lovable or capable. You have unresolved issues of grief, anger, loss,abandonment or trauma. Or, you are vulnerable due to past problems or failures.


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2 You experience certain triggers where you are vulnerable.

These can be people, places, things, thoughts, or situations. They cause youuncomfortable feelings such as anxiety, sadness, loneliness, rejection, guilt,shame, grief, or anger. You may have tried to control or reduce this discomfortquickly.

3 Your coping skills don't work or you may not believe your coping skillswill work.

You may not even recognize that you have a problem.

Have your problems become greater?

Problems grow when:

! we're especially vulnerable,

! and there are many triggers,

! or they affect us in a powerful way, and

! we have no "coping" strategies other than our old harmful behaviors.


SAMPLE

An example:

Jimmy has a lot of pressure in his life. Things aren’t going so well at home. He’s arguingwith his family a lot these days. His wife lost her job a long time ago, and there are moneyproblems. His kids are getting into a lot of trouble at school. His mother had helped, andthey were very close, but she died a few months ago.

Jimmy’s having trouble with work, too. His boss seems to always be on his case. Hisneighborhood is also part of the problem. There are a lot of bars in the area and he oftenfinds himself wondering if just having one or two drinks would help him forget his problemsfor as little while.

Is Jimmy vulnerable? Of course. There are many areas of his life wherehe is vulnerable. He’s trying to support his family on one income. His wife isunemployed now and she is probably very stressed. His mother had helped,but she’s gone, and he’s probably still grieving. He’s very much alone.

Are there a lot of triggers? Yes: stress in the family, alcohol, workproblems, etc..

Are these triggers powerful? They can be overwhelming. On theoutside, he might even look strong or tough, but inside, he’s probably scared,lonely, hurt, and angry.

How can Jimmy cope? What sort of examples of “good” coping has Jimmyseen? Alcohol, or drugs may look like the best answers.

Jimmy’s problems are growing. How do you think his story might end?

Have your problems become larger? yes ‘ no ‘

Do you have more of them? yes ‘ no ‘

If so, did you handle them well? yes ‘ no ‘

Did you use drugs or alcohol more often? yes ‘ no ‘


SAMPLE

When you were under stress, did you use drugs or alcohol to help “cope?” yes ‘ no ‘

You may have discovered that you had less and less control over your addictions andyour life. Your problems became progressively worse. If you used poor coping choices(like drugs or alcohol), they added to your problems. You became more vulnerable. You probably experienced bad feelings or discomfort most of the time. To "help" dealwith this, you may have used more of those old coping choices. They may even haveincreased your vulnerability. When you have no new or better ways to cope, yourproblems remain huge and your life feels out of control.

You may even have finally "hit bottom." Are you truly "sick and tired of being sick andtired?" If you have accepted that the pain of keeping your old addictions and harmfulbehaviors is too great, you may finally be ready to change. The pain involved in facingyour past and making changes may be less painful than keeping your life as it is.

4 Dependencies and harmful behaviors

People use all of the behaviors on the list below to help cope with life. They go bydifferent names: dependencies, habits, harmful behaviors, poor coping choices, or addictions. No matter what the name, they are ways some of us address the symptoms or feelingsof our underlying problems. Typically, most people with dependencies have more thanone of these at any given time - until they resolve their problems and use moreappropriate coping techniques.

Check "T" those that apply to you:

‘ abuse of drugs (any kind)‘ alcohol‘ gambling‘ buying things you don't need‘ showing off your possessions or lifestyle‘ tobacco products‘ workaholism‘ eating in response to stress‘ purging or not eating‘ sex dependency, sexual acting out‘ sick or harmful relationships‘ compulsively seeking love or intimacy


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‘ controlling others, manipulating or caretaking‘ being dependent on others - or on relationships‘ isolating or avoiding others‘ compulsive exercise such as running or weight lifting ‘ compulsive worrying‘ compulsive lying‘ over-dependent on religious activities‘ dependent on groups or social activities ‘ dangerous or high risk activities‘ stealing, shoplifting, burglary‘ violent crime‘ involvement in a cult‘ membership in a gang‘ drug dealing

Of course, nearly any behavior can become harmful if we abuse it.

Useful questions to ask about any of your behaviors:

Do I go back to the same behaviors nearly every time I experience emotionaldiscomfort? yes ‘ no ‘

Do they solve the underlying problem? yes ‘ no ‘

Do they simply postpone the problems? yes ‘ no ‘

Have they sometimes made things worse? yes ‘ no ‘

Have my old harmful behaviors "cost" me too much? yes ‘ no ‘

Have I become dependent on them to help me feel better? Yes ‘ no ‘

If went a few days without using them, would I feel uncomfortable? yes ‘ no ‘

If the answer to any of these questions is "yes," you may have a problem with thatbehavior. Most of us have problems with more than one behavior, of course. We canbe addicted to certain drugs, alcohol, gambling and sick relationships all at once, forexample.


