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Addictions Worksheets, Dual Diagnosis, And Relapse Prevention

Misuse of alcohol and other drugs frequently co-occurs with other mental health conditions. For example, rates of PTSD among some groups misusing substances have been reported to be as high as 50% (Reynolds et al., 2005). Mental health professionals working with substance misuse use a variety of psychological approaches. These include cognitive behavioral techniques, relapse prevention, motivational interviewing, and solution-focused brief therapy. Read more
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Resource type


Therapy tool

A Guide To Emotions (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ...


ABC Model

ABC is an acronym for Antecedents, Behavior, Consequences. It is used as a tool for the assessment and formulation of problem behaviors and is useful ...


Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ...


Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ...


Classical Conditioning

Classical conditioning is a process by which stimuli become associated with responses. This information handout describes key principles of Classical ...

Information Handout

Cognitive Behavioral Model Of The Relapse Process (Larimer, Palmer, Marlatt, 1999)

Marlatt’s (1985) cognitive behavioral model of relapse conceptualizes relapse as a “transitional process, a series of events that unfold over ...

Information Handout

Developing Psychological Flexibility

Developing Psychological Flexibility is a client information handout which can be used to familiarize clients with the ACT model. ...

Information Handout

Functional Analysis

Functional analysis examines the causes and consequences of behavior. This classic A-B-C Functional Analysis worksheet can be used to collect informat ...


Functional Analysis With Intervention Planning

This classic A-B-C functional analysis worksheet can be used to collect information about what came before a behavior (antecedents), the behavior itse ...


Grounding Statements (Audio)

Grounding techniques are used to help people to reorient themselves to the present moment and to safety. Grounding Statements are a form of cognitive ...


Grounding Techniques Menu

Dissociation can be described as a shift of a person’s attention away from the present moment. When working with traumatized clients, this shift oft ...

Information Handout

Intrusive Memory Record

Intrusive (unwanted, involuntary) memories are a common feature of PTSD, but also depression and other conditions. This Intrusive Memory Record is des ...


Lapse And Relapse Management

Recovery has a fluctuating course and so Lapse And Relapse Management is necessary when learning any new skill. It is applicable to most CBT work, as ...


Mindful Attention (Audio)

Mindful Attention is a technique for becoming aware of one’s thoughts and experiences, and being able to observe these as transient mental events. ...


Motivation and Ambivalence

Motivation is a necessary precursor to change, yet many clients are ambivalent about the process of change. The Motivation And Ambivalence worksheets ...


Properties Of Trauma Memories

Important properties of trauma memories include involuntary recall, ‘nowness’, vividness, and immutability. People who have experienced t ...

Information Handout

Psychology Tools For Mindfulness Audio Collection

The Psychology Tools For Mindfulness Audio Collection is the perfect way to introduce your clients to the practice of mindfulness. Developed by a clin ...

Audio Collection

Relaxed Breathing Exercise 1 (Audio)

Breathing Exercise 1 guides the listener through simple instructions to make their breathing slower, deeper, and more regular. ...


Relaxed Breathing Exercise 2 (Audio)

Breathing Exercise 2 uses the imagery of inflating a balloon to help the listener make their breathing slower, deeper, and more regular. ...


Relaxed Breathing Exercise 3 (Audio)

Breathing Exercise 3 uses the imagery of breathing air of different colours to help the listener make their breathing slower, deeper, and more regular ...


Relaxed Breathing Exercise 4 (Audio)

Breathing Exercise 4 guides the listener through simple instructions to breathe in a more relaxed fashion. ...


Sensory Grounding Using Smells (Audio)

The Sensory Grounding Using Smells exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to teach ...


Sensory Grounding Using Your Five Senses (Audio)

The Sensory Grounding Using Your Five Senses exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed ...


Stages Of Change

The Stages Of Change model is helpful for conceptualizing the mental states of individuals at different stages of their change journey. This informati ...

Information Handout

Therapy Blueprint

Since the publication of this version of the therapy blueprint we have also developed a more sophisticated version: Therapy Blueprint (Universal) A th ...


Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. Cognitive restructuring is the process of helping individuals to overcome their biases ...

Information Handout


  • Drinking motives questionnaire | Cooper, Russell, Skinner, Windle | 1992
    • Scale  download  archived copy
    • Cooper, M. L., Russell, M., Skinner, J. B., & Windle, M. (1992). Development and validation of a three-dimensional measure of drinking motives. Psychological Assessment,4,123-132.
  • Drinking motives questionnaire – adolescent | Cooper | 1994
    • Scale  download  archived copy
    • Cooper, M.L. (1994). Motivations for alcohol use among adolescents:  Development and validation of a four-factor model.  Psychological Assessment, 6,117-128.
  • Leeds Dependence Questionnaire | Raistrick, Bradshaw, Tober, Weiner, Allison, Healey | 1994
    • Scale  download  archived copy
    • Raistrick, D.S., Bradshaw, J., Tober, G., Weiner, J., Allison, J. & Healey, C. (1994) Development of the Leeds Dependence Questionnaire, Addiction, 89, pp 563-572.
  • Maudsley Addiction Profile (MAP) | Marsden, Gossop, Stewart, Best, Farrell, Lehmann, Edwards, Strang | 1998
    • Scale  download  archived copy
    • Marsden, J. Gossop, M. Stewart, D. Best, D. Farrell, M. Lehmann, P. Edwards, C. & Strang, J. (1998) The Maudsley Addiction Profile (MAP): A brief instrument for assessing treatment outcome, Addiction 93(12): 1857-1867.
  • Readiness to Change Questionnaire (RTQ) | Heather, Rollnick | 1993
  • Severity of Dependence Scale | Gossop, Darke, Griffiths, Hando, Powis, Hall, Strang | 1995
    • Scale  download  archived copy
    • Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., Strang, J. (1995). The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction 90(5): 607-614.
  • Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) | Miller, Tonigan | 1996
    • Scale  download  archived copy
    • Miller, W. R., & Tonigan, J. S. (1996). Assessing drinkers’ motivation for change: the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Psychology of Addictive Behaviors10(2), 81.


