Counselor's Manual for Relapse Prevention With Chemically Dependent Criminal Offenders

Counselor's Manual for Relapse Prevention With Chemically Dependent Criminal Offenders
Technical Assistance Publication (TAP) Series 19

Appendix--Relapse Prevention Workbook for Chemically Dependent Criminal Offenders

Introduction

If you are reading this workbook, you probably have had trouble with alcohol or drugs and have gotten into trouble with the law. Many people who have trouble with alcohol and drugs don't believe it is a problem for them. You may not believe it is a problem for you.

The purpose of this workbook is to find out if you have a problem with alcohol or drugs and how this connects with your problems with the law. If you can understand how the two are connected, you may be able to prevent problems from happening again.

Problems with the law usually occur for one or both of the following reasons.

The way you think gets you into trouble
You have an alcohol or drug problem that gets you in trouble.

Some people know they have an alcohol or drug problem. They want to stop using, but they haven't been able to. These people are called chemically dependent. This workbook is designed to help you if you have a problem with alcohol or drugs and the law, whether or not you believe you are chemically dependent.

One thing you probably want to do is to resolve your problems with the law. In order for that to happen, you must be willing to do several things.

Consider that you might have a problem with alcohol and/or drugs. If alcohol and drugs get you into trouble with the law, your family, or your job, it is likely that you are chemically dependent. If this is true, the only way you can resolve these problems is to stop using alcohol and drugs. This may not be easy, but you can do it if you will accept help.
Consider that your thinking might be wrong on some issues. If your thinking is wrong, it can cause you to act in ways that get you into trouble. It can cause you to feel like you don't fit in, prevent you from getting what you want out of life, and cause you to not get along with other people. When this happens, the only way you know how to feel good is to try to fool or "con" other people.
Decide that you can change your life. No matter how much people try to help you, you must be willing to believe that you can make your life better if you do certain things. You must be willing to look honestly at your life and want to change. If you are willing to do this, you can make your life different. This workbook can help you.

Section I: What Are My Problems?

The first section of this workbook has two self-tests. If you are honest when you answer the questions, you will find out

If you are chemically dependent (can't stop using alcohol and drugs without help). By finding out whether you are chemically dependent, you can make decisions that will change your future.
If your personality is like that of other offenders. You will see evidence of these similarities in your life. Your personality is made up of the way you think, feel, and act. These questions will help you to decide if you want to change your personality.

Understanding your problems is important in getting where you want to go. It is all right if you don't like what you find, but if you want to change, you must accept that you have problems.

To get where you want to go, you have to be honest about where you are. It is like the man who called somebody to ask directions to get to his house. He didn't want to tell the person where he was at the time because he didn't want him to know, so he told him he was somewhere else. Of course, the directions he received were useless to him.

Section II: How Did I Get Here?

The second section of this workbook will help you understand how you have gotten into trouble in the past. By understanding your past thoughts, feelings, and actions, you can understand what will happen in the future unless you change. This section will show you what you have to change.

This section will also help you to understand your thinking, feeling, and ways of acting that caused you to use alcohol or drugs or break the law. It will help you understand how one thing leads to the other.

Sections III, IV, and V: How To Change

The final three sections of this workbook teach you how to change your thoughts, feelings, and ways of acting that have gotten you into trouble in the past. They will show you how to make a plan that you can use on a daily basis to change your life for the better.

This workbook alone will not change your life. You must also use other forms of help. You can change your life for the better if you are willing to do several things.

Not Use Alcohol or Drugs. The first thing you must do is be willing to stop using alcohol and drugs. Recovery from chemical dependency must begin with abstinence. There is help available to do this.
Attend Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) Meetings. The best place to find out how to recover is somewhere you can be with people who have been in the same situation as you. You should attend as many meetings as possible. The more you talk with recovering people, the more you can learn from them.

When you go to meetings, listen to what people say. Ask yourself, "How am I like these people?" "How did they change?" "What things did they do that I can try?" Ask someone to be your sponsor. A sponsor is a person whom you respect who has been sober for quite a while. This is someone you can talk to on a one-on-one basis. He or she can help you by listening and sharing his or her own experiences.

When you speak at these meetings, be as honest as you can. You will get more help if you tell people how you really think and feel than if you try to impress them. Read as many of the AA or NA books as possible. The more you read about recovery, the more your thinking will change. When your thinking changes, you will start to feel and act differently.

Get Counseling. Go to one-on-one counseling sessions at least once a week, and more often if you can. Counseling will help you work on issues that may cause problems in recovery.
Read This Workbook. By reading and doing the exercises in this workbook, you will have a better chance of recovery and less chance of relapse. Follow the instructions very carefully. Sometimes it will seem as if you are doing the same thing over and over again. This repetition forces you to see certain things again and again so you will remember them. Many times the instructions will have you copy answers from previous exercises. This is to help you understand how all of the exercises and all the things in the exercises and in your life work together.

Sometimes you won't understand why you are doing a certain thing. The reason will become clearer as you move on. Sometimes you may get angry and frustrated. Sometimes you will want to quit. This is normal. Quit for a while, but then try again later. People who do not quit are more likely to recover.

Try to work in the workbook for 1 or 2 hours, once or twice a day. There is plenty of space available for each answer. You do not have to fill in every line for every question.

If you have trouble reading this workbook or understanding it, ask for help. It may not be easy, but learning how to ask for help is one of the things you must do to recover.

Most of all, you must put your work into action. It is only by working on changing that we will change and our lives will get better. It can happen to you if you try.

We know of a man who spent over half of his life in reform schools and prisons. He finished high school in prison but had no further education. He began attending AA in prison, and got out of prison at age 35. He worked very hard at his recovery. Today, he has two college degrees, is married and has a family, and works as a counselor with inmates. He has been sober for over 10 years.

