Substance Abuse Workbook
Substance Abuse Workbook
Substance Abuse
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Substance Abuse
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& &Recovery
Recovery
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Workbook
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Workbook le at
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Ester A. Leutenberg
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Illustrated by
Amy L. Brodsky, LISW
Ester A. Leutenberg
John J. Liptak, EdD
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101 W. 2nd St., Suite 203
Duluth, MN 55802
800-247-6789
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ISBN: 978-1-57025-225-9
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Using This Book (For the professional)
Substance abuse has no universally accepted definition. Substance abuse refers to the use of
substances in ways outside of societal conventions and that have an adverse effect on an individual.
Other terms associated with substance abuse include chemical dependency, drug addiction, drug
abuse, and substance dependence. Any use of drugs in a manner that violates the norms of society is
considered substance abuse. In the fourth edition of the Diagnostic and Statistical Manual of Mental
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Disorders (DSM-IV), the American Psychological Association defines substance abuse as . . .
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as
manifested by one or more of the following, occurring within a twelve month period of time:
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1) Recurrent substance use resulting in a failure to fulfill major role obligations at
work, school, or home (e.g., repeated absences or poor work performance related
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to substance abuse; substance-related absences, suspensions or expulsions from
school; neglect of children or household).
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2) Recurrent substance use in situations in which it is physically hazardous (e.g.,
driving an automobile or operating a machine when impaired by substance use).
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3) Recurrent substance-related legal problems (e.g., arrests for substance-related
disorderly conduct).
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4) Continued substance use despite having persistent or recurrent social or
interpersonal problem caused or exacerbated by the effects of the substance, e.g.,
arguments with spouse about consequences of intoxication, physical fights).
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Addictions come in many different shapes and forms. When most people hear the word addiction, they
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usually think of drug use and abuse. In reality, there are many different types of addictions that have
very different effects on the body and mind of the abuser. Some of the different types of addictions
include:
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Drug and alcohol – This is probably the most common of all of the addictions. It is estimated that
there are approximately twenty million people in the United States who suffer from the abuse of
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alcohol and certain drugs. Common among these include LSD, Speed, PCP, Steroids, and prescription
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drugs.
Caffeine – Many people do not even see this as an addiction. However, caffeine is a stimulant that
many people consume in vast quantities on a daily basis.
Cigarettes and cigars – Tobacco today is one of the most popular as well as most problematic of all
of the addictions. Nicotine has been proven to be a very powerful, highly addictive drug.
Computers – Because our society has become so dependent on different types of technology,
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computers can become very addictive. Computers were designed to help people reduce their
workweek by making work easier, but people are actually spending so much time using a computer
that they have become dependent on them and suffer withdrawal when they are unable to use them.
Gambling – As the opportunities become increasingly available to gamble, so does the number of
people who are addicted to gambling. As gambling is seen on television, available on the Internet,
and now available in many states, people are increasingly becoming addicted to the risks involved in
gambling.
(Using This Book continued)
There are many other types of addictions including sexual, eating, and shopping to name a few.
Although this book is geared toward people suffering from substance abuse issues, many of the pages
might be applicable to populations suffering from some of the other addictions. You will need to use
your clinical judgment in determining whether the assessments and activities will be effective for the
population with whom you work. There may be some handouts you will not use because they do
not fit the needs of your population. If your clients are working on other programs, such as AA, you
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will need to make sure that the exercises and journaling activities do not conflict with your program
objectives.
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The Substance Abuse & Recovery Workbook contains five separate sections that will help the
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participants learn more about themselves as well how substance abuse is impacting their lives.
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• Substance Abuse Scale helps individuals to determine the level of their addiction to drug
and/or alcohol, and the nature of their addiction.
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• Addictive Personality Scale helps individuals examine if they have a constellation of
personality traits that predisposes them to various addictions.
