Slick Recovery Worksheet
The Voice of Addiction Worksheet
How has my drug or alcohol use hurt key areas in my life? It’s helpful to watch the video “Who is Slick” on the slickrecovery.com website before completing this form. Slick & Denial: Below list the various things Slick has told you to encourage denial and keep using despite numerous harmful consequences. Example: “Your not as bad as a bunch of your friends — so you don’t have a problem!” 1) 2) 3) 4) Slick & Relapse: If you have in the past tried to cut down or quit everything, Slick has probably tried convincing you to return to chemical use. List below things Slick has said designed to get you to return to using once you have decided to stop. Example: “If you just do it once, nobody will know” 1) 2) 3) 4) Resisting Slick: Slick will certainly try to get you to return to using; when he does so, what thoughts or behaviors can you do to resist him? Example: I will keep a picture of my kids in my pocket and if I’m tempted to relapse I will look at it to remind me how returning to using will hurt my kids. 1) 2) 3) 4)
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Consequences of Using
How has my drug or alcohol use hurt key areas in my life?
For best results fill this form out with people who know you well and will be honest. Area of Importance
How has my drug or alcohol use negatively impacted this area in my life?
What has “Slick” said to help me ignore or minimize this problem?
Relationships - Conflicts with family - Avoiding family - Neglecting family - Resentments - Lost friends - Other
Work - Lost jobs - No motivation to work - Conflicts with boss - Conflict with workers - Missed time - Other Finances - Debt - Unpaid bills - Stealing, - Other Health - Car accidents - Medical problems - Other
Emotional - Depression, - Anxiety/fear - Anger/resentment - Sadness, - Other Legal - DUI - Divorce - Assault - Possession - Distribution - Other Spiritual - Violating values - Avoiding religion/God - Guilt/Shame - Anger at God - Other
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Consequences of Using Drugs & Alcohol Observed by my Family and Friends
From_____________________ To ________________________ Dear _______________ I am trying to honestly examine if my drug or alcohol use has hurt me or others and considering if I would be better off giving up drugs and alcohol permanently. Would you please complete this form as honestly as possible and return it to me. Feel free to use additional paper if you think that would be helpful. Relationship Consequences: How has my using negatively impacted my relationships? Examples might be, conflicts, avoiding, neglecting, resents, lost relationships etc, etc. Work/Employment Consequences: How has my using impacted my employment? Examples might be lost jobs, missed work, conflicts with employers or co-workers, lost advancement opportunities, unable to drive to work due to license suspension, etc. Financial Consequences: How has my using impacted my finances? Examples might be debt, financial dependence on others, unpaid bills, stealing, etc. etc. Health/Medical Consequences: How has my using impacted my finances health? Examples might be illness, accidents etc. Emotional/Mental Health Consequences: How has my emotions or mental health? Examples might be depression, anxiety, anger, resentment, poor impulse control, sadness, etc Legal Consequences: How has my using impacted my legal issues? Examples might be DUI, divorce, assault, possession, dealing, etc. Spiritual Consequences: How has my using impacted my spiritual life. Examples might be violating values, shame/guilt, anger at God, avoiding religion, etc. Other Consequences List any other problems you have observed due to my using drugs or alcohol
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Why I Like Getting High
Learning new ways to cope without drugs and alcohol For each drug you use check in the appropriate boxes what reasons you use it, (alcohol is a drug) Reasons I like using
Alcohol
Pot
Speed Meth Cocaine
Opiates Pain Meds
Sedatives Like xanax
All Other Drugs
To fit in with friends – this is what my friends do so I want to “fit in” Reduce Boredom: It makes my life less boring. To Have Fun: It makes fun stuff more fun. For Social Comfort: I like it because it helps me relax and speak up in social situations To Relax & Reduce Stress – after a long day it helps me relax To Sleep- I have difficulty sleeping without it. To Reduce Physical Pain – I need to cope with pain To Reduce Emotional Pain – to cope with fear, hurt, anger, depression etc Physical Addiction – I use to avoid withdrawal symptoms Energy – it gives me the energy to get things done. Weight Loss – It helps me lose weight Focus – It helps my attention stay focused Sexual Pleasure – it helps me perform or enjoy sex Courage – Assertiveness – I say things I might not always have the courage to say Excuse Bad Behavior – It lets me do things I typically would feel too guilty to do To reduce worry & anxiety: It helps me not worry about problems To function normally: I need it to work, and do life. List you own reasons:
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Why I Like Getting High - page 2 Learning new ways to cope without drugs and alcohol
This section is designed to help you to consider how to develop healthy ways to address the positive things your drug or alcohol use provided.
Circle the items below that you checked on page one
List alternate ways you can begin to address this area without drug and alcohol use.