You can change your life too. But, you must understand that it will take time and hard work.

The "Big Book" is the "school book" of AA that shows you how to recover. It uses the letters H-O-W to explain how to recover. This workbook will work for you in the same way.

Honesty—This means being totally honest about how you think, feel, and act. Unless you are willing to be honest, you cannot make progress.

Open-mindedness—You must be willing to think that you may be wrong about some things. Unless you can do this, you cannot change. If you do not change, the same things will keep happening to you.

Willingness—You must be willing to try difficult things that you do not like and that sometimes hurt at first. The easiest thing for you to do is what you have always done. The hardest thing to do is change. But you can do it if you work on changing day by day. If you change a little each day, in the end you will be a different person.

Section I: What Are My Problems?

This first section contains two tests. (1) the Alcohol and Drug Addiction Test and (2) the Offender Personality Self-Test. Completing each test will help you to understand yourself better and begin to change.

Alcohol and Drug Addiction Test

Purpose. This test describes things that happen to people who are addicted to alcohol or drugs. By taking this test, you will be able to determine if you are addicted and, if so, how serious your addiction is. To be addicted means that you cannot stop using alcohol or drugs without help. This test was adopted from the Jellinek Chart for Addiction. The following problems do not happen to people who are not addicted.

Instructions. Read each question and think back over your life. If this has ever happened to you, make a check mark in the left column (yes). If this has never happened to you, make a check mark in the right column (no). When you are finished, see the scoring sheet at the end of the test.

Yes	No
____	____	Use to feel better: I use alcohol or drugs to get away from things that bother me or are hard to face.
____	____	Use to solve most problems: I use alcohol or drugs to try to solve most of my problems and things that bother me.
____	____	It takes more: It takes more or stronger kinds of alcohol or drugs to get the same feelings than it used to.
____	____	Memory loss: Sometimes after I have been using, I do not remember what happened.
____	____	Sneaking: Sometimes I hide from other people how much I'm using or drinking. This might be because I do not want people to know or because I do not want to share.
____	____	Dependence: I rarely do anything for fun unless I use alcohol or drugs.
____	____	Fast start: I use stronger alcohol or drugs or use a lot quickly at first to get a "good start."
____	____	Feel guilty: I feel guilty about using alcohol or drugs or about the things that I do when I use.
____	____	Do not listen: Other people complain or try to talk to me about my using but I do not listen.
____	____	Regular blackouts: I do not remember what happened and I get into trouble when I use alcohol or drugs.
____	____	Excuses: I use problems in my life as an excuse for using alcohol or drugs. I feel that I have to use to deal with these problems.
____	____	Using more than others: I use more than most people, so I hang around people who use as much or more so that I feel that I fit in.
____	____	Feel bad: I feel bad about how my using hurts other people, but I don't know what to do about it.
____	____	Show off: I show off or get pushy with other people to feel better and prove that I am okay.
____	____	Promises: I promise to get my life in order and do better. I mean it, but it doesn't work out that way.
____	____	Control: I try to control my use, but it doesn't work.
____	____	Give up other things: I've stopped doing things that I used to do that didn't involve using alcohol or drugs.
____	____	Make changes: I change jobs, move, or leave a relationship to try to make my life better, but it doesn't make any difference.
____	____	Work and money troubles: I have problems on the job, owe money or can't work at all because of my using.
____	____	Avoid friends and family: I avoid old friends and family that do not use—unless I need something from them.
____	____	Neglect food: I do not eat healthy foods or eat at regular times, especially when I'm using.
____	____	Resentment: I feel like other people are out to get me, and I feel angry a lot.
____	____	Withdrawal: I need a drink or a drug in the morning or else I get the shakes or sweats because I feel terrible.
____	____	Can't make decisions: I can't make decisions about even small things. I just wait until things happen.
____	____	Health problems: I am sick, have lost a lot of weight, or feel physically bad most of the time.
____	____	Decrease in amount to get high: It takes less for me to get high or doesn't matter how much I use because I can't get the effect I want.
____	____	Over the line: I do things I said I would never do or things that do not reflect the way I was raised.
____	____	Use all the time: I use whenever I can, and I don't try to have a normal life.
____	____	Find someone worse: I try to use with people who are worse off than I am so that I feel better.
____	____	Major damage: Even when I'm not using, I have a hard time thinking, remembering,and doing things that used to be easy.
____	____	Afraid: I feel like something terrible might happen to me, people are out to get me, and I have to be on guard at all times.
____	____	Give up: I don't try to change anything. I just wait to see what happens.
____	____	Using is everything: Getting something to use, using, and getting over using are my whole life.
____	____	Turn to God: I want God or religion to save me from my life.
____	____	I'm lost: I don't try to pretend my life is normal. I know I am an addict or an alcoholic. I believe that things will never change.
____	____	Desperation: I am willing to do anything to get better.
____	____	Confinement: I have been in jails and mental wards because of my using.

Part of the Relapse Prevention Workbook for Chemically Dependent Criminal Offenders

Scoring Sheet for Alcohol and Drug Addiction Test

Early Stage Addiction

Count up the number of yes answers you checked in questions 1–12 and write the number below.

Number of checks for questions 1–12 _____

If you have one or more checks in this section, there is a possibility that you are addicted to alcohol or drugs. This means that you use alcohol or drugs to try to solve problems and to make yourself feel better. While using alcohol or drugs will not really make things better, it will feel like it does. If you have any checks in this section, you have a possibility of becoming addicted if you keep using. The closer your score is to 12, the higher your chance of addiction.