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• Codependency Characteristics Scale helps individuals measure how well they fulfill the
normal responsibilities of adult life, how they can identify their feelings of inadequacy, and
leads them to explore things that are lacking in their life.
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• Relapse Warning Signs Scale helps individuals identify the changes in thinking, feeling and
behavior that accompany relapse.
• Substance Abuse Cessation Scale helps individuals get a clearer picture of the excuses that
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These sections serve as an avenue for individual self-reflection, as well as group experiences revolving
around identified topics of importance. Each assessment includes directions for easy administration,
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• take into account similarities across cultures and unique aspects of cultures that may possibly
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Each section includes exploratory activities, reflective journaling exercises and educational handouts to
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help participants discover their habitual and ineffective methods of managing substance abuse, and to
explore new ways for bringing about healing.
In the past twenty years, many research studies have focused on the value of self-reflection and
journaling as a way of exploring personal characteristics, identifying ineffective behaviors and
examining thoughts and feelings that lead to ineffective behaviors. This book is unique with its
combination of two powerful psychological tools for substance abuse and recovery management: self-
assessment and journaling.
(Using This Book continued)
The art of self-reflection goes back many centuries and is rooted in many of the world’s greatest
spiritual and philosophical traditions. Socrates, the ancient Greek philosopher, was known to walk
the streets engaging the people he met in philosophical reflection and dialogue. He felt that this type
of activity was so important in life that he proclaimed, “The unexamined life is not worth living!” The
unexamined life is one in which the same routine is continually repeated without ever thinking about
its meaning to one’s life and how this life really could be lived. However, a structured reflection and
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examination of beliefs, assumptions, characteristics and patterns can provide a better understanding
which can lead to a more satisfying personal life and career. A greater level of self-understanding
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about important life skills is often necessary to make positive, self-directed changes from the negative
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patterns that keep repeating throughout life. The assessments and exercises in this book can help
promote this self-understanding. Through involvement in the in-depth activities, the participant claims
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ownership in the development of positive patterns.
Journaling is an extremely powerful tool for enhancing self-discovery, learning, transcending traditional
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problems, breaking ineffective lifestyle and career habits, and helping to heal from past psychological
traumas. From a physical point of view, writing reduces feelings of stress and lowers muscle tension,
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and writing lowers blood pressure and heart rate levels. Psychologically, writing reduces feelings of
sadness, depression and general anxiety, and leads to a greater level of life satisfaction and optimism.
Behaviorally, the journaling leads to enhanced social skills, emotional intelligence and creativity.
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By combining reflective assessment and journaling, your participants will engage in a revolutionary
method for reducing and managing their substance abuse issues.
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Thanks to the following professionals whose input in this book has been invaluable!
Nancy Day, OT Reg (Ont.)
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The Assessments, Journaling Activities, and Educational Handouts in this book are reproducible and
ready to be photocopied for participants’ use. The assessments in this book focus on self-reported
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data and are similar to ones used by psychologists, counselors, and career consultants. The accuracy
and usefulness of the information provided is dependent on the truthful information that each
participant provides about him / herself. By being honest, participants help themselves to learn about
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unproductive and ineffective patterns, and to uncover information that might be keeping them from
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being as happy and / or as successful as they can be.
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An assessment instrument can provide participants with valuable information about themselves;
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however, it cannot measure or identify everything about themselves. Its purpose is not to pigeon-
hole certain characteristics, but rather to allow them to explore all of their characteristics. This book
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contains informal assessments and not tests. Tests measure knowledge or whether something is right
or wrong. For the assessments in this book, there are no right or wrong answers. These assessments
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only ask for personal opinions or attitudes about a topic of importance in the participant’s career and
life.
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When administering the assessments in this workbook, remember that the items are generically
written so that they will be applicable to a wide variety of people but will not account for every
possible variable for every person. None of the assessments are specifically tailored to one person, so
use the assessments to help participants identify negative themes in their lives and find ways to break
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the hold that these patterns and their effects have in life.
