Skip to main content

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

Filter

Addictions Worksheets, Dual Diagnosis, And Relapse Prevention

Filter


Search


Language


Resource type


Problem


Therapy tool

52 of 52 resources

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 ... https://www.psychologytools.com/resource/grounding-techniques-menu

Failure To Achieve

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/failure-to-achieve

Abandonment

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/abandonment

Window Of Tolerance

The window of tolerance concept was coined by Dan Siegel in his 1999 book The Developing Mind. Siegel proposes that everyone has a range of intensitie ... https://www.psychologytools.com/resource/window-of-tolerance

Therapy Blueprint (Universal)

A therapy blueprint is CBT tool which summarizes the work a therapist and patient have completed together. It represents the past (the problems, what ... https://www.psychologytools.com/resource/therapy-blueprint-universal

Entitlement

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/entitlement

Enmeshment

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/enmeshment

Emotional Deprivation

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/emotional-deprivation

Approval-/Admiration-Seeking

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/approval-admiration-seeking

Unhelpful Thinking Styles (Archived)

NOTE: Two improved versions of this resource are available here: Cognitive Distortions – Unhelpful Thinking Styles (Common) and Cognitive Disto ... https://www.psychologytools.com/resource/unhelpful-thinking-styles-archived

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 ... https://www.psychologytools.com/resource/behavioral-experiment

Defectiveness

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/defectiveness

Emotional Inhibition

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/emotional-inhibition

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 ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format

Dependence / Incompetence

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/dependence-incompetence

Audio Collection: Psychology Tools For Mindfulness

The Psychology Tools For Mindfulness Audio Collection is the perfect way to introduce your clients to the practice of mindfulness. Developed by a clin ... https://www.psychologytools.com/resource/psychology-tools-for-mindfulness-audio-collection

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 ... https://www.psychologytools.com/resource/abc-model

Managing Your Substance Use Disorder (Third Edition): Workbook

Managing Substance Use Disorder comes in two volumes. This page is for the Client Workbook. Click on the following link to access the Practitioner Gui ... https://www.psychologytools.com/resource/managing-your-substance-use-disorder-workbook

Boundaries - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/boundaries-self-monitoring-record

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 ... https://www.psychologytools.com/resource/lapse-and-relapse-management

Managing Substance Use Disorder (Third Edition): Practitioner Guide

Managing Substance Use Disorder comes in two volumes. This page is for the Practitioner Guide. Click on the following link to access the Workbook.&nbs ... https://www.psychologytools.com/resource/managing-substance-use-disorder-practitioner-guide

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 ... https://www.psychologytools.com/resource/a-guide-to-emotions-psychology-tools-for-living-well

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 ... https://www.psychologytools.com/resource/stages-of-change

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 ... https://www.psychologytools.com/resource/intrusive-memory-record

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 ... https://www.psychologytools.com/resource/functional-analysis-with-intervention-planning

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 ... https://www.psychologytools.com/resource/motivation-and-ambivalence

Permissive Thinking

The Permissive Thinking information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effec ... https://www.psychologytools.com/resource/permissive-thinking

Externalizing

The Externalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/externalizing

Urges – Self-Monitoring Record

The Urges – Self-Monitoring Record worksheet is designed to help clients capture information about their urges and cravings. It includes columns to ... https://www.psychologytools.com/resource/urges-self-monitoring-record

Mental Filter

The Mental Filter information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/mental-filter

Body Scan (Audio)

The Body Scan is a mindfulness exercise encouraging present-moment awareness, with the sensations of the body being used as an anchor for mindful atte ... https://www.psychologytools.com/resource/body-scan-audio

Fortune Telling

The Fortune Telling information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effective ... https://www.psychologytools.com/resource/fortune-telling

Magnification And Minimization

The Magnification And Minimization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work ... https://www.psychologytools.com/resource/magnification-and-minimization

Relaxed Breathing Exercise 1 (Audio)

Relaxed Breathing Exercise 1 is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. The aim of this breathing exercise is t ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-1-audio

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 ... https://www.psychologytools.com/resource/sensory-grounding-using-your-five-senses-audio

Mindfulness Of Breath (Short Version) (Audio)

Mindfulness Of Breath (Short version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ... https://www.psychologytools.com/resource/mindfulness-of-breath-short-version-audio

Grounding Statements (Audio)

The Grounding Statements exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track is designed for p ... https://www.psychologytools.com/resource/grounding-statements-audio

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 ... https://www.psychologytools.com/resource/functional-analysis

Mindfulness In Everyday Life (Audio)

Mindfulness In Everyday Life is a short mindfulness exercise which guides clients how to bring present-moment awareness into everyday life. This audio ... https://www.psychologytools.com/resource/mindfulness-in-everyday-life-audio

Permissive Thinking – Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/permissive-thinking-self-monitoring-record

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Marlatt & Gordon’s cognitive behavioral model of relapse (1985) conceptualizes relapse as a “transitional process, a series of events that unf ... https://www.psychologytools.com/resource/cognitive-behavioural-model-of-the-relapse-process-marlatt-gordon-1985

Classical Conditioning

Classical conditioning is a process by which stimuli become associated with responses. This information handout describes key principles of Classical ... https://www.psychologytools.com/resource/classical-conditioning

Mindfulness Of Sounds And Thoughts (Audio)

