Identify your biggest trigger. Triggers can be people, places, things, events, emotions, feeling physical pain, etc.

What usually leads you off track?

🔹 Purpose

Awareness is the first step to change.

If you are not aware of:

• your thoughts
• your emotions
• your behaviors

…you will continue repeating the same patterns.

This exercise helps you slow down and start paying attention to what is actually happening in your daily life.

🔹 SECTION 1: CHECKING IN WITH YOURSELF

Take a moment and answer honestly.

How have you been feeling lately?

What has been on your mind the most?

What has your behavior been like recently?

👉 Think about your actions, decisions, and reactions

🔹 SECTION 2: DAILY AWARENESS

Think about a typical day.

What do you usually do from morning to night?

When during the day do you feel the most:

• Stressed? __________________________________________
• Bored? __________________________________________
• Triggered? ________________________________________

👉 Start noticing patterns, even if they seem small

🔹 SECTION 3: REACTIONS

How do you usually respond when something doesn’t go your way?

👉 Examples: get irritated, shut down, avoid, act quickly

🔹 SECTION 4: DECISION-MAKING

Think about your recent decisions.

What kinds of decisions have you been making?

Are your decisions usually:

☐ Thought out
☐ Impulsive
☐ Based on emotions
☐ Based on habit

👉 Check all that apply

🔹 SECTION 5: WHAT YOU MAY BE OVERLOOKING

Sometimes we avoid or ignore things.

What have you been avoiding?

What have you been telling yourself?

👉 Be honest—this is where real awareness starts

🔹 SECTION 6: WHAT NEEDS ATTENTION

What area of your life needs the most attention right now?

👉 Examples: stress, behavior, relationships, decision-making

🔹 SECTION 7: ONE THING TO FOCUS ON

What is one thing you want to become more aware of moving forward?

👉 Example: “I want to pay attention to how I react when I’m stressed”

🔹 SECTION 8: COMMITMENT

I understand that change starts with awareness. I commit to paying attention to my thoughts, emotions, and behaviors instead of ignoring them.

Signature: ____________________________
Date: ____________________________

🔹 Purpose

Your behavior is not random—it follows patterns.

Understanding your patterns helps you:

• recognize what leads up to decisions
• interrupt the cycle earlier
• make different choices

The goal is to identify the full pattern, not just the outcome.

🔹 SECTION 1: IDENTIFY A RECENT SITUATION

Think of a recent time where you:

• made a poor decision
• felt triggered
• went off track

Describe the situation:

🔹 SECTION 2: BREAK DOWN THE PATTERN

Let’s look at what happened step-by-step.

1. What happened first? (Trigger)

👉 What situation, person, or event started this?

2. What did you feel?

👉 Examples: stress, anger, boredom, frustration

3. What did you think?

👉 Examples: “I need a break,” “It’s not that serious,” “I’ll be fine”

4. What did you do?

5. What was the outcome?

🔹 SECTION 3: IDENTIFY THE PATTERN

Now step back and look at the full sequence.

My pattern looks like this:

👉 Example: “When I feel stressed after work, I tell myself I need a break, and then I make a bad decision.”

🔹 SECTION 4: REPEATING PATTERNS

Have you seen this pattern before?

☐ Yes
☐ No

If yes, describe how it repeats:

👉 Think about how often this has happened and in what situations

🔹 SECTION 5: EARLY WARNING POINT

At what point in the pattern could you have made a different decision?

☐ At the trigger
☐ When you started feeling something
☐ When the thought came up
☐ Right before the behavior

Explain:

👉 This is where you can interrupt the pattern next time

🔹 SECTION 6: INTERRUPTING THE PATTERN

What can you do differently at that point?

👉 Examples: pause, leave, call someone, change environment, use coping skill

🔹 SECTION 7: BUILD A NEW PATTERN

Complete this:

When I feel ____________________, instead of ____________________, I will ____________________.

🔹 SECTION 8: REFLECTION

• What pattern shows up the most in your life?

• What usually triggers it?

• What will you do differently next time?

🔹 SECTION 9: COMMITMENT

I understand that my behavior follows patterns. I commit to recognizing my patterns and interrupting them before they lead to poor decisions.

Signature: ____________________________
Date: ____________________________

🔹 Purpose

Your environment plays a major role in your decisions. The people, places, and situations around you can either support your progress or increase your risk.