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Advise the participants taking the assessments that they should not spend too much time trying
to analyze the content of the questions; they should think about the questions in general and
then spontaneously report how they feel about each one. Whatever the results of the assessment,
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encourage participants to talk about their findings and their feelings about what they discovered about
themselves.
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Writing and talking about substance abuse and recovery issues is therapeutic for most people.
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Layout of the Book
The Substance Abuse & Recovery Workbook is designed to be used either independently or as part of
an integrated curriculum. You may administer one of the assessments and the journaling exercises
to an individual or a group with whom you are working, or you may administer a number of the
assessments over one or more days.
This book includes five sections, each of which contains:
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• Assessment Instruments — Self-assessment inventories with scoring directions and
interpretation materials. Group facilitators can choose one or more of the activities relevant to
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their participants.
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• Activity Handouts — Practical questions and activities that prompt self-reflection and
promote self-understanding. These questions and activities foster introspection and promote
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pro-social behaviors.
• Reflective Questions for Journaling — Self-exploration activities and journaling exercises
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specific to each assessment to enhance self-discovery, learning, and healing.
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• Educational Handouts — Handouts designed to enhance instruction can be used individually
or in groups to enhance recovery from substance abuse and provide positive reinforcement for
continued health and wellness. They can be distributed, converted into masters for overheads
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or transparencies, or written down on a board and discussed.
This book has been designed as a practical tool for helping professionals, such as therapists,
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counselors, psychologists, teachers, and group leaders. Depending on the role of the professional
using The Substance Abuse & Recovery Workbook and the specific client or group’s needs, these
sections can be used individually, combined or as part of an integrated curriculum, for a more
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comprehensive approach.
Self-assessments are important in teaching various substance abuse management skills because they
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help participants . . .
• Become aware of the primary motivators that guide their behavior
• Explore and learn to let go of troublesome habits and behavioral patterns learned in childhood
• Explore the effects of unconscious childhood messages
• Gain insight and a wake up call for behavioral change
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• Uncover resources they possess that can help them to cope better with problems and difficulties
• Explore their personal characteristics without judgment
• Develop full awareness of their strengths and weaknesses
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Substance abuse refers to an over-indulgence in, and a dependence on, a variety of addictive
substances including cigarettes, alcohol, illegal drugs, prescription drugs, and smokeless tobacco.
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People abuse these types of substances for a variety of complicated reasons, but primarily because
they like the way they feel when they are using them. Pleasure can be a motivating force in your life
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and your body and brain are wired to continue doing things that feel good. Thus, all addictive drugs
can affect and be affected by your system’s natural need to keep doing things that feel good.
An addiction is a disease that negatively affects your emotions, thinking and behavior. Once you begin
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to use addictive substances, their effect on your brain and body will make you want to continue using
them. You will know that you have a substance abuse problem if you continue to use substances even
though they cause problems in your relationships, at home or at school, in the workplace, with money,
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with the law, or with your health. You also may have a problem if you need to keep using more and
more of the substance to get the same effect.
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The good news is that if you feel as if you have a problem, the assessments and journaling activities
included in this book can help you commit to a plan to ensure that you break the addictive habit.