Mindfulness Of Sounds And Thoughts is a mindfulness practice exercise that encourages relating to thoughts as ‘just thoughts’ that come and go in ... https://www.psychologytools.com/resource/mindfulness-of-sounds-and-thoughts-audio

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 ... https://www.psychologytools.com/resource/sensory-grounding-using-smells-audio

Mindfulness Of Breath (Long Version) (Audio)

Mindfulness Of Breath (Long version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ... https://www.psychologytools.com/resource/mindfulness-of-breath-long-version-audio

Relaxed Breathing Exercise 2 (Audio)

Relaxed Breathing Exercise 2 is an audio track taken from the Psychology Tools For Overcoming PTSD Audio Collection. The aim of this breathing exercis ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-2-audio

Mindful Attention (Audio)

The Mindful Attention exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track was originally recor ... https://www.psychologytools.com/resource/mindful-attention-audio

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 ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-3-audio

Operant Conditioning

Operant conditioning / instrumental learning is a mechanism by which behaviors can be strengthened or weakened over time. This information handout des ... https://www.psychologytools.com/resource/operant-conditioning

Relaxed Breathing Exercise 4 (Audio)

Relaxed Breathing Exercise 4 is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. Slow, relaxed, diaphragmatic breathing ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-4-audio

Thinking Versus Sensing (Audio)

Thinking Versus Sensing is a short mindfulness exercise to demonstrate the difference between thinking about our experience and sensing it directly. E ... https://www.psychologytools.com/resource/thinking-versus-sensing-audio

Raisin Exercise (Audio)

The Raisin Exercise is a short mindfulness exercise encouraging present-moment awareness of the senses, connecting with taste, touch and smell while y ... https://www.psychologytools.com/resource/raisin-exercise-audio

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Drinking motives questionnaire – adolescent | Cooper | 1994
    • Cooper, M.L. (1994). Motivations for alcohol use among adolescents:  Development and validation of a four-factor model.  Psychological Assessment, 6,117-128.
    • Scale
  • Leeds Dependence Questionnaire | Raistrick, Bradshaw, Tober, Weiner, Allison, Healey | 1994
    • 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.
    • Scale
  • Maudsley Addiction Profile (MAP) | Marsden, Gossop, Stewart, Best, Farrell, Lehmann, Edwards, Strang | 1998
    • 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.
    • Scale
  • Readiness to Change Questionnaire (RTQ) | Heather, Rollnick | 1993
  • Severity of Dependence Scale | Gossop, Darke, Griffiths, Hando, Powis, Hall, Strang | 1995
    • Scale
    • 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
    • Reference 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 Behaviors, 10(2), 81.
  • Drinking motives questionnaire | Cooper, Russell, Skinner, Windle | 1992
    • 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.
    • Scale

Guides and workbooks

  • Psychosis And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimingham | 2011
  • Trauma And Substance Use | NDARC: Mills, Ewer, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimmingham | 2011
  • Changing Addictive Thought Patterns | Mayo Clinic
  • Personality And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimingham | 2011
  • Alcohol And You (An NHS Self-Help Guide) | Holdsworth, Anslow, Crawford, Hall, Jcques, McNally, Reynolds, Widdas, Maunder, Cameron | 2020
  • Anxiety And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Triningham | 2011
  • Mood And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimingham | 2011

Information Handouts

Presentations

Treatment Guide

  • Counselor’s Manual For Relapse Prevention With Chemically Dependent Criminal Offenders | USDHHS | 1996
  • Enhancing motivation to change in substance use disorder treatment | SAMHSA | 2019
  • Individualized treatment for problem gamblers: patient workbook | Timothy W. Fong, Richard J. Rosenthal | 2009
  • Integrated cognitive behavior therapy: clinician's manual | Mark McGovern, Kim Mueser, Jessica Hamblen, Mary Jankowski
  • 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
  • Enhancing Motivation for Change in Substance Use Disorder Treatment | SAMHSA | 2019
  • Motivational Enhancement Therapy Manual | Miller, Zweben, DiClemente, Rychtarik | 1995
  • Clinical guidelines for implementing relapse prevention therapy | Marlatt, Parks, Witkiewitz | 2002
  • A Cognitive-Behavioral Approach: Treating Cocaine Addiction (National Institute On Drug Abuse: Therapy Manuals For Drug Addiction) | Kathleen Carroll | 1998
  • Patient’s workbook for cognitive behavioral therapy sessions – Intensive Treatment and rehabilitation program for residential treatment and rehabilitation centers for drug dependents (INTREPRET) | Phillipines Department of Health | 2020
  • Substance use / brain injury bridging project – Client workbook | Community Head Injury Resource Services of Toronto (CHIRS) and the Centre for Addiction and Mental Health (CAMH)
  • Substance Use / Brain Injury Workbook | Community Head Injury Resource Services of Toronto (CHIRS), Centre For Addiction And Mental Health (CAMH)

Recommended Reading

  • Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse.American Psychologist,41(7), 765.
  • Hendershot, C. S., Witkiewitz, K., George, W. H., & Marlatt, G. A. (2011). Relapse prevention for addictive behaviors.Substance abuse treatment, prevention, and policy,6(1), 17.
  • 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
  • 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
  • Addictions And Trauma Recovery (Paper Presented At The International Society For The Study Of Dissociation) | Janina Fischer | 2000

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

References

  • 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.