Middle Stage Addiction

Count up the number of yes answers you checked in questions 13–24 and write the number below.

Number of checks for questions 13–24 ____

Any number of checks in this section means that you are addicted and have started to have bad things happen to you because of your addiction. During this stage, you may try to do things to control your addiction. Some of these may work for a while, but not for long. For questions 13–24, the closer your score is to 12, the more addicted you are, and the worse things will get if you do not get help.

Late Stage Addiction

Count up the number of yes answers you checked in questions 25–37 and write the number below.

Number of checks for questions 25–37 ____

Any number of checks in this section means that you are in the late stage of addiction. During this stage, you may have given up and thought that you could not do anything to change. Serious life problems, such as being sick, or going to jail or a mental ward, have happened or will happen to you if you do not try to get help. For questions 25–37, the closer your score is to 13, the more addicted you are. Your chances of dying are high if you continue to use.

Reactions: Complete the sentences below and think about what they mean for your recovery.

How do you feel about the results of the test you just took?
What do you think about the results of the test you just took?
What do you want to do about the results of the test you just took?

It is normal to feel angry or upset about the results of this test. Some people think, "This doesn't mean anything," and try to ignore the results. This is called denial. Alcoholics and addicts usually deny that they are dependent on alcohol or drugs because they can't think about how to live without drinking or using. You can give up here and repeat the past, or you can decide to change.

Complete the following sentences.

If I do not stop using, I will probably

If I do stop using, I might be able to

Offender Personality Self-Test

Purpose. This test is to determine whether you are similar to other people who commit crimes. People who commit crimes behave in certain ways. These behaviors show how these people have learned to think. Although you may not like to think of yourself as having an offender personality, it is important for you to find out if you do. The problems that your thinking and behaviors cause with the law can help you see that you need to change. (Adapted from DSMIIIR criteria.)

Instructions. Read the following descriptions and check the left column (yes) if this has happened to you or if you have done this and the right column (no) if this has not happened to you or you have not done this. Read the scoring instructions at the end of this test to find your results.

Part 1: Before Age 15

Yes	No
____	____	Skipped school: I often skipped school because I didn't want to be there or because I wanted to do other things.
____	____	Ran away: I ran away from home or from where I lived at least two times, overnight.
____	____	Fights: I started physical fights with others more than once.
____	____	Weapons: I used a gun, knife, club, chain, or other weapon in more than one fight.
____	____	Sex: I forced someone into sex or sexual activity.
____	____	Cruelty to animals: Sometimes I was cruel to or hurt animals.
____	____	Cruelty to people: I physically hurt other people sometimes.
____	____	Property damage: I destroyed or damaged other people's property on purpose.
____	____	Fires: I set fires on purpose.
____	____	Lying: I often lied to other people.
____	____	Theft: I took things that didn't belong to me, forged checks, or broke into places to steal more than once.
____	____	Robbery: I forced people to give me things that belonged to them.
____	____	Total in each column for questions 1–12.

Scoring: Add up the check marks in the yes column for questions 1–12 and put the number in the space above. Do the same for the no column. If you have three or more yes answers, you act and think similarly to people who commit crimes. This behavior usually starts very early in life. This means you will have to work hard to change the way you think and act.

Part 2: Since Age 15

Yes	No
____	____	Work problems: I haven't worked when work was available, have skipped work or classes because I wanted to, or have quit several jobs or schools without any plans for the future.
____	____	Illegal activities: I have committed crimes or done illegal things that I could have been arrested for.
____	____	Using violence: I have had many physical fights or have beaten up my spouse, lover, or children.
____	____	Avoid money responsibilities: I have failed to pay bills or child support, or I have failed to take care of my family.
____	____	Moving around: I have moved without having a job, drifted from place to place, or have lived without a home for more than a month at a time.
____	____	Conning: I have lied, used false names, or conned people to get what I want.
____	____	Reckless: I have driven a car recklessly while using or drinking or have acted in ways that caused danger to others.
____	____	Parenting: I have failed to take care of my children by leaving them alone, not feeding them, or depending on others to take care of them for me.
____	____	Relationships: I have never been able to stay faithful to a sexual partner for more than 1 year.
____	____	Remorse: I do not feel bad most of the time when I steal from, hurt, or treat someone else badly.
____	____	Total in column for questions 13–22.

Scoring: Add up the check marks in the yes column for questions 13–22 and put the number in the space above. Do the same for the no column. If you have four or more yes answers, it means you act and think similarly to other people who commit crimes. If you did not have three or more yes answers on the section before age 15, it may mean that your offender behavior is completely connected to your alcohol and drug use. One way to make sure is to review your yes answers on questions 13–22 and ask yourself if these things always happened when you were trying to get alcohol or drugs, using alcohol or drugs, or because you had been using alcohol or drugs recently. If alcohol and drugs were not part of why you did these things, ask yourself what happened or changed in your life that made you start doing them.

Reactions: Complete the sentences below and think about what they mean in your recovery.

How do you feel about the results of the test you just took?
What do you think about the results of the test you just took?
What do you want to do about the results of the test you just took?

It is normal to feel angry or upset about the results of this test. Some people think, "This doesn't mean anything," and try to ignore the results. Part of what causes people to continue to get into trouble with the law is that they ignore things that they do not want to hear. This is called denial. You can quit here and repeat the past, or you can decide to change by continuing to work in this workbook. In order to change, you must accept who you are now.

Complete the following sentences.

If I do not change the way I think, I will probably

If I do change the way I think, I might be able to

The Offender Personality Self-Test and the Alcohol and Drug Addiction Test will help you understand what you must change as you complete this workbook. You will need to change in order to avoid having problems with the law. The remainder of this workbook will show you how to do this.