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The Substance Abuse & Recovery Workbook relies on a self- reflective method that is both therapeutic
and fun. Self-realization through journaling enables you to deeply understand your addictions and how
your body and mind has become used to behaving. This strong insight through reflective journaling
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then allows you the opportunity to use the exercises in this book to break the addictive cycle and form
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Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Substance Abuse Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
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Scoring Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
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Profile Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
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Scale Descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Activity Handouts
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Problems in Your Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Self-Defeating Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
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Addictive Life History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
When You Were Using . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
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Non-Addicted People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Journaling Activities
Learning About Habits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
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Feeling Scared . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
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Feeling Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Educational Handouts
Signs of Addictive Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
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Activity Handouts
Increasing Your Self-Esteem . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Passions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Nurturing Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Friends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
How I Get My Highs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
About Your Risks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
table of Contents
Journaling Activities
The Perfect Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
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More Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Current Risk-Taking Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . 53
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Educational Handouts
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Stages of Addictions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Types of Highs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
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SECTION III – Codependency Characteristics
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Codependency Characteristics Scale
Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
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Codependency Characteristics Scale . . . . . . . . . . . . . . . . . . . . 60
Scoring Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
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Profile Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Scale Descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Activity Handouts
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Caretaking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
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Attachments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Low Self-Worth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Dependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
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Communications Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Journaling Activities
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‘Responsibilities’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
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Codependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Irresponsible People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Educational Handouts
Codependency Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Codependent Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 77
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Changes in Your Feelings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Changes in Your Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
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Life History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
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Recovery Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Journaling Activities
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How Thinking Affects Potential Relapse . . . . . . . . . . . . . . . . . . 94
How Feelings Affect Potential Relapse . . . . . . . . . . . . . . . . . . . 95
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How Behavior Affects Potential Relapse . . . . . . . . . . . . . . . . . . 96
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Plan for Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Educational Handouts
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Rewards of Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Facts About Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Substance Abuse Cessation Scale . . . . . . . . . . . . . . . . . . . . . . 104
Scoring Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
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Substance Abuse
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Scale
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Name____________________________________________
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Date___________________________
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14 © 2008 Whole Person Associates, 101 W. 2nd St., Suite 203, Duluth MN 55802 • 800-247-6789
Section I: Substance Abuse Scale
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and/or alcohol, and the nature of your addiction. This scale contains 32 statements. Read
each of the statements and decide whether or not the statement describes you. In each of the
choices listed, circle the number of your response on the line to the right of each statement.
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4 = Very Much 3 = Usually 2 = Somewhat 1 = Not
Like Me Like Me Like Me Like Me
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In the following example, the circled 4 indicates the statement is very much like the person
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completing the scale.
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This is not a test, and there are no right or wrong answers. Do not spend too much time
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thinking about your answers. Your initial response will likely be the most true for you. Be sure
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© 2008 Whole Person Associates, 101 W. 2nd St., Suite 203, Duluth MN 55802 • 800-247-6789 15
Section I: Substance Abuse scale
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2. I have difficulty in thinking, remembering, and doing things
I used to be able to do. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
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3. I often give up on things in my life . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
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4. I have problems working and keeping a job. . . . . . . . . . . . . . . . 4 3 2 1
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5. Sometimes I can’t remember what has happened to me. . . . . . . 4 3 2 1
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6. I can’t make decisions about things, so I just
wait to see what happens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
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7. Nothing else matters in my life except getting and using. . . . . . 4 3 2 1
8. I want a Higher Power to save me from my addictions. . . . . . . . 4 3 2 1
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9. It often takes stronger alcohol / drugs to get the same effect. . . 4 3 2 1
10. I change jobs, move or leave relationships a lot . . . . . . . . . . . . . 4 3 2 1
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than I do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
14. I often avoid family and friends unless I need something. . . . . . 4 3 2 1
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Section I: Substance Abuse scale
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20. I make promises but have trouble keeping them. . . . . . . . . . . . . 4 3 2 1
21. It takes me much less time to get high than it used to . . . . . . . . 4 3 2 1
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22. I get into trouble when I use alcohol / drugs. . . . . . . . . . . . . . . . 4 3 2 1
23. I feel angry and resentful a lot of the time. . . . . . . . . . . . . . . . . . 4 3 2 1
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24. I rarely do anything that does not involve my addictions . . . . . . 4 3 2 1
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25. I do things that I never thought I would do. . . . . . . . . . . . . . . . . 4 3 2 1
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26. I don’t eat the proper foods or eat at a regular time . . . . . . . . . . 4 3 2 1
27. I feel guilty about using and the things I do when I use . . . . . . . 4 3 2 1
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28. I don’t listen when other people try to talk with me about
my addictions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
29. I would often use with other people who were worse
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31. I feel bad about how my using hurts other people, but I
can’t stop my behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1
32. I use drugs and alcohol to cope with my problems. . . . . . . . . . . 4 3 2 1
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Section I: Substance Abuse scale
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substances. Four areas have been identified to make up the scales for this assessment:
Physical, Behavioral, Emotional, and Psychological. The items that make up each of the four
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scales are grouped so that you can explore how your addictions are showing themselves.