You may not control every situation—but you can control what you allow and how you respond.

This worksheet will help you:

• identify environmental risks
• recognize what influences your behavior
• create a plan to reduce those risks

🔹 SECTION 1: YOUR CURRENT ENVIRONMENT

Think about your daily life and surroundings.

Where do you spend most of your time?

Who do you spend the most time with?

What does your typical day look like?

👉 Be honest—this is about awareness, not judgment

🔹 SECTION 2: ENVIRONMENTAL RISK FACTORS

Identify things in your environment that could lead to relapse or poor decisions.

Check all that apply and add your own:

☐ Being around people who use or encourage negative behavior
☐ Being in places where you used before
☐ Lack of structure or too much free time
☐ Stressful environments (work, home, relationships)
☐ Easy access to substances or triggers
☐ Social pressure
☐ Isolation or being alone too much
☐ Other: ______________________________________

List at least 3 specific risks in your environment:

👉 Be specific (not just “people”—who? where? when?)

🔹 SECTION 3: HIGH-RISK SITUATIONS

When are you most likely to go off track?

Examples:

• after work
• late at night
• weekends
• when stressed

My high-risk times/situations:

🔹 SECTION 4: HOW YOUR ENVIRONMENT AFFECTS YOU

Think about how your environment influences your thinking and behavior.

When I’m in these environments, I tend to:

👉 Examples: feel pressured, justify decisions, act impulsively

🔹 SECTION 5: MAKING CHANGES

You don’t have to change everything—but you do need to make adjustments.

What can you reduce or avoid?

What can you change?

What can you replace it with?

👉 Examples: different routine, different people, different locations

🔹 SECTION 6: SAFE & SUPPORTIVE ENVIRONMENTS

Where can you go or be that supports better decisions?

Examples:

• home
• work
• gym
• meetings
• supportive family/friends

My safe environments:

🔹 SECTION 7: ENVIRONMENT PLAN

When I am in a risky environment, I will:

☐ Leave early
☐ Avoid the situation completely
☐ Bring support with me
☐ Have a plan before going
☐ Other: ______________________________________

My plan:

🔹 SECTION 8: BOUNDARIES

What boundaries do you need to set in your environment?

How will you enforce them?

👉 Examples: saying no, limiting time, avoiding certain people/places

🔹 SECTION 9: REFLECTION

• What is the biggest environmental risk for you?

• What is one change you can make immediately?

🔹 SECTION 10: COMMITMENT

I understand that my environment affects my behavior. I commit to making changes that support better decisions and reduce my risk.

Signature: ____________________________
Date: ____________________________

🔹 Purpose

Cravings are temporary urges. They can feel intense, but they do not last forever. The goal is not to eliminate cravings—it is to respond to them differently.

This plan helps you slow down, take control, and make a better decision in the moment.

🔹 STEP 1: NAME THE MOMENT

When a craving hits, the first step is awareness.

Instead of reacting automatically, pause and identify what is happening.

Ask yourself:

• What am I feeling right now?
• What triggered this craving?
• What is my urge telling me to do?

Example:

• “I’m feeling stressed after work and want to drink.”
• “I’m bored and thinking about going back to old habits.”

Write your example:

👉 Naming the moment helps you slow down and interrupt automatic behavior.

🔹 STEP 2: IMMEDIATE ACTIONS

Cravings get stronger when you sit still and think about them. You need to take action quickly.

Examples of Immediate Actions:

• Leave the situation
• Go outside or take a walk
• Drink water or eat something
• Turn on music or TV for distraction
• Call or text someone
• Do something physical (clean, exercise, move around)

What are 3 things you can do immediately?

👉 These should be things you can do right away—not later.

🔹 STEP 3: CHANGE YOUR ENVIRONMENT

Your surroundings have a strong influence on your behavior. If you stay in the same place, the craving may continue.

Ask yourself:

• Where am I right now?
• Is this environment helping or hurting me?

Examples:

• Leave a party or gathering
• Go to a different room
• Get in your car and go somewhere safe
• Avoid certain people or places
• Go somewhere structured (store, gym, meeting, home)

What will you do to change your environment?

👉 Changing your environment can immediately reduce the intensity of a craving.

🔹 STEP 4: RESILIENCE STATEMENT

A resilience statement is something you tell yourself to stay grounded and focused.

It helps you push through the moment without reacting.