Section II: How Did I Get Here?

In this second section, you will find out how your problems have changed your life. You will find that you have had the same things happen over and over again. You will find out why and begin to understand how you can change this. It is important to be as honest as you can on these exercises. This is the only way you can find out what you need to change.

Exercise No. 1: Why Do I Want To Change?

Purpose. In this exercise, you will look at why you want to change. It is important to ask yourself this question. If you only want to escape the problems that you are facing right now, this workbook will not help you. If you want to change your life, it will.

Instructions. Complete the following sentences.

The reason I decided to try to get sober and clean this time is . . . (Tell what happened that made you seek help, such as job, health, or legal problems.)
Unless I really want to give up alcohol and drugs, I will not get better. Things might get better for a short time, but this will not last. I want to change because . . .

Exercise No. 2: Reasons for Relapse

Purpose. This exercise will show you why you have trouble with recovery. By knowing this, you will know more about what you need to change.

When someone is having trouble staying sober and clean, it is because that person is having trouble with one of four major areas of recovery:

Acceptance of their disease: People who are having trouble accepting their disease believe they can still use alcohol or drugs and learn to control their use.
Unable to stabilize: Every time they try to stop using, they become sick, feel crazy, or cannot think about anything except drugs or alcohol. Therefore, they use alcohol or drugs to feel better.
Cannot get comfortable being sober: When they stop using, they do not know how to change the way they live so they can enjoy sobriety.
Relapse: They get sober and clean, they attend AA or NA meetings and enjoy sobriety, but then something happens, and they become unhappy and start to use again.

Instructions. Answer the following questions.

True	False
____	____	I believe that I can learn to drink or use drugs and control my use so that it will not hurt me.
____	____	I know that I should not use alcohol or drugs at all, but every time I try to quit, I get sick and feel crazy, so I use alcohol or drugs to feel better.
____	____	I know I cannot use alcohol or drugs, but when I quit for a while, I always end up using again.
____	____	I know I cannot use alcohol or drugs, and I attend AA or NA and do everything I can to stay sober and clean. Sometimes I get very happy in recovery, but I still end up using again.

Notice if your above answers change as you complete the next exercise.

Exercise No. 3: Alcohol/Drug/Legal Calendar

Purpose. This exercise will help you to examine your past and how things have gone for you. By doing this exercise, you will begin to understand how your alcohol or drug use and legal problems are related.

Instructions. Write a history of your problems with the law, alcohol, and drugs. Include all the times you went to jail, were arrested, and went into treatment, the times when you were clean and sober, and the times you relapsed. Complete a month-by-month calendar of your alcohol/drug/legal activities. (A sample calendar appears in the hard copy of this TAP.)

Do this by writing in the year you first got into trouble with the law or began to use alcohol and drugs on a regular basis. Make a wavy line through the middle of each month that you used alcohol and/or drugs. Write the name of the drug you usually used during that time under the line. Draw a straight line where you weren't using any alcohol or drugs. Write in the name of any treatment centers or jails you were in under either line and put a line up and down to show the beginning and the end of that time. Above the line for each period you weren't using, write a word that reminds you of that time. Do the same for any period you were using. Write in parentheses the things you used to help you abstain from alcohol/drugs. Write this information in each line for every year up to and including the present. Make additional copies of the calendar if necessary.

Exercise No. 4: Relapse Episode List

Purpose. This exercise will help you notice what happened when you tried not to use alcohol and drugs. By understanding what happened during these times, you can see what to change.

Instructions. Make three copies of this exercise. Go back to Exercise No. 3 and fill out one of the worksheets for each of the last three times you tried to stay clean and sober.

Attempt no. _________

I stopped using on ____________________________(month and year).
I stayed completely clean and sober for ________________ (days, weeks, months, and/or years).
When I stopped using alcohol/drugs, I used the following help:
1. AA/NA. Meetings per week ._____
2. Sponsor. I talked to my sponsor ______ times (fill in number of times per week).
3. Worked on steps: 1 2 3 4 5 6 7 8 9 10 11 12 none
4. Detox. Number of days _____.
5. Outpatient counseling. Number of times per month _____.
6. Inpatient program. Length of inpatient time _______.
7. Prescribed medications ________________________________
How did you feel during this time? (check one)
1. I never felt good or calm.
2. I felt good once in a while, but it didn't last.
3. I felt good most of the time, but sometimes I felt awful.
4. I always felt good and thought I could do well.
I had problems during this period of not using.
I had the following problems with people. Example: I fought with my wife.
I had the following problems with situations. Example: I lived in a place where there were drug dealers.
I had the following problems with thoughts and feelings. Example: I was angry and couldn't seem to think about anything but using alcohol or drugs.
I had the following problems with pain and sickness. Example: My back hurt and I was tired all the time.
I started to use again when:
1. I started to think
2. I started to feel
3. I wanted to
The first drug I used was (include alcohol):
Then I used

Then I used
I used for ___________ (days, weeks, months, and/or years) before stopping again.

Exercise No. 5: Summary of Relapse History

Purpose. In this exercise, you will see if the same reasons caused you to return to using alcohol or drugs.

Instructions. Reread the Alcohol/Drug/Legal Calendar (Exercise No. 3) and the worksheets from Exercise No. 4 and answer the questions below. Remember that you do not have to fill in every line.