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To score your Substance Abuse Scale:
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1. Record each of the scores from the previous two pages on the lines below. For example,
if you circled the 4 for item number 1, you would put a 4 on the line above the 1 on the
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chart below. Do the same for all 36 items.
2. Add the totals for each of the 4 rows and put that total on the total line to the right.
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___ ___ ___ ___ ___ ___ ___ ___ ___ ________
1 5 9 13 17 21 25 29 33 Physical Total
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___ ___ ___ ___ ___ ___ ___ ___ ___ ________
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2 6 10 14 18 22 26 30 34 Behavioral Total
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___ ___ ___ ___ ___ ___ ___ ___ ___ ________
3 7 11 15 19 23 27 31 35 Emotional Total
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___ ___ ___ ___ ___ ___ ___ ___ ___ ________
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4 8 12 16 20 24 28 32 36 Psychological Total
The Profile Interpretation section on the next page can help you interpret your scores on the
Substance Abuse Scale.
18 © 2008 Whole Person Associates, 101 W. 2nd St., Suite 203, Duluth MN 55802 • 800-247-6789
Section I: Substance Abuse scale
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Substance Abuse Scale Profile Interpretation
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total Scores
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for each of the result Indications
on
four scales
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You are probably experiencing many of the difficulties
28 to 36 High
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For scales which you scored in the Moderate or High range, find the descriptions on the
pages that follow. Then, read the description and complete the exercises that are included.
No matter how you scored, low, moderate or high, you will benefit from these exercises.
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Section I: Substance Abuse scale
Scale Descriptions
PHYSICAL – People who are addicted to substances fail to take adequate care of themselves
because they are preoccupied with their addiction. They may not get enough sleep, take
unnecessary risks, often skip meals and do not eat a proper diet. They often feel bad
physically and start to find themselves making excuses while they are using various
substances. They find that it often takes stronger substances to get the same effects they
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had been getting, and that they can get high in less time than usual. They find themselves
starting to forget things and often find themselves doing things they never thought they
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would. Substances rapidly become the most important thing in their lives.
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BEHAVIORAL – People who are addicted to substances have difficulty maintaining
relationships with others. They often lose their sense of self and their connection to others. In
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addition, they may start to have trouble at work or in school. They find themselves beginning
to have trouble making decisions and completing tasks. They find themselves frequently
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changing jobs and leaving relationships. They find themselves avoiding friends and family
who may find out about their addiction. They often begin to hide substances and sneak to
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use them so people do not know how much they are using. They also find themselves feeling
bad and shaking when they are not using.
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EMOTIONAL – People who are addicted to substances generally have low self-esteem. They
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tend to experience feelings such as anxiety, fear, guilt, depression and shame. They tend to
have unexplained mood swings and are likely to have episodes of anger and rage. At times
they will even be violent with others around them. They often feel like they are not good at
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anything but using substances. They sometimes feel alone, lost and afraid. They feel angry
and resentful, and then feel bad about the effect that their using has on people around them.
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The next sections are some self-reflective questions to help you overcome your addictions.
Please complete the questions and journaling exercises on the following pages.
20 © 2008 Whole Person Associates, 101 W. 2nd St., Suite 203, Duluth MN 55802 • 800-247-6789
Section I: Activity Handouts
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How has substance abuse caused problems for you…
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With your family?
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With your friends?
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© 2008 Whole Person Associates, 101 W. 2nd St., Suite 203, Duluth MN 55802 • 800-247-6789 21