Treatment manuals

  • Motivational Enhancement Therapy Manual | Miller, Zweben, DiClemente, Rychtarik | 1995 download archived copy
  • Cognitive Behavioural Coping Skills Treatment Manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence | Kadden, Carroll, Donovan, Cooney, Monti, Abrams, Litt, Hester | 2003 download archived copy
  • Clinical guidelines for implementing relapse prevention therapy | Marlatt, Parks, Witkiewitz | 2002 download archived copy
  • A cognitive-behavioral approach: Treating cocaine addiction | Carroll | 1998 download archived copy
  • Addictions and trauma recovery | Janina Fischer | 2000 download archived copy

Information Handouts

Information handouts


  • Cognitive behavioral & relapse prevention strategies | UNODC | 2007 download archived copy
  • Acceptance and commitment therapy for substance abuse | Richie | 2013 download archived copy
  • The great porn experiment – TED lecture | Gary Wilson
  • Yourbrainonporn – contains useful information about neurobiology of addition  link

Recommended Reading

  • Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist41(7), 765. download
  • Hendershot, C. S., Witkiewitz, K., George, W. H., & Marlatt, G. A. (2011). Relapse prevention for addictive behaviors. Substance abuse treatment, prevention, and policy6(1), 17. download
  • Larimer, M. E., Palmer, R. S., Marlatt, G. A. (1999). An overview of Marlatt’s Cognitive-Behavioural Model. Alcohol Research and Health, 23(2), 151-160 download archived copy
  • Marlatt, G. A., & Witkiewitz, K. (2005). Relapse prevention for alcohol and drug problems. download archived copy
  • Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371 download

What Is Addiction?

Signs and Symptoms of Addictions and Relapse

Behavioral and Social Signs of Addictions Include:

  • Continuing to use a substance (or engage in certain behaviors) despite the negative consequences that they cause
  • Trying but failing to reduce or stop misusing a substance
  • Secretive, furtive, or dishonest behavior

Psychological Symptoms of Addictions Include:

  • Mood swings
  • Anger or irritability
  • Paranoia
  • Defensiveness
  • Poor judgment

Psychological Models of Addictions and Relapse

There is considerable psychological theory which clinicians working in the field of addiction can draw upon.

Prochaska and DiClemente’s Transtheoretical Model (Stages of Change Model)

The transtheoretical model (Prochaska & DiClemente, 1982; Prochaska, DiClemente, Norcross, 1992) is used to conceptualize the process of intentional behavior change. It identifies important stages in the process of changing a behavior: precontemplation, contemplation, preparation, action, and maintenance. The transtheoretical model also identifies processes which need to be implemented to attain behavior change: consciousness raising (awareness of the facts), dramatic relief (paying attention to feelings), environmental re-evaluation (noticing our effects upon others), self–re-evaluation (creating a new self-image), social liberation (noticing support around us), self-liberation (making a commitment), counterconditioning (using substitutes), helping relationships (getting support), reinforcement management (using rewards), stimulus control (managing your environment).

Marlatt and Gordon’s Cognitive Behavioral Model of Relapse

Marlatt and Gordon published a cognitive behavioral model of relapse in 1985. They conceptualize relapse as a “transitional process, a series of events that unfold over time” (Marlatt & Gordon, 1985). The model identifies factors that can contribute toward episodes of relapse. These include intrapersonal factors such as self-efficacy (the degree to which an individual feels confident and capable of performing a certain behavior in a specific situational context), outcome expectancies (an individual’s anticipation of the effects of a future experience), craving, motivation, and social support.

The Cognitive Behavioral Model of Substance Abuse

The cognitive behavioral model of substance abuse (Beck, Wright, Newman, & Liese, 1993) describes psychological areas of vulnerability that predispose an individual to misusing substances including: dysfunctional beliefs about drugs, oneself, or one’s relationship with drugs; ‘permission-giving beliefs’ with which an individual may justify their drug use; and reactions to a lapse or relapse that lead to a vicious cycle of maintenance.

Evidence-Based Psychological Approaches for Working with Addictions and Relapse

Cognitive approaches to working with addictions may include:

  • identifying patterns of dysfunctional thinking such as ‘permission-giving beliefs’;
  • learning how to delay and distract in response to cravings and urges;
  • learning problem-solving techniques;
  • making positive lifestyle changes;
  • treating underlying mental health conditions which predispose an individual toward substance misuse.

Resources for Working with Addictions and Relapse

Psychology Tools resources available for working therapeutically with addictions may include:

  • psychological models of addiction and relapse
  • information handouts for addiction and relapse
  • exercises for addiction and relapse
  • CBT worksheets for addiction and relapse
  • self-help programs for addiction and relapse


  • Beck, A. T., Wright, F., Newman, C., & Liese, B. (1993). Cognitive therapy of substance abuse: a treatment manual. New York Guilford.
  • Larimer, M. E., & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt’s cognitive-behavioral model. Alcohol Research and Health, 23(2), 151–160.
  • Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention. New York: Guilford Press.
  • Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research & Practice,19(3), 276–288.
  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to the addictive behaviors. American Psychologist, 47(9), 1102–1114.
  • Reynolds, M., Mezey, G., Chapman, M., Wheeler, M., Drummond, C., & Baldacchino, A. (2005). Co-morbid post-traumatic stress disorder in a substance misusing clinical population. Drug and Alcohol Dependence, 77(3), 251–258.