I first attempted recovery in __________________ (fill in month and year).
Since that time, I have tried to quit using ____________ times.
The longest I have been able to be completely free of alcohol and drugs (including methadone) was ___________________ (days, months, or years).
The problems that appeared more than once before I started using alcohol or drugs again are:
1. Problems with people:
2. Problems with situations:
3. Problems with thoughts and feelings:
  D. Problems with pain and sickness:
These problems usually happen in the following order:
I started to use alcohol or drugs again when:
1. I started to think
2. I started to feel
3. I wanted to
The first drug I used was (include alcohol): _____________________
Then I used

Then I used

Exercise No. 6: Life and Addiction History

Purpose. It is important to understand your life, how it has caused your addiction to progress, and how it has helped or hindered your recovery. This exercise will help you do this.

Instructions. For each period in your life, answer the list of questions. Take your time and try to remember as much as possible. You may skip periods that do not apply to your life (for example, if you did not go to high school or college).

Childhood before you started school: Describe what happened to you in your childhood and how it causes problems now when you try to recover.
Use during this time: Do you remember using alcohol or drugs during this time? Tell what you recall about your use of alcohol or drugs and the use of other people around you.
1. What and how much were you using? What and how much were your family members using?
2. How often were you using? How often were other family members using?
3. What did alcohol or drugs help you or other family members do that could not be done without using?
4. What thoughts, feelings, or situations/problems did using help you or other family members to avoid?
5. What happened to you or other family members as a result of using?
6. How did people around you act when they used? Was there violence? Was there divorce, money worries, or other problems?
7. What crimes did you or other family members commit, or what trouble did you or they get into?
Grades K–6: Describe what happened to you in grade school and how you find that causes problems when you try to recover.
Use during grade school: Describe your alcohol and drug use or that of a family member during grade school. Do you remember using alcohol or drugs during this period?
1. What and how much were you or your family members using?
2. How often were you using? How often were other family members using?
3. What did alcohol or drugs help you or your family members do that could not be done without using?
4. What thoughts, feelings, problems or situations did the alcohol or drugs help you or other family members avoid?
5. What happened to you or your family because of your use or their use?
6. How did people around you act when they used? Was there violence? Was there divorce, money worries, or other problems?
7. What crimes did you or other family members commit, or what trouble did you or they get into?
Junior high and high school: Describe what happened to you in junior high school and high school and how that causes problems when you try to recover.
Use during junior high and high school: Describe your alcohol and drug use and that of family members during junior high and high school. Do you remember using alcohol or drugs during this period?
1. What and how much were you and other family members using?
2. How often were you using it? How often were other family members using?
3. What did alcohol or drugs help you or other family members do that could not be done without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you or your family members to avoid?
5. What happened to you or other family members because of using?
6. How did people around you act when they used? Was there violence? Was there divorce, money worries, or other problems?
7. What crimes did you or other family members commit, or what trouble did you or they get into?
College: Describe what happened to you in college and how that causes problems when you try to recover.
Use During College: Describe your alcohol and drug use in college.
1. What and how much were you using?
2. How often were you using?
3. What did alcohol or drugs help you do that you couldn't do without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you to avoid?
5. What happened to you because of using?
6. What crimes did you commit, or what trouble did you get into?
Military: Describe what happened to you in the military and how that causes problems when you try to recover.
Use During Military: Describe your alcohol and drug use in the military.
1. What and how much were you using?
2. How often were you using?
3. What did alcohol or drugs help you do that you couldn't do without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you to avoid?
5. What happened to you because of using?
6. What crimes did you commit, or what trouble did you get into?
Adult work: Describe what happened to you in your adult work history and how that causes problems when you try to recover.
Impact of using upon work: Describe your alcohol and drug use in the jobs you've had.
1. What and how much were you using?
2. How often were you using?
3. What did alcohol or drugs help you do that you couldn't do without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you to avoid?
5. What happened to you because of using?
6. What crimes did you commit, or what trouble did you get into?
Adult family/intimate relationships: Describe your adult family/intimate relationship history and how this causes problems when you try to recover.
Impact of using upon family/intimate life: Describe the impact your alcohol and drug use had on your family life and intimate relationships.
1. What and how much were you using?
2. How often were you using?
3. What did alcohol or drugs help you do that you couldn't do without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you to avoid?
5. What happened to you because of using?
6. What crimes did you commit, or what trouble did you get into?
Adult social/friendship: Describe your adult social/friendship history and how that causes problems when you try to recover.
Impact of addiction on social life and friendships: Describe the impact your alcohol and drug use has had on your social life and friendships.
1. What and how much were you using?
2. How often were you using?
3. What did alcohol or drugs help you do that you couldn't do without using?
4. What thoughts, feelings, problems, or situations did alcohol or drugs help you to avoid?
5. What happened to you because of using?
6. What crimes did you commit, or what trouble did you get into?
Instructions: Read the history you just completed. Think about what you wrote, and complete the following statements.
The things that I used to believe alcohol or drugs would help me do or become in my life are . . .
The thoughts, feelings, problems, and situations I used to believe that alcohol or drugs could help me cope with are . . .

Exercise No. 7: Life History Summary

Purpose. To understand your drug or alcohol use, it is helpful to review the main points in your life. Main points are things that have happened to you, decisions you have made, or things you did that have a strong impact on where you are today.

Instructions. Review the previous exercise and use the form below to list the main points in your history.

Life Event History	Alcohol/Drug Use and Crime History
Childhood Before School
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Grade School
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Junior High and High School
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College
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Military
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Adult Work
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Adult Family/Intimate Relationships
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Adult Social and Friendship
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.	.

The three main things I used to believe alcohol or drugs would help me do or become in my life are . . .
The three main thoughts about myself and others that I have used alcohol or drugs to cope with are . . .
The three main feelings I used alcohol or drugs to help me cope with are . . .
The three main problems or situations I used alcohol or drugs to help me cope with are . . .

Section III: How Do These Warning Signs Happen to Me?