Examples:

• “This will pass.”
• “I don’t have to act on this.”
• “I’ve been here before—I can handle it.”
• “This is not worth the consequences.”
• “Pause. Think. Respond.”

Complete this statement:

“When cravings surface, I remember…”

👉 Repeat this to yourself when the craving feels strong.

🔹 STEP 5: WHAT WILL YOU DO NEXT TIME?

Now put everything together.

When a craving hits, what is your plan?

My Craving Response Plan:

1. I will recognize and name what I’m feeling
2. I will take immediate action (__________________________)
3. I will change my environment by (_______________________)
4. I will repeat my resilience statement
5. I will follow through and not act on the craving

Write it in your own words:

🔹 REMEMBER

• Cravings are temporary
• You do not have to act on them
• Your response determines the outcome

🔹 COMMITMENT

I commit to using this plan when cravings occur instead of reacting automatically.

Signature: ____________________________
Date: ____________________________

🔹 Purpose

Routine and structure help reduce risk and improve decision-making. When your day is unstructured, you are more likely to:

• act based on how you feel
• fall into old habits
• make impulsive decisions

A consistent routine helps you:

• stay focused
• reduce idle time
• make fewer risky decisions

The goal is not to create a perfect schedule—it is to create simple, consistent structure that supports your progress.

🔹 SECTION 1: YOUR CURRENT ROUTINE

Think about a typical day. Be honest and specific.

Morning (wake up – mid-morning):

Midday (late morning – afternoon):

Evening (after work / late afternoon – bedtime):

👉 Include what you actually do—not what you think you should do

🔹 SECTION 2: IDENTIFY RISK AREAS

Looking at your current routine, where are you most at risk of going off track?

☐ Too much idle time
☐ Being around certain people
☐ Being in certain places
☐ Lack of structure
☐ Stress after work
☐ Late nights
☐ Other: ______________________________________

Describe the highest risk part of your day:

🔹 SECTION 3: WHERE CAN YOU MAKE CHANGES?

What changes can you make to reduce your risk?

List at least 2–3 adjustments:

👉 Examples: leave earlier, avoid certain places, plan an activity, change evening routine

🔹 SECTION 4: BUILDING A BETTER ROUTINE

Now create a simple structure for your day.

Morning Anchor (something you will do every day):

Midday Anchor:

Evening Anchor:

👉 Keep it realistic and repeatable

🔹 SECTION 5: ONE DAILY CONSISTENT HABIT

Choose one thing you will do every day, no matter what.

My daily habit:

When will you do it?

Why is this important?

🔹 SECTION 6: PLAN FOR HIGH-RISK TIMES

What will you do during times when you usually struggle?

👉 Be specific (call someone, leave, distract, go somewhere safe, etc.)

🔹 SECTION 7: COMMITMENT

I understand that structure helps me stay on track. I commit to following a routine that supports better decisions and reduces risk.

Signature: ____________________________
Date: ____________________________

Reflect on your progress. You made it a week!

What's different this week?

🔹 Purpose

You are one week into the program. This reflection is meant to help you pause, evaluate your progress, and stay focused moving forward.

🔹 SECTION 1: WHAT HAVE YOU NOTICED?

What have you learned about yourself over the past 7 days?

🔹 SECTION 2: WHAT HAS GONE WELL?

List at least 2 things you’ve done better this week:

🔹 SECTION 3: WHERE HAVE YOU STRUGGLED?

Be honest—what has been difficult?

🔹 SECTION 4: PATTERNS

Have you noticed any patterns in your behavior, thinking, or reactions?

🔹 SECTION 5: TRIGGERS

What situations, people, or emotions have affected you the most this week?

🔹 SECTION 6: ONE CHANGE MOVING FORWARD

What is one thing you will focus on improving over the next 7 days?

🔹 SECTION 7: COMMITMENT

I will continue this process by staying aware and making intentional decisions moving forward.

Signature: ____________________________
Date: ____________________________

Tell someone your goal.

Who can help hold you accountable? How are you going to reach out to them?

🔹 Purpose

Accountability helps you stay on track when things get difficult. Trying to do everything on your own increases the risk of poor decisions and repeated patterns.

This worksheet will help you:

• identify your support system
• understand how to use it
• create a plan for reaching out

🔹 SECTION 1: UNDERSTANDING ACCOUNTABILITY

Accountability means taking responsibility for your decisions and using support to help you make better choices.