To Fit In With Friends Reduce Boredom To Have Fun For Social Comfort To Relax & Reduce Stress To Sleep To Reduce Physical Pain To Reduce Emotional Pain Physical Addiction Energy – Weight Loss – Focus – Sexual Pleasure – Courage – Assertiveness Excuse Bad Behavior To Reduce Worry & Anxiety To Function Normally List Your Own Reasons
What is Slick saying to you as you complete this worksheet?
Slick
Video’s, Counseling, Interventions, Worksheets by Saul Selby MA LADC webisite: www.slickrecovery.com / phone: 651-253-6818 / e-mail:
[email protected]
Slick Recovery Worksheet
Relationships & Recovery
Do I need to change my relationships with using friends of family? This worksheet is designed to help you consider what, if any, relationship changes you need to make to support your recovery. In column #1 list all the people you used drugs or alcohol with, n column #2 indicate the type of relationship you had with the person, in column # 3 indicate what if any changes you thing you need to make in this relationship, and in column # 4 indicate if you need to send them a letter describing your intention to avoid using people and using settings. 1-Names of People You Used Drugs or Alcohol With List the names of the people you used drugs or alcohol with
Slick
2-Type of Relationship
3-Setting Boundaries – changes I need to make.
Friend, Associate, Dealer, 1) Avoid Entirely Family Member, Signifi- 2) See only in sober setting cant Other 3) Make no changes at all 4) Other – indicate what you mean
4– Communication of Boundary How will you inform this person that your relationship with them needs to end or change. Options are none, phone, letter, face to face.
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Stages of Change By Drug
Moving Through The Stages Toward Recovery Directions: List dates you were in each stage for each drug used (see sample column on right) Then answer questions on the bottom on the back of the form or and uses separate paper if needed. Alcohol
Stages of Change
Pot
Speed Opiates Sedatives Meth Pain Like Cocaine Meds xanax
All Other Drugs
Sample Column
Pre-Contemplation — I don’t have a problem and I don’t need to stop using this drug
3/1998 To 6/2002
Contemplation — I’m confused, a part of me wants to stop using and a part of me wants to keep using.
6/2002 To present
Determination/Preparation — I have become convinced that I need to stop using this drug.
not yet
Action — My determination to quit is being demonstrated by a number of behaviors like going to recovery meetings, changing friends, avoiding triggers.
Not yet
Maintenance —I have successfully been abstinent from this drug for a period of time and I’m fine-tuning ways to insure on-going success. Questions: answer questions on the back and separate paper.
How did Slick keep us stuck in early stages — what did he say?
What happened that caused you to move from one stage to the next. Were there consequences or just new insights?
What is Slick telling you now to keep you from moving to action for all the drugs you use?
What would have to happen to help you move toward the Action stage for drugs you have not yet reached action?
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Relapse Prevention Planning Identifying Slick Triggers Circle Emotions That Slick Might Use To Nurture Relapse Shame
Guilt
Anger
Resentment
Depression
Self-Pity
Boredom
Rejection
Fear
Anxiety
Loneliness
Joy
Stress
Sadness
Grief
List Others → Circle Activities or Places That Slick Might Use To Nurture Relapse Payday
Weekends
Sex
Conflicts
Seasonal Changes
Types of Music
Smells
Smoking
Bars or Restaurants
Anxiety
Concerts
Trips out of town
Being on Vacation
Being Alone
With Using People
List Others
→
Names of People Slick Might Use to Trigger You
Type of Relationship
How Will I Manage or Change This Relationship
Slick Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Relapse Prevention - Trigger Journal Coping with Triggers & Slick Date of Craving
What Triggered The Craving
What Did Slick Say To Encourage Relapse
How I Coped With This Trigger/Craving
Slick Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Amends — Seeing the damage my addiction has caused From_____________________ To ________________________ Dear _______________ I know that my drug/alcohol use has hurt you and damaged our relationship. If possible, I want to improve our relationship and make amends for the different ways I have hurt you. Would you be willing to complete this form and return it to me so that I can work toward making amends? If not, I understand. However if you do complete this form and return it to me I will use it to develop a plan to “make amends” and contact you within a week to describe my “amends plan”. Ways my using/drinking has negatively impacted you (that I am aware of)
How has my using/drinking negatively impacted our relationship? (circle the areas to the left and describe details in box)
Financial harm Emotional hurt Physical hurt Dishonesty Other
What can I do to improve our relationship and make amends?
Slick
Slick worksheets and videos can be viewed at: www.slickrecovery.com
Slick Recovery Worksheet
Proposed Amends Plan From_____________________ To ________________________ Dear __________________ thank you for taking the time to complete my amends form. Based on the information you provided I have developed the “amends plan” listed below. Please let me know what you think of the plan. Thanks again _________________________ Type of Harm Done
Slick
Proposed Amends Plan
Slick worksheets and videos can be viewed at: www.slickrecovery.com