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Stopping these behaviors "cold turkey," or quitting, isn't easy. It's really hard to quitsimply by wanting to. You'll need more than willpower.

The good news is that you can learn to control your behaviors. This process, "relapseprevention," is a skill that you can learn, which works! You can learn to say "no" to theharmful behaviors and replace them with a happier and better lifestyle. You can have agood life.

The first step is to make a commitment to change your harmful behaviors.

5 Which dependencies and harmful behaviors do you want to change?

Review the list of behaviors you checked on the previous page. In the spaces below, listthose you want to change and those you do not.

Behaviors I want to change Behaviors I do not want to change

Share these lists with a counselor or a safe and supportive friend. Explain whyyou listed each item in both lists, and why it is important to you to change them. Write down what they told you about your lists:

Knowing what you want to change is a critical starting point. In other workbooks, you'lllearn specific ways to achieve these changes. In the pages that follow, however, you'lllearn more about yourself and the pattern of your past problems. This knowledge willhelp you to take the steps you need when you need them most.


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6 Become sensitive to your thoughts, feelings, and typical behaviors

Knowing more about yourself will help you develop one of the most critical recoverytools, your "relapse prevention plan." It is based on several ideas:

! You have had a typical series of thoughts and feelings leading up to your pastproblem behavior (drinking, drug abuse, etc.). It has occurred again-and-again. We sometimes call this a “cycle” since we go ‘round and ‘round.

! You can identify this pattern and consider each step as a "warning sign."

! When you identify your warning signs and high risk situations, you can then applya variety of effective techniques, "coping skills," to stop your cycle. You can prevent relapse.

Your first steps will include becoming more aware of your thoughts, feelings, and typicalbehaviors. Since we have much in common, seeing this in someone else first may behelpful. Consider this scene:

Joe has been a smoker for most of his life, but now he is trying to stop smoking. Hehasn't smoked for three days. He is sitting in a restaurant, having just finished a greatmeal. This was always his favorite time for a cigarette.

How might he be feeling? (Check “U” those that might apply.)

‘ frustrated‘ angry‘ anxious‘ "hyper" or "antsy"‘ tempted‘ craving ("jonesing")


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What might he be thinking?

‘ "I'd like a smoke." ‘ "What if I only took a few puffs?"‘ "I've got to stay strong; I've made a commitment to quit."‘ "This is driving me crazy."‘ Other: (list below)

What might he be doing?

‘ Fidgeting?‘ Moving around in his seat? ‘ Eating a second desert?‘ Saying or doing unkind things to his dinner companions.

Describe some specific behaviors you have seen at times like this:

He might fail at this point. However, he also might succeed in stopping theurge to smoke. When he finishes his meal, he leaves the restaurant and beginsto walk down the street. He comes to a convenience store and stands infront of the store - a store where he can buy cigarettes. How might he befeeling at this point?

‘ Tempted? ‘ Confused? ‘ Frustrated?


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1 - Symptoms Charts

HOW ARE YOU DOING?FEELINGS AND SYMPTOMS “FREQUENCY, INTENSITY, AND DURATION” CHART

FREQUENCYHow often does it happen?

NEVER RARELY OCCASIONALLY OFTEN MOST OF THE TIME

1 2 3 4 5 6 7 8 9 10

INTENSITYHow powerful is it?

NOT AT ALL A LITTLE SOMEWHAT POWERFUL VERY INTENSE

1 2 3 4 5 6 7 8 9 10

DURATIONHow long does it last?

VERY BRIEF A SHORT TIME MEDIUM DURATION A LONG TIME A VERY LONG TIME

1 2 3 4 5 6 7 8 9 10

You can use the other worksheets to keep track of your total points on the scales above. Keeping trackof the Frequency, Intensity, and Duration (FID) of your thoughts, your feelings, and your othersymptoms or cues helps you know whether things are getting better or worse. When you areuncomfortable, or notice these symptoms, be sure to use your thought stopper and other coping skills.


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HOW ARE YOU DOING - SESSION LOGFEELINGS AND SYMPTOMS CHART

DIRECTIONS: USE THIS CHART TO TRACK YOUR FEELINGS OR SYMPTOMS SINCE YOUR LASTSESSION. USE THE “FREQUENCY, INTENSITY, AND TIME” CHART AND WRITE DOWNYOUR TOTAL (OR AVERAGE) POINTS FOR EACH DAY.