Without accountability:

• you rely only on yourself
• you are more likely to isolate
• you are more likely to repeat patterns

With accountability:

• you have support
• you have outside perspective
• you increase your chances of making better decisions

🔹 SECTION 2: IDENTIFY YOUR SUPPORT SYSTEM

Your support system is not limited to friends and family. It can include:

• Friends
• Family members
• Sponsor / mentor
• Therapist / counselor
• Doctor / medical provider
• Pastor / church leader
• Church members
• Support groups (AA, NA, etc.)
• Probation officer (if applicable)
• Case manager
• Employer / supervisor (if appropriate)

🔹 SECTION 3: SUPPORT SYSTEM PLAN (CHART)

Fill out the chart below with real people or resources you can use.

👉 Guidance:

How I Will Reach Out:

Be specific:

• Call
• Text
• In person
• Attend meeting
• Schedule appointment

When / Why I Will Reach Out:

Examples:

• When I feel stressed or overwhelmed
• When I feel triggered
• Before making a risky decision
• After a difficult situation
• When I need accountability
• When I notice warning signs

🔹 SECTION 4: BARRIERS TO REACHING OUT

What might stop you from using your support system?

☐ Pride
☐ Fear of judgment
☐ Not wanting to bother others
☐ Thinking you can handle it alone
☐ Other: ______________________________________

How will you push past these barriers?

🔹 SECTION 5: ACCOUNTABILITY PLAN

When I feel myself going off track, I will:

1. Recognize the warning sign
2. Reach out to someone from my support system
3. Be honest about what is going on
4. Follow through on the support given

My personal accountability plan:

🔹 SECTION 6: REFLECTION

• Who is the easiest person for you to reach out to?

• Who is the hardest person for you to reach out to? Why?

• When do you usually avoid reaching out?

🔹 SECTION 7: COMMITMENT

I understand that I am responsible for my decisions, and I will use my support system to help me stay on track instead of trying to handle everything on my own.

Signature: ____________________________
Date: ____________________________

Catch one negative thought.

What excuse have you told yourself?

🔹 Purpose

Your thoughts influence your feelings and your behavior. When your thinking is distorted or inaccurate, it can lead to poor decisions and repeated negative patterns.

This worksheet will help you:

• identify unhelpful thinking patterns
• understand how they affect your behavior
• learn how to challenge and replace them

🔹 SECTION 1: UNDERSTANDING COGNITIVE DISTORTIONS

Cognitive distortions are inaccurate or unhelpful ways of thinking that can lead to negative emotions and poor decisions. These thoughts often feel true in the moment, but they are not always based on facts.

🔹 Common Cognitive Distortions & Examples

1. All-or-Nothing Thinking

Seeing things as all good or all bad.

• “If I mess up once, I’ve failed completely.”
• “If it’s not perfect, it’s worthless.”

2. Overgeneralization

Taking one situation and applying it to everything.

• “I messed up today, so I’ll never get it right.”
• “Nothing ever works out for me.”

3. Mental Filter

Focusing only on the negative and ignoring the positive.

• “I did one thing wrong, so the whole day was bad.”

4. Minimizing / Discounting the Positive

Ignoring or downplaying progress or success.

• “That doesn’t count—I should be doing better.”

5. Jumping to Conclusions

Assuming something without evidence.

• “They’re judging me.”
• “This is going to go wrong.”

6. Catastrophizing

Expecting the worst-case scenario.

• “If this happens, everything will fall apart.”

7. Emotional Reasoning

Believing something is true because of how you feel.

• “I feel stressed, so everything must be going wrong.”

8. Should Statements

Placing unrealistic expectations on yourself.

• “I should be doing better.”
• “I shouldn’t feel this way.”

9. Labeling

Defining yourself based on mistakes.

• “I’m a failure.”
• “I always mess things up.”

10. Justification / Rationalization

Making a poor decision seem acceptable.

• “I deserve this.”
• “It’s not that serious.”
• “Just this once won’t matter.”

🔹 SECTION 2: IDENTIFY YOUR THOUGHTS

Think of a recent situation where you felt stressed, triggered, or made a poor decision.

Situation:

What were you thinking?

🔹 SECTION 3: IDENTIFY THE DISTORTION

Which cognitive distortion(s) apply to your thoughts?