In this section you will learn how the warning signs combine to cause you to relapse into criminal behavior and alcohol and drug use.

Exercise No. 8: Alcohol and Drug Relapse Warning Signs

Purpose. There are many ways you can tell that you may relapse—that is, start using drugs or alcohol again. This section will help you examine thoughts, feelings, and behaviors you have before you relapse.

Instructions. Read the following lists of relapse warning signs. Place a check mark next to any that have happened to you. Place a question mark next to any that you do not understand. Underline any words that cause you to have strong thoughts or feelings, or make you want to do something.

Phase I: Internal Warning Signs

___	1.	Trouble thinking clearly: Sometimes I cannot understand what is going on. At times, it is hard to think, or I can only think about the same thing over and over. At times I cannot think at all, or when I do, I make mistakes that I usually would not make
.___	2.	Trouble managing feelings and emotions: Sometimes I have mood swings. I go from feeling excited to feeling depressed within a matter of minutes. Sometimes I do not feel anything when I know I should. At times the way I feel does not match up with anything that is happening. At times I feel or act crazy and feel bad later. When these things happen, I try to forget about them.
___	3.	Trouble remembering things: At times, I forget things I have just learned. Sometimes I can remember things from the past and other times I can't, no matter how hard I try. Sometimes when I can't remember, I make mistakes that I feel bad about later.
___	4.	Trouble managing stress: Sometimes I do not know when I am tense until I become really uptight. When I try to relax, it gets worse. Sometimes it gets so bad that I am afraid I might collapse or go crazy.
___	5.	Trouble sleeping: At times, I cannot sleep at night. When I do, I still feel tired the next day. Sometimes I have strange dreams and nightmares, including dreams about using that seem real. Sometimes I get very tired and sleep much longer than usual.
___	6.	Trouble with physical coordination: Sometimes I stagger, have dizzy spells, stumble, or have accidents. At times reading and writing become more difficult.
___	7.	Feelings of shame, guilt, and hopelessness: At times I feel guilty and ashamed. I think something is wrong with me and I am afraid I won't get better. When these things happen, I try to take care of them on my own. I do not tell anyone. No matter how hard I try, things seem to get worse and I begin to think it is hopeless to try.

Phase II: Return of Denial

___	8.	Concern about well-being: Sometimes I worry about my recovery. This worry comes and goes and doesn't seem to last very long.
___	9.	Denial of the concern: In order to deal with these worries, I try not to think about them. Soon I forget what I was worried about. Sometimes even when I try to remember, I can't.

Phase III: Avoidance and Defensive Behavior

___	10.	Believing "I'll never use again": Sometimes I believe I will never use alcohol or drugs again. Sometimes I tell others, but most of the time I keep this to myself. When I start believing this, I do not feel I have to work as hard to stay clean and sober.
___	11.	Thinking about others instead of myself: When I stop working as hard to stay sober and clean, I find myself blaming other people for my problems. Sometimes I think others should be acting differently, and I criticize them to others or to myself.
___	12.	Defensiveness: When I start thinking this way, I feel as if others do not like what I am doing. I get angry when people try to talk to me and I avoid them. I do not let other people talk, or I do not talk so they won't find out how I feel.
___	13.	Compulsive behaviors: I overdo things and get wrapped up in things so I do not have time to think. I may get overinvolved with work, sex, food, exercise, or AA, just so I do not have to think about or feel my problems. This doesn't make my problems go away.
___	14.	Impulsive behavior: I become so stressed out that I do things on the spur of the moment that I feel bad about later.
___	15.	Tendencies toward loneliness: Even though I want to be around people, I make excuses so that I do not have to. I spend more time alone, and do things to avoid thinking and feeling.

Phase IV: Crisis Building

___	16.	Tunnel vision: I look only at a small part of my life, and ignore everything else. When little things go wrong, I blow up and feel like life is unfair.
___	17.	Minor depression: I start to feel down and depressed. I have less and less energy, and I oversleep. I try not to feel these things by getting busy and not talking about it, but the feelings do not go away.
___	18.	Loss of constructive planning: I stop making plans for my day and react to whatever comes up.
___	19.	Plans begin to fail: My plans are not well thought out or realistic. I begin to have more and more problems. I feel bad about them, but do not know how to solve them.

Phase V: Immobilization

___	20.	Daydreaming and wishful thinking: I daydream about something that might solve all my problems like winning the lottery or running away to another place.
___	21.	Feeling that nothing can be solved: I begin to feel as if I have failed at recovery. Nothing I do appears to make things better.
___	22.	Unfulfilled wish to be happy: I want things to work out and I want to be happy, but I don't know how to make them better or I'm afraid to try.

Phase VI: Confusion and Overreaction

___	23.	Periods of confusion: I can't figure anything out. This makes me angry with myself and I become more confused.
___	24.	Easily angered: I become angry with people over little things. I feel angry most of the time and am afraid I might hurt someone. Sometimes I want to hurt others.
___	25.	Irritation with friends: When other people try to talk to me about what is going on, I think they are criticizing me and we have arguments.

Phase VII: Depression

____	26.	Irregular eating habits: I stop eating regular meals, and eat junk food instead. I either overeat or eat little or nothing.
___	27.	Lack of desire to take action: I feel scared and trapped. It seems impossible to start, let alone finish anything.
___	28.	Irregular sleeping habits: I find it impossible to sleep until I am completely exhausted. When I finally get to sleep, I have bad dreams and may sleep for 12 to 20 hours at a time.
___	29.	Loss of daily structure: I get so stressed and miserable that I cannot make decisions. I miss appointments and meetings. Sometimes I plan on going, but I am running so late that I decide not to go at all.
___	30.	Periods of deep depression: I feel hungry, angry, lonely, and tired. I feel angry with others. They try to help, but I think that nobody really cares.