HOW HAVE YOU BEEN DOING SINCE THE LAST TIME WE MET?

DATE SESSION DATE SESSION DATE SESSION DATE SESSION DATE SESSION DATE SESSION DATE SESSION DATE

TOTAL

30

27

24

21

18

15

12

9

6

3

Keeping track of the Frequency, Intensity, and Duration(FID) of your thoughts, your feelings, and yourother symptoms or cues helps you know whether things are getting better or worse. If things aregetting worse, you may be at increasing risk.

When you are uncomfortable, or notice these symptoms, be sure to use your thought stopper andother coping skills, or seek out members of your safety net.


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HOW ARE YOU DOING TODAY?FEELINGS AND SYMPTOMS CHART

DIRECTIONS: USE THIS CHART TO TRACK YOUR FEELINGS OR SYMPTOMS DURING THE DAY. USE THE “FREQUENCY, INTENSITY, AND TIME” CHART AND WRITE DOWN YOUR TOTAL

(OR AVERAGE) POINTS EACH TIME YOU USE THE CHECKLIST.

TIME earlymorning

break-fast time

latemorning

lunchtime

afternoon rectime

dinnertime

beforebed time

other

TOTAL

30

27

24

21

18

15

12

9

6

3

Keeping track of the Frequency, Intensity, and Duration (FID) of your thoughts, your feelings, and yourother symptoms or cues helps you know whether things are getting better or worse. If things aregetting worse, you may be at increasing risk.

When you are uncomfortable, or notice these symptoms, be sure to use your thought stopper andother coping skills, or seek out members of your safety net.


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2 - SINCE THE LAST TIME WE MET . . . .

Since we met did you have any uncomfortable feelings?

Whendid ithappen?

What washappening?

What were yourthoughts?

What did you do? Whatbetterthings couldyou do nexttime?

faulty thinking choices that didn’t work

functional thinking choices that worked


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3 - Stop-Think-Act Scale

Stop-Think-Act Scale

I usually act before Ithink things through.

I often act before Ithink things through.

Sometimes I stop andthink before I act

Most of the time, Istop and think before

I do act.

I stop and think beforeI act. I think about

what I really want tohappen.

1 2 3 4 5 6 7 8 9 10


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4 - THE LAST TIME YOU USED DRUGS AND/OR ALCOHOL

Think about the last time you used drugs and/or alcohol.

What was going on? (Check all that apply.)

‘ I was at a party‘ I was hanging out with some of my old buddies.‘ I didn’t want to look like a wimp.‘ I was with some other people and they really wanted me to join in with them. ‘ I didn’t think about it. I just did it.‘ I was just going to have one.‘ I just wanted to test myself.‘ The cravings were too much to handle.‘ I didn’t think anyone would find out.‘ I thought it would be exciting.‘ I did it on a dare. ‘ I wanted their respect.‘ other: _________________________

What were you feeling when it was going on: (Check all that apply)

‘ I felt angry.‘ I felt stressed.‘ I felt worried,‘ I felt confused.‘ I felt like I didn’t care.‘ I felt like it was unreal.‘ I felt hyper or excited.‘ I felt brave and confident. ‘ I felt like things were out of control.‘ I felt happy.

What do you think about it now? (Check all that apply.)

‘ I did something wrong. I accept responsibility for what I did. ‘ I did something wrong, but they made a bigger deal of it.‘ It wasn’t my fault. It was someone else’s fault. ‘ I didn’t intend to use anything, I just got caught up in it.‘ I was just in the wrong place at the wrong time. ‘ I was set up.‘ Sometimes you have to do what you have to do. What I did was really okay.‘ I did it, and, I would do it again. I’m proud of what I did.


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IMPORTANCE RULERHow important is it to you to change these problems?

(this is not very important to me) (this is somewhat important to me) (this is very important to me)

1 2 3 4 5 6 7 8 9 10

CONFIDENCE RULERIf you tried hard, how confident are you that you would be able to make this change?

(I don’t think I can do it) (I might be able to make this change) (I’m very confident I can do this if I try)

1 2 3 4 5 6 7 8 9 10

READINESS RULERHow ready are you to make this change?

(not ready to change) (somewhat interested in trying to change) ( ready to try to make a change)

1 2 3 4 5 6 7 8 9 10

Stop-Think-Act Scale

I usually act before Ithink things through.

I often act before Ithink things through.

Sometimes I stop andthink before I act

Most of the time, Istop and think before

I do act.

I stop and think beforeI act. I think about

what I really want tohappen.

1 2 3 4 5 6 7 8 9 10


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5 - TRIGGERS SUMMARY ACTIVITY: HOW WELL DO YOU KNOW YOURSELF?