☐ All-or-Nothing Thinking
☐ Overgeneralization
☐ Mental Filter
☐ Minimizing Positive
☐ Jumping to Conclusions
☐ Catastrophizing
☐ Emotional Reasoning
☐ Should Statements
☐ Labeling
☐ Justification

🔹 SECTION 4: CHALLENGE THE THOUGHT

Now slow it down and question your thinking.

Ask yourself:

• Is this thought 100% true?
• What evidence do I have?
• What happened last time I thought this way?
• Is this helping me or hurting me?

Write your response:

🔹 SECTION 5: REPLACE THE THOUGHT

Now create a more realistic and helpful thought.

Old Thought:

New Thought:

👉 Make it realistic—not overly positive, just more accurate

🔹 SECTION 6: CONNECT THOUGHT → BEHAVIOR

When I think this way, I usually:

If I change my thinking, I could:

🔹 SECTION 7: PRACTICE

Write 2 additional examples:

Example 1:

Situation: _______________________________________________

Thought: ________________________________________________

Distortion: ______________________________________________

New Thought: ____________________________________________

Example 2:

Situation: _______________________________________________

Thought: ________________________________________________

Distortion: ______________________________________________

New Thought: ____________________________________________

🔹 SECTION 8: REFLECTION

• What thinking pattern do you use the most?

• How does it affect your behavior?

• What will you do differently moving forward?

🔹 SECTION 9: COMMITMENT

I understand that my thoughts influence my decisions. I commit to slowing down, identifying my thinking patterns, and choosing more accurate and helpful thoughts.

Signature: ____________________________
Date: ____________________________

Replace one negative behavior.

What will you do instead?

🔹 Purpose

You cannot just stop a behavior—you must replace it.

When you remove a behavior without replacing it, your brain will go back to what it knows. This worksheet helps you identify what to do instead when triggers, cravings, or urges show up.

🔹 SECTION 1: TARGET BEHAVIOR

What is the behavior you are trying to stop or change?

👉 Be specific (not “do better”—identify the exact behavior)

🔹 SECTION 2: TRIGGERS

What usually leads to this behavior?

People:

Places:

Situations:

Emotions:

🔹 SECTION 3: CURRENT PATTERN

Describe what usually happens step-by-step:

1. What happens first?

2. What do you feel?

3. What do you think?

4. What do you do?

👉 This helps you understand the full pattern—not just the behavior

🔹 SECTION 4: WHY THIS BEHAVIOR CONTINUES

What does this behavior do for you in the moment?

☐ Relieves stress
☐ Helps you avoid something
☐ Feels familiar
☐ Helps you cope
☐ Other: ______________________________________

Describe in your own words:

👉 Understanding the “why” helps you choose a better replacement

🔹 SECTION 5: REPLACEMENT BEHAVIORS

You must replace the behavior with something that meets a similar need.

List at least 3 replacement options:

👉 Examples: leave the situation, go for a walk, call someone, delay decision, distraction activity

🔹 SECTION 6: MATCHING THE REPLACEMENT TO THE TRIGGER

Fill this out so you know exactly what to do in the moment:

👉 Be specific: “If I feel ___, I will ___ instead of ___”

🔹 SECTION 7: IN-THE-MOMENT PLAN

When I feel the urge, I will:

1. Pause and recognize the trigger
2. Delay my response (5–10 minutes)
3. Choose one replacement behavior
4. Follow through

My specific plan:

🔹 SECTION 8: OBSTACLES

What might make it hard to use your replacement behavior?

How will you handle those obstacles?

🔹 SECTION 9: ACCOUNTABILITY

Who can help you stay on track?

Name: ____________________________
Phone: ____________________________

How will you use support?

🔹 SECTION 10: REFLECTION

After using a replacement behavior, answer:

• Did I follow through?
• What worked?
• What didn’t?
• What will I adjust next time?

🔹 SECTION 11: COMMITMENT

I understand that stopping a behavior requires replacing it with a better one. I commit to using my replacement plan when triggers occur.

Signature: ____________________________
Date: ____________________________

Identify your stress response.

🔹 Purpose

This worksheet is designed to help you:

• identify how you respond to stress
• increase awareness of your patterns
• develop healthier ways to respond

Stress is not the problem—how you respond to it determines the outcome.

🔹 SECTION 1: IDENTIFY YOUR STRESS RESPONSE

When you feel stressed, how do you typically respond?