Phase VIII: Behavioral Loss of Control

___	31.	Irregular attendance at AA/NA and treatment meetings: I stop going to my regular AA or NA meetings. I miss counseling appointments. I begin to feel that there are more important things to do and that the sessions aren't helping anyway.
___	32.	Development of an "I don't care" attitude: I feel like everything is hopeless. I don't want other people to know this, so I act as if I don't care.
___	33.	Open rejection of help: When people try to help me, I blow up and drive them away. I tell others that I do not need their help and avoid anyone who might see how I really feel.
___	34.	Feelings of powerlessness and helplessness: Things appear to be so bad that it seems useless to try to do anything to make them better.

Phase IX: Recognition of Loss of Control

___	35.	Self-pity: I feel sorry for myself and try to get sympathy and attention from friends or AA/NA and family members.
___	36.	Thoughts of social drinking: I start thinking that maybe I could drink or use drugs and stay in control. I think about how good it would feel to drink or use drugs for just a little while.
___	37.	Conscious lying: I start to lie to others even when I do not need to.
___	38.	Complete loss of selfconfidence: I think I am a total failure at recovery and in life. I do not believe that I can change things for the better, no matter what I do.

Phase X: Option Reduction

___	39.	Deep resentments: I feel angry with the world and feel as if everyone is against me.
___	40.	Discontinue all treatment and AA/NA: I do not attend AA/NA meetings, avoid my sponsor, and have stopped going to counseling or aftercare.
___	41.	Overwhelming loneliness, frustration, anger, and tension: I begin to feel like I am insane and think my only choices are drinking or using drugs, suicide, or insanity.
___	42.	Loss of behavioral control: I have problems in all areas of my life. I cannot control how I act, think, or feel.

Phase XI: Return to Use, or Physical/Emotional Collapse

___	43.	Return to "controlled" use: I try to use with control and sometimes I am able to do this for a short period.
___	44.	Shame and guilt: I feel ashamed and guilty for using and believe that if I had done things the right way, this wouldn't have happened to me. I believe I am a bad person because I've started to use again.
___	45.	Loss of control: I begin to use just as much or more than I did before.
___	46.	Life problems: I begin to have severe problems with my spouse/partner, job, friends, health, or the law. I need professional help in order to get better.

Exercise No. 9: Offender Relapse Warning Signs

Purpose. This offender relapse warning sign list will help you to understand how you return to breaking the law, even when you do not want to.

Instructions. Below is a list of thoughts, feelings, and actions that offenders may experience before committing a crime. Read the list and place a check mark next to any signs that you have experienced. Place a question mark next to any that you do not understand. Underline any words that cause you to have strong thoughts or feelings or make you want to do something. (This list was adapted from the work of Stanton E. Samenow, Ph.D.)

Phase I: Internal Dysfunction: During this period, changes occur in thoughts and feelings. These changes are unnoticed by other people.

___	1.	Worry: I worry about being able to survive in the real world. I wonder how I am going to be able to find and keep a job, pay bills and fines, get along with my family, or stay away from my old friends.
___	2.	Denial: I tell myself it will all work out. I pretend everything is all right. When people ask me about my problems, I tell them I will be okay, even though I am not sure.
___	3.	Belief that troubles are over: I convince myself that I've learned my lesson and will never do anything illegal again. I tell my friends, family, counselor and probation officer, "I've really learned this time," even though I do not have a plan for how to change.
___	4.	Uncomfortable feelings: I feel uncomfortable around people who are not involved in illegal activities. They seem boring, and I get nervous and jumpy. I want more excitement in my life.
___	5.	"All or nothing" thinking: I feel like I must be the best or I will be nothing. I must be very successful at everything I do. I get excited and build up in my mind how successful I must be. I feel that if I do not do everything right, I will fail.
___	6.	Unrealistic feelings: I think things should go my way just because I want them to. Because other people want me to succeed and I want to do well, things will happen the way I want them to.
___	7.	Not planning ahead: I do not plan for the future. When people ask me what my plans are, I tell them what I think they want to hear.
___	8.	Lack of effort: I do not do things that I do not like or that are boring or hard for me. I do not look into jobs or other things that might help me, and I find excuses for not doing these things.
___	9.	Building self up: I make myself feel better by putting other people down. I tell myself how stupid other people are. Most of the time I just think it, but sometimes I tell people that they are dumb or do not know anything.
___	10.	Poor decision making: I make decisions on the spur of the moment without thinking about what might happen. Afterwards, I think, "I really screwed up."
___	11.	Sensing a lack of trust: I feel like others do not agree with me or do not trust me. I think people should trust me no matter what I may have done in the past. I tell them I have changed, and I expect them to believe me. Their lack of trust makes me angry.

Phase II: External Dysfunction: In this phase, other people start to notice that you are acting differently. Your behavior starts to cause problems with others.

___	12.	Feeling put down: I think other people are putting me down when they point bad things out to me or when things do not happen the way I want. I think people do not understand me, and I begin to argue with them.
___	13.	Wanting to be alone: I start to avoid my family and other people. I wander around alone or go places by myself.
___	14.	Feeling depressed: I feel depressed, lonely, and angry. I don't think other people understand me. I start having problems sleeping, or I don't eat regularly and eat junk food. I feel hopeless.
___	15.	Denying fears: I do not want others to know I am afraid because I think being afraid is being weak. I tell people I am fine when I am really not. I'd rather tell people what they want to hear so that they won't know how I really feel.
___	16.	Having envious thoughts: I start to think about people I know who break the law and get away with it. I start to wish that I could do that, too. I wonder if there is an easier way to do things.

