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Clients Name _______________________________________ Date _______________

BASIC-ID Worksheet Read the statement by each category and circle the appropriate rating in the shaded area in the column on the right. (6 = highest and 0 = lowest)

Behavior

How active are you? How much of a doer are you? Do you like to keep busy? How emotional are you? How deeply do you feel things? How much do you focus on the pleasures and pains derived from your senses? How tuned in are you to your bodily sensations to sex, food, music, art? Do you have a vivid imagination? Do you engage in fantasy and daydreaming? Do you think in pictures? How much of a thinker are you? Do you like to analyze things or reason things out?

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Affect Sensation

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Imagery

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Cognition

Interpersonal How social are you? How important are other people to you? Do you gravitate to people? Do you desire intimacy with others? Drugs & Biology Are you healthy and health conscious? Do you take good care of your body and physical health? Do you overeat? Do you avoid abusing drugs and alcohol?

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Clients Name _______________________________________ Date _______________ Disentangling Thoughts, Feelings, and Situations This exercise will help you better distinguish your thoughts, feelings, and situations. Circle your answer in the right column to indicate if the item in the left column is a thought, feeling, or situation. Depressed Thought Feeling Situation At the bar Thought Feeling Situation Im crazy Thought Feeling Situation Angry Thought Feeling Situation Irritated Thought Feeling Situation At work Thought Feeling Situation Its awlful. Thought Feeling Situation At home Thought Feeling Situation Im good at this Thought Feeling Situation Driving a car Thought Feeling Situation Something terrible happened Thought Feeling Situation Nothing ever goes right Thought Feeling Situation In the garage Thought Feeling Situation Discouraged Thought Feeling Situation I cant stand this Thought Feeling Situation Sitting alone Thought Feeling Situation Furious Thought Feeling Situation Im a failure Thought Feeling Situation Talking on the phone Thought Feeling Situation Panic Thought Feeling Situation She is being inconsiderate Thought Feeling Situation Im a loser Thought Feeling Situation Guilty Thought Feeling Situation Drinking and driving Thought Feeling Situation At a friends house Thought Feeling Situation Im having a heart attack Thought Feeling Situation He took advantage of me Thought Feeling Situation Anxious Thought Feeling Situation In bed trying to get to sleep Thought Feeling Situation Im going to loose everthing Thought Feeling Situation Im in trouble Thought Feeling Situation Thrilled Thought Feeling Situation I hate my life Thought Feeling Situation I have to get sober Thought Feeling Situation Sad Thought Feeling Situation Sitting in an AA meeting Thought Feeling Situation I always work hard Thought Feeling Situation Im lazy Thought Feeling Situation Panic Thought Feeling Situation In the office Thought Feeling Situation

Clients Name _______________________________________ Date _______________

Goals Worksheet Reviewing your goals can strengthen your motivation. The changes I want to make during the next ________ weeks are:

The most important reasons why I want to make those changes are:

The steps I plan to take in changing are:

The ways other people can help me are:

Some things that might interfere with my plan are:

Clients Name _______________________________________ Date _______________ The CBT Model of Addiction We think ten times faster than we talk. On the average we talk about 150 words a minute but we think about 1500 words a minute. This inner dialogue is continuous (you are doing it right now). We process information through words, images and memories. There are five components: thoughts, feelings, behavior, physiological reactions, and environment (situation). Each of the five components affects and interacts with the others. Small changes in any one area can lead to changes in the other areas.

Environment

Thought s

Addiction
Physical Reaction

Feelings

Behavio r

Clients Name _______________________________________ Date _______________ The CBT Model of Addiction

Environment

Thought s

Addiction
Behavio r

Feelings

Physical Reaction

Conceptualizing the Client Who Is Seeking Treatment Environment Thoughts Feelings Physical Reaction Behavior Several family members and friends abuse alcohol and drugs. Legal trouble. Financial trouble. Divorce and parent-child problems. Problems at work. Im a failure. I am worthless. My life is hopeless. I am rejected. I will never get sober. I may as well be dead. Depressed, Anxious. Great deal of time spent in using alcohol and drugs, or recovering from hangovers. Sweating, rapid pulse, insomnia, nausea or vomiting, physical agitation Great deal of time spent thinking about, acquiring and using alcohol and drugs. Difficulty working; isolating self, crying, anger outburst, suicide attempts

Clients Name _______________________________________ Date _______________ The CBT Model of Addiction

Environment

Thought s

_________
Behavio r

Feelings

Physical Reaction

Understanding My Problems Describe the five areas listed below. Environment Thoughts Feelings Physical Reaction Behavior