Check all that apply and add your own:

☐ Shut down / withdraw
☐ Get irritated or angry
☐ Make impulsive decisions
☐ Avoid responsibilities
☐ Overthink / worry
☐ Use substances or unhealthy coping
☐ Become overwhelmed
☐ Other: ______________________________________

Describe your typical stress response in your own words:

🔹 SECTION 2: HOW DO YOU HANDLE STRESS RIGHT NOW?

Be honest—what do you usually do when you feel stressed?

👉 Think about both helpful and unhelpful responses

🔹 SECTION 3: CHANGING YOUR RESPONSE

What are 2 things you can do differently when you feel stressed?

👉 Be specific (ex: walk away, pause, breathing, call someone, delay decisions)

🔹 SECTION 4: STRESS MANAGEMENT TECHNIQUES

🧠 1. BOX BREATHING (Calming Your Body)

Use this when you feel overwhelmed, anxious, or triggered.

Steps:

1. Inhale slowly through your nose for 4 seconds
2. Hold your breath for 4 seconds
3. Exhale slowly through your mouth for 4 seconds
4. Hold again for 4 seconds
5. Repeat for 3–5 minutes

👉 This helps slow your heart rate and calm your body.

🧠 2. MANTRAS (Redirecting Your Thinking)

A mantra is a short phrase you repeat to yourself to stay focused and grounded.

Examples:

• “I don’t have to react right now.”
• “This will pass.”
• “I can handle this differently.”
• “Pause. Think. Respond.”

👉 Choose one that works for you:

My mantra: ___________________________________________

🧠 3. THOUGHT STOPPING

Use this when your thoughts are escalating or becoming negative.

Steps:

1. Notice the thought
2. Say “STOP” (in your mind or out loud)
3. Interrupt the pattern
4. Shift to a different thought or action

👉 This helps prevent thoughts from taking over your behavior.

🧠 4. CHALLENGING YOUR THOUGHTS

Ask yourself:

• Is this thought completely true?
• What happened last time I thought this way?
• Is this helping me or hurting me?
• What is a better way to think about this?

Rewrite your thought:

Old thought: __________________________________________

New thought: __________________________________________

🔹 SECTION 5: STRESS LOG (DAILY TRACKING)

Use this to track patterns and increase awareness.

👉 Scale Guide:
0 = no stress
5 = moderate stress
10 = extreme stress

🔹 SECTION 6: REFLECTION

After completing your log, answer:

1. What patterns do you notice?

2. What situations increase your stress the most?

3. What helps you reduce stress?

🔹 SECTION 7: COMMITMENT

I understand that I cannot eliminate stress, but I can improve how I respond to it.

My commitment:

Signature: ____________________________
Date: ____________________________

Visualize your next 30 days.

What changes if you stay on track?

🔹 Purpose

This exercise is designed to help you visualize where your life is headed based on your decisions.

Change becomes easier when you clearly see:

• where you are going if nothing changes
• where you can go if you stay consistent

This is not about imagination—it is about direction and awareness.

🔹 SECTION 1: IF NOTHING CHANGES

Take a moment and be honest.

If you continue making the same decisions and following the same patterns, where will your life likely be in the next 30–90 days?

Think about:

• work/employment
• legal situation
• relationships
• stress level
• overall stability

Write your answer:

👉 Be realistic, not hopeful. Base this on your past patterns.

🔹 SECTION 2: IF YOU STAY CONSISTENT

Now shift your focus.

If you continue applying what you’ve learned, stay consistent, and make better decisions—where could your life be in the next 30–90 days?

Write your answer:

👉 Think about progress, stability, and improvement—not perfection.

🔹 SECTION 3: DAILY DECISIONS = DIRECTION

Your future is shaped by daily decisions.

List 3 decisions you can make consistently that will move you forward:

👉 Examples: avoiding certain environments, following routine, reaching out for support

🔹 SECTION 4: VISUALIZING A HIGH-RISK MOMENT

Think about a situation where you would normally go off track.

Now visualize yourself handling it differently.

Situation:

What you would normally do:

What you will do differently:

👉 Picture it step-by-step: what you say, what you do, how you leave or redirect

🔹 SECTION 5: OBSTACLES

What could get in the way of you staying on track?

Write at least 3:

How will you respond to these obstacles?