This activity is designed to help you assess your internal and external triggers for drug and alcohol use.

INTERNAL TRIGGERSA good place to start is to check to see if you can identify your most common internal triggers for drugand alcohol use.

Thoughtswhichcause meto want touse drugsand/oralcohol

List two typical thoughts which cause you to want to use drugs and/or alcohol:

1

2

Which thoughts have caused you the most trouble in the past?

SELF-MONITORING RULER FOR YOUR INTERNAL TRIGGERSUse the ruler below to indicate how you are doing at knowing what you are feeling or thinking (this iscalled self-management or monitoring yourself). How are you doing in terms of knowing when you are

having the urge to use drugs and/or alcohol?

SELF-MONITORING RULER FOR FEELINGS

(I never seem to know) (Sometimes I know) (I always know)

1 2 3 4 5 6 7 8 9 10

SELF-CONTROL RULER - INTERNAL TRIGGERSUse the ruler below to indicate how well you are doing at using your new skills (STOP-THINK-ACT andAVOID-ESCAPE-REFUSE) to make good choices when you are having the urge to use drugs and/oralcohol.

SELF-CONTROL RULER - INTERNAL TRIGGERS

(I can’t seem to use this skill) (Sometimes the skill works for me) (I am doing very well with this skill)

1 2 3 4 5 6 7 8 9 10


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EXTERNAL TRIGGERSExternal triggers are the generally the people, places things and situations where you have had problemsin the past.

Types of TRIGGERS List 2-3 for each area

People triggers (the types ofpeople who have been a partof past problems)

1

2

3

Places triggers (the types ofplaces when you have hadproblem in the past)

1

2

3

Things triggers (things whichhave cause you problems inthe past).

1

2

3

Situations triggers (where youhave had problems in thepast)

1

2

3


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A key goal for this program is for you to master a set of new skills which allow you to manage stressfulsituations and risk factors successfully. These skills include: “STOP-THINK-ACT” and “AVOID-ESCAPE-REFUSE.” Use the rulers below to assess how successful you are - so far - at using theseimportant skills.

SELF-MANAGEMENT RULER #1 - EXTERNAL TRIGGERSUse the ruler below to indicate how well you are doing at using your new STOP-THINK-ACT skills tomake good choices to reduce your problems with high risk people, places, things, and situations.

SELF-MANAGEMENT RULER #1 - EXTERNAL TRIGGERS

(I can’t seem to use these skills) (Sometimes the skills work) (I am doing very well with these skills)

1 2 3 4 5 6 7 8 9 10

SELF-MANAGEMENT RULER #2 - EXTERNAL TRIGGERSUse the ruler below to indicate how well you are doing at using your new skill at AVOIDING problemswith high risk people, places, things, and situations



1 2 3 4 5 6 7 8 9 10

SELF-MANAGEMENT RULER #3 - EXTERNAL TRIGGERSUse the ruler below to indicate how well you are doing at using your new ESCAPE skill to make getaway from possible problems with high risk people, places, things, and situations.



1 2 3 4 5 6 7 8 9 10


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8 - YOU FEEL THE WAY YOU THINK!In the thought bubble below, write a example of a thought that doesn’t work which could lead to thefeeling on the right.

ANXIETY orWORRY

Now, describe one goodthing you could do if youhad this feeling:

ANGER

Now, describe one goodthing you could do if youhad this feeling:

SADNESS ORDEPRESSION

Now, describe one goodthing you could do if youhad this feeling


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9 - 6 STEP ACTIVITY (CBT)

Let’s look at a time recently where you used drugs and/or alcohol, and examine the thoughts, feelings,and actions that occurred.

TRIGGER EVENT

Describe what happened:

FAULTY THINKING

Now, let’s look at the connections between this trigger and your thoughts, feelings, and actions. Didyou have any faulty thinking What were those thoughts? (Describe below).

FEELINGS

What feelings did you have? (Anger, anxiety, worry, sadness, depression, etc.)

ACTIONS

At that point, did you think about what choices you had? yes ‘ no ‘ If you did, what choicesdid you consider? (Describe below).


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WHAT ABOUT FUNCTIONAL THINKING?

Did you take time to think what you really wanted? yes ‘ no ‘ Did you stop and take a lookat your thinking? Did you replace any faulty thoughts with functional thoughts? (Describe whathappened.)

What is a good example of a functional thought in this situation?

DIFFERENT FEELINGS

If you make choices based on functional thoughts what feelings will you have? If you did make a goodchoice, how did you feel? (Describe how you felt.).

THE FUTURE

What will you do the next time?


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