Clients Name _______________________________________ Date _______________

Identifying and Rating Moods Emotion can be difficult to identify. Below is a list of moods. Although the list is not comprehensive it may help you describe your feelings in more exact terms. Check these lists for the exact nuance to describe your moods and intensity of feelings.
Intensity of Feelings High HAPPY Elated Excited Overjoyed Thrilled Exuberant Ecstatic Fired up Delighted Cheerful Up Good Relieved Satisfied Contented Glad Content Satisfied Pleasant Fine Mellow Pleased AFRAID Terrified Horrified Scared stiff Petrified Fearful Panicky SAD Depressed Disappointed Alone Hurt Left out Dejected Hopeless Sorrowful Crushed Heartbroken Down Upset Distressed Regret Unhappy Moody Blue Sorry Lost Bad Dissatisfied WEAK Helpless Hopeless Beat Overwhelmed Impotent Small Exhausted Drained Dependent Incapable Lifeless Tired Rundown Lazy Insecure Shy Unsatisfied Under par Shaky Unsure Soft ANGRY Furious Enraged Outraged Aggravated Irate Seething CONFUSED Bewildered Trapped Troubled Desperate Lost

Medium

Mild

Upset Mad Annoyed Frustrated Agitated Hot Disgusted Perturbed Uptight Dismayed Put out Irritated Touchy

Disorganized Foggy Misplaced Disoriented Mixed up Unsure Puzzled Bothered Uncomfortable Undecided Baffled Perplexed GUILTY Sorrowful Remorseful Ashamed Unworthy Worthless

Intensity of Feelings High

STRONG Powerful Aggressive Gung ho Potent Super Forceful Proud Determined Energetic Capable Confident Persuasive Sure

Medium

Scared Frightened Threatened Insecure Uneasy Shocked Apprehensive Nervous Worried Timid Unsure

Sorry Lowdown Sneaky

Mild

Secure Durable Adequate Able Capable

Embarrassed

Clients Name _______________________________________ Date _______________


Anxious Lethargic Inadequate

Rating Moods In addition to identifying moods, it is important to learn to rate the intensity of the moods we experience. Rating the intensity of your moods allows you to observe how your moods fluctuate. Rating the intensity of your moods helps alert you to which situations or thoughts are associated with changes in our moods. You can also use changes in emotional intensity to evaluate the effectiveness of strategies your learn in CBT.

Rating Your Mood What was the situation? Situation: ________________________________________________________ What did you feel? Mood: ________________________________________ To what degree would you rate the intensity of this feeling? _______________________________________________________________ 0 10 20 30 40 50 60 70 80 90 100

Things to Remember Moods can usually be described in a word. Rating your moods allows you to evaluate their strength and track the fluctuations of your emotional reactions. Identifying specific moods can help you set and track goals. Strong feelings or moods signal that something important is going on in your life. Rating your moods can enable you to choose interventions designed to alleviate particular moods or reduce their intensity. It is important to separate situations, thoughts and moods.

Clients Name _______________________________________ Date _______________

Rating Your Mood What was the situation? Situation: ________________________________________________________ What did you feel? Mood: ________________________________________ To what degree would you rate the intensity of this feeling? _______________________________________________________________ 0 10 20 30 40 50 60 70 80 90 100

Rating Your Mood What was the situation? Situation: ________________________________________________________ What did you feel? Mood: ________________________________________ To what degree would you rate the intensity of this feeling? _______________________________________________________________ 0 10 20 30 40 50 60 70 80 90 100

Clients Name _______________________________________ Date _______________ Rating Your Mood What was the situation? Situation: ________________________________________________________ What did you feel? Mood: ________________________________________ To what degree would you rate the intensity of this feeling? _______________________________________________________________ 0 10 20 30 40 50 60 70 80 90 100

Rating Your Mood What was the situation? Situation: ________________________________________________________ What did you feel? Mood: ________________________________________ To what degree would you rate the intensity of this feeling? _______________________________________________________________ 0 10 20 30 40 50 60 70 80 90 100

Clients Name _______________________________________ Date _______________

Daily Mood Log


Situation Mood

Clients Name _______________________________________ Date _______________

Functional Analysis

What is your pattern of use (weekends only, every day, binge use)? ________________ _________________________________________________________________ What were the triggers? ___________________________________________________ _________________________________________________________________ Were alone or with other people? If so, who were you with? _______________________ _________________________________________________________________ Where did you buy drugs or alcohol? _________________________________________ _________________________________________________________________ Where do you use? _______________________________________________________ _________________________________________________________________ Where and how did you acquire the money to buy drugs or alcohol? ________________ _________________________________________________________________ What has happened to (or within) you before the most recent episodes of abuse? _______ _________________________________________________________________ What circumstances were at play when abuse began or became problematic? _________ _________________________________________________________________ How would you describe its effects on you during and after? ______________________ _________________________________________________________________

Clients Name _______________________________________ Date _______________

Managing Availability List sources of alcohol and drugs here and what you'll do to reduce availability (for example, people who might offer you alcohol or other drugs, places you might get it). Source Steps I'll take to reduce availability

Clients Name _______________________________________ Date _______________

Refusal Skills
Tips for responding to offers of alcohol or other drugs: Say no first. Make direct eye contact. Ask the person to stop offering it. Don't be afraid to set limits. Don't leave the door open to future offers (e.g., not today).