🔹 SECTION 6: IDENTITY SHIFT

How you see yourself influences your decisions.

Right now, I see myself as:

Moving forward, I want to see myself as:

👉 Examples: “someone who follows through,” “someone who makes better decisions,” “someone who stays consistent”

🔹 SECTION 7: COMMITMENT TO THE FUTURE

I understand that my daily decisions determine my future.

I am choosing to focus on long-term outcomes instead of short-term relief.

My commitment:

Signature: ____________________________
Date: ____________________________

Write a relapse response plan.

What will you do if you slip?

🔹 Purpose

This relapse prevention plan is designed to help you identify your personal risk factors, recognize early warning signs, and respond effectively before a situation escalates.

Relapse is not a single event—it is a process. The goal is to recognize the process early and interrupt it.

🔹 SECTION 1: PERSONAL TRIGGERS

Triggers are situations, emotions, or environments that increase your risk of making poor decisions.

My Triggers:

People:

Places:

Situations:

Emotions (circle or add):
Stress / Anger / Boredom / Loneliness / Frustration / Anxiety / Other: __________

🔹 SECTION 2: HIGH-RISK SITUATIONS

Identify situations where you are most likely to go off track.

👉 Be specific (time of day, events, social settings, etc.)

🔹 SECTION 3: WARNING SIGNS

These are early signs that you are starting to move toward a bad decision.

My Warning Signs:

👉 Examples: negative thinking, isolating, skipping routines, increased stress

🔹 SECTION 4: THINKING PATTERNS

What do you typically tell yourself before making a poor decision?

My Common Thoughts:

• “______________________________________________________”
• “______________________________________________________”
• “______________________________________________________”

👉 Examples: “It’s not that serious,” “I’ll be fine,” “Just this once”

🔹 SECTION 5: CONSEQUENCES

List the real consequences of going back to old behaviors.

Short-Term Consequences:

Long-Term Consequences:

👉 Think about legal, financial, emotional, and relationship impacts

🔹 SECTION 6: COPING STRATEGIES

What can you do instead when you feel triggered?

Healthy Alternatives:

👉 Examples: leave the situation, go for a walk, call someone, distract yourself

🔹 SECTION 7: RESPONSE PLAN

When I feel triggered or notice warning signs, I will:

👉 Be specific and realistic

🔹 SECTION 8: SUPPORT SYSTEM

People I Can Contact:

1. ____________________________ Phone: __________________
2. ____________________________ Phone: __________________
3. ____________________________ Phone: __________________

How I Will Use Support:

👉 Example: “I will call when I feel overwhelmed or before making a decision”

🔹 SECTION 9: BOUNDARIES

I need to avoid or limit:

My boundary will be:

🔹 SECTION 10: DAILY STRUCTURE

Structure helps reduce risk and improve decision-making.

My Daily Routine:

Morning:

Midday:

Evening:

🔹 SECTION 11: RELAPSE RESPONSE PLAN

If I make a poor decision, I will:

✔ Acknowledge it immediately
✔ Identify what led up to it
✔ Contact support
✔ Get back on track within 24 hours

My Plan:

👉 The goal is to prevent one mistake from turning into a pattern

🔹 SECTION 12: PERSONAL COMMITMENT

I understand my triggers, warning signs, and risk areas. I commit to using this plan to make better decisions and respond differently moving forward.

Signature: ____________________________
Date: ____________________________

Set your next goal.

SMART GOAL:

Specific (what specifically do you want to do? "I want to never drink alcohol again" is not specific. We need a plan by which we can accompany this goal.

Measurable - Put a measurement on it. Example: "I want to cut back on my drinking by only drinking 2 on the weekends and none during the week days."

Attainable - Make sure it is something you can do. If I'm at a pack a day, then cold turkey is going to be really tough. I may want my goal to be more attainable: I will cut back my use by 2 cigarettes daily for the next 30 days.

Realisitic - Is this something you can realistically do? If my goal is to stop using alcohol, but everyone uses alcohol daily in my household, it may not be realistic without making some changes.

Time bound - Put a date on it. When do you want to do this by? If you don't put a date on it, you may never reach your goal.

What are you continuing after this?

If you want ongoing support, weekly sessions, and accountability, ,join the Recovery Support Program here: https://grc.coursify.me/customer/brand/courses/30-day-recovery-reset-breaking-the-cycle-building-consistency