People who might offer me alcohol/drugs A friend I used to use with:

What I'll say to them

A coworker:

At a party:

Reminder Sheet For Problemsolving


These, in brief, are the steps of the problemsolving process. "Is there a problem?" Recognize that a problem exists. We get clues from our bodies,

Clients Name _______________________________________ Date _______________

our thoughts and feelings, our behavior, our reactions to other people, and the ways that other people react to us. "What is the problem?" Identify the problem. Describe the problem as accurately as you can. Break it down into manageable parts. "What can I do?" Consider various approaches to solving the problem. Brainstorm to think of as many solutions as you can. Consider acting to change the situation and/or changing the way you think about the situation. "What will happen if . . .?" Select the most promising approach. Consider all the positive and negative aspects of each possible approach and select the one likely to solve the problem. "How did it work?" Assess the effectiveness of the selected approach. After you have given the approach a fair trial, does it seem to be working out? If not, consider what you can do to beef up the plan, or give it up and try one of the other possible approaches.

Select a problem that does not have an obvious solution. Describe it accurately. Brainstorm a list of possible solutions. Evaluate the possibilities, and number them in the order of your preference. Identify the problem:

List brainstorming solutions:

Identifying Core Beliefs Check the core beliefs that you identify with during times of distress. Indicate which core beliefs you are most vulnerable to when you are upset.

Clients Name _______________________________________ Date _______________

Helpless Core Belief I am helpless I cant get sober I am trapped I cant stay sober I am a failure I cant be successful I am hopeless I cant ask for help I am inadequate I cant work the program I am ineffective I cant improve my life I am incompetent I cant change I am defective I cant work the steps I am useless I cant trust

Unlovable Core Belief I am unlovable I am not good enough I am unlikable I am different I am unattractive I am abandon I am unwanted I am alone I am rejected I am unnecessary I am bad I am hated (by myself) I am uncared for I am hated (by others) I am unworthy I am evil I am worthless I am insignificant Understanding Core Beliefs It is important to understand the following about core beliefs: That it is an idea, not necessarily the truth. That you can believe it strongly, even feel it to be true, and yet have it be mostly or entirely untrue. That, as an idea, it can be tested. That it is usually rooted in past events; that it may or may not have been true at the time you first believed it. That it continues to be maintained through the operation of your schemas, in which you readily recognize data that support the core belief while ignoring or discounting data to the contrary. That you and your counselor working together can use a variety of strategies over time to change this idea so that you can view yourself in a more realistic way.

Core Belief Record

Clients Name _______________________________________ Date _______________ Record evidence that this Core Belief is not 100% true all the time. Dysfunctional Core Belief __________________________________________________ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Clients Name _______________________________________ Date _______________

Modifying Core Beliefs


The purpose of this exercise is to modify dysfunctional core beliefs. Please follow the instructions and complete the worksheet. Old Core Belief ________________________________________________________ Whats the most that youve believed this? (0-100%) _________________ Whats the least that youve believed this? (0-100%) _________________ How much do you believe it right now? (0-100%) _________________ New Belief ____________________________________________________________ How much do you believe it right now? (0-100%) _________________

Evidence to Support the New Belief List five or more reasons you believe it is true. 1.

2.

3.

4.

5.

Clients Name _______________________________________ Date _______________

Core Belief Record Record evidence that supports an alternative Core Belief. New Core Belief __________________________________________________ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Clients Name _______________________________________ Date _______________

Core Belief Record Rate Confidence in new Core Belief over time. New Core Belief __________________________________________________ Date Date Date Date Date Date Date Date Date Date

Clients Name _______________________________________ Date _______________

Historical Test of New Core Belief To strengthen your new Core Belief review your life history looking for evidence that supports it New Core Belief __________________________________________________ Birth - 2 Age 3 - 5 Age 6 -12 Age 13 - 18 Age 19 - 25 Age 26 - 35 Age 36 - 50 Age 51 - 65 Age 66+ Summary ______________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

Clients Name _______________________________________ Date _______________

Examples of Dysfunctional Thoughts About self


I am a total failure I should never be afraid I always mess up. I will not be able to stay sober. I am the worst example on earth. I never follow directions. I am so stupid. I cant solve problems. I should be perfect. About others No one cares about anyone else. All men (or women) are dishonest and are never to be trusted. I can control other people. People are out to get whatever they can from you; you always end up being used. People never listen to my point of view. I always get hurt in relationships so I should withdrawal from other people. All people are out for #1. I must be accepted by other people. I have to be on my guard because people always disappointment me. About treatment

I dont need help. All counselors are untrustworthy. All those people who attend AA meetings gossip. I will never be able to work the steps. The people in treatment dont really want to get sober. I cant learn new coping skills. Its impossible for me to attend AA meetings. Counselors are in for the money. I cant help the way I feel. I will never get sober. I will never be able to maintain sobriety. Counselors dont like to work with me.

Clients Name _______________________________________ Date _______________

Ten Common Dysfunctional Beliefs


Read the ten common dysfunctional beliefs and identify which beliefs you are most vulnerable to when you are upset by placing a check ( ) in the shaded area. I should be loved and approved by significant others and live up to their expectations. I must be highly competent, adequate, intelligent and achieving before I can me happy. When people act unfairly I should blame them and view them as bad people. It is a terrible catastrophe when I am rejected, treated unfairly, or when things arent as I would like them. Since my feelings are caused by external factors, I have little or no ability to control or change them. I should be greatly concerned about dangerous and fearful things and must center my attention on them until the danger has past. I can handle difficulties and responsibilities better by avoiding them than by facing them. People and things should turn out better than they do, and when they dont I should see them as awful, terrible, etc. My past remains all-important, and must influence my feelings and behavior now because it once did. I can achieve happiness by being passive.

Clients Name _______________________________________ Date _______________

Thought Record
Situation What happened Thoughts List five or more thoughts. Describe any images. Feelings Identify and rate the intensity of each feeling on a scale of 0-100%.

Clients Name _______________________________________ Date _______________

Socratic Questioning 21 Questions to Ask Yourself Before You Get Upset

Thought to be Tested ____________________________________________________ 1. 2. 3. 4. 5. Are my thoughts and/or images true and accurate? Are my thoughts and/or images healthy? Are they helpful? What evidence supports my ideas? What evidence does not support my ideas? Are there other more central thoughts and images left unidentified or unevaluated? 6. Have I correctly identified the problem or upsetting event? 7. Do I completely understand the situation or upsetting event? What is known? What remains unknown? 8. What is the worst possible thing that could happen? 9. What is the best thing that could happen? 10. What is the most realistic outcome? 11. What was going through my mind before I started to feel this way? 12. Are there other disturbing circumstances that contribute to my upset emotion? 13. What images or memories do I have about this situation? 14. If it is true, what does it mean about me? my life? my future? 15. Is there an alternative explanation? 16. Am I going to be able to live through this? 17. What is the effect of my believing this thought or imagining this scene? 18. What could be the effect of changing my thinking? 19. What can I do about it? Are their certain aspects about it that are beyond my control? 20. What would I tell a friend if he or she were in the same situation? 21. Can I speak to myself in the same compassionate way I would talk to a friend?

Clients Name _______________________________________ Date _______________

Labeling Cognitive Distortions


Category
Magnifying the negative All or nothing thinking Overgeneralizations Mind reading Catastrophic exaggerations Blaming Assuming Shoulds (Musts/oughts) The fairy tale fantasy Mislabeling Unfavorable comparisons Personalizing Fortune telling Perfectionism Making feelings facts Entitlement

Thoughts and Beliefs

Clients Name _______________________________________ Date _______________

The ABCD Worksheet


Activating Event Beliefs Consequent Emotion

Dispute B Is it true? Is it helpful or healthy?

Clients Name _______________________________________ Date _______________

Coping Plan If I run into a high-risk situation: 1. I will leave or change the situation. Safe places I can go: ______________________________________________________ 2. I will put off the decision to use for 15 minutes. I'll remember that my cravings usually go away in ______ minutes and I've dealt with cravings successfully in the past. 3. I'll distract myself with something I like to do. Good distracters: _________________________________________________________ 4. I'll call my list of emergency numbers: Name:________________________________ Phone #: __________________________ Name:________________________________ Phone #: __________________________ Name:________________________________ Phone #: __________________________ 5. I'll remind myself of my successes to this point: ______________________________ _______________________________________________________________________ 6. I'll challenge my thoughts and beliefs by: ____________________________________ _______________________________________________________________________

Clients Name _______________________________________ Date _______________

Symptoms Leading to Relapse

Not attending meetings. Not having or working with a sponsor. Not working the steps. Not mediating. Not praying. Not reading AA material. Not serving. Exhaustion. Dishonesty. Impatience. Anger Conflict in relationships. Depression. Frustration. Self-pity. Cockiness. Complacency. Expecting too much from others. Entitlement. The use of mood-altering chemicals.