Phase III: Loss of Control: Your feelings at this time seem to control you. You can't seem to get yourself back on track. You feel like you can never change and wonder why you should try.

___	17.	Avoiding responsibility: I do what I want instead of what I told people I would do. When things go wrong, I tell people "I forgot." I either change the subject, or do not give them an answer. Sometimes I say "yes" when I do not really mean it.
___	18.	Using alcohol or drugs: Sometimes I feel good but I want to feel better. Sometimes I feel bad and I want to escape from my feelings. I begin to use alcohol or drugs to make good feelings better or to get rid of bad feelings. At first, I keep this a secret. If my probation officer, counselor, or family asks me about it, I lie.
___	19.	Seeing old friends: I start to hang around people who commit crimes. I want to be comfortable and they are the only people who seem to understand me. I go back to my old hangouts. I call people I know from jail or prison. I tell myself I am only doing this to find out how they are doing.
___	20.	Missing appointments: I miss appointments with my probation officer, counselor, job interview, or school. I make up excuses as to why I wasn't there. I begin to believe these people are out to get me and I can't trust them.
___	21.	Thinking "I can't": I tell people I can't do something, or I don't know how when I really just do not want to. I feel afraid or angry when I think about doing things that others want me to do.
___	22.	Playing the victim: I blame others when things go wrong. I tell people I couldn't help it. I feel like others are picking on me or are not giving me a chance. I feel like people will never be satisfied with me.
___	23.	Not understanding how I hurt others: I feel like other people are always telling me that I hurt them. I do not see how the things I do may hurt other people, and sometimes I get frustrated and I do not care.
___	24.	Committing petty crimes: I start stealing small things. I begin using illegal drugs, destroying other people's property, or getting into fights.
___	25.	Rejecting others: When people ask me what is wrong, I tell them that there is nothing wrong. If they persist, I tell them to leave me alone, yell at them, or do something to make them leave me alone.
___	26.	Thinking that I'm always right: I don't back down when other people do not agree with me. I feel that I am never wrong no matter what. I feel if I admit to others that I am wrong, they will think I am weak and will take advantage of me. Even if it turns out I am wrong, I leave or start a fight rather than admit it.
___	27.	Feeling entitled to what I want: I think other people should give me what I want, when I want it. If they do not, I have a right to take it. I feel angry that they won't do what I want or give me what I want. I feel like I have to teach them a lesson. I start thinking about illegal things I can do to get what I want.
___	28.	Feeling that my anger is justified: I feel that if I do not get what I want, I have the right to get angry, threaten, hurt, or get even with people. I feel I have the right to do whatever I have to because other people do not understand.
___	29.	Wanting to win: I feel I must win at all costs. I get "high" when I come out on top, even if the fight wasn't important. I will do whatever it takes to get back at someone who makes me angry. I am willing to commit crimes just to make me feel on top of things.

Phase IV: Return to Regular Law Breaking: You now get back into breaking the law on a regular basis.

___	30.	Believing "just this time": I decide to get even with someone just this one time. I sell drugs, steal something, or do something that I probably won't get caught at.
___	31.	Worsening of a pattern: Soon I start breaking the law on a regular basis. I am always thinking about how I can get away with something.
___	32.	Having serious problems: I get caught, picked up on a probation violation, have run-ins with the police, and get rejected by my family.

Exercise No. 10A: Initial Alcohol and Drug Warning Sign List

Purpose. This exercise will help you notice which of the warning signs are important to you, and help you understand them better.

Instructions. Make three copies of this exercise. Pick the three warning signs that you had the strongest feelings and thoughts about in the Alcohol and Drug Relapse Warning Signs exercise and list them on the worksheets in this exercise. For each one, follow the directions below.

Alcohol and Drug Warning Sign: No. __________
1. Title
2. Write the words you underlined.
3. Why did you pick this sign?
4. Write the warning sign in your own words, beginning with:
  I know my recovery is in trouble when . . .
  
  Repeat this sentence several times out loud. Then complete the sentences that follow.
5. When I say this sentence . . .
  1. My thoughts are
  2. My feelings are
  3. I want to

Exercise No. 10B: Initial Offender Warning Sign List

Purpose. In this exercise you will find out which of the warning signs are important to you and understand them better.

Instructions. Make three copies of this exercise. Choose the three warning signs that you had the strongest feelings and thoughts about in the Offender Relapse Warning Sign List Exercise and list them on the worksheets in this exercise. For each one, follow the directions below.

Offender Relapse Warning Sign: No. __________
1. Title
2. Write the words you underlined.
3. Why did you pick this sign?
4. Write the warning sign in your own words, beginning with:
  I know my recovery is in trouble when . . .
  
  Repeat this sentence several times out loud. Then complete the sentences that follow.
5. When I say this sentence . . .
  1. My thoughts are
  2. My feelings are
  3. I want to

Exercise No. 11: Warning Sign Analysis

Purpose This exercise will help you to understand how each warning sign you checked in the previous section can happen to you.

Instructions. Write down each title of the six relapse warning signs you identified in Exercise No. 10 (A and B). Then complete the following exercises about each one. If you are having trouble, quit for a short period, but come back to the exercise.

Initial Relapse Warning Signs:

Alcohol and Drug Warning Signs	Offender Warning Signs
No. 1	No. 1
No. 2	No. 2
No. 3	No. 3

Description: Describe how these relapse warning signs work together to set you up to return to using and criminal behavior. Refer to the thoughts, feelings, and things you wanted to do in Exercise No. 10 to help you complete this description.

Write down any new thoughts, feelings or urges that you had when describing the warning signs (above).

A.	D.
B.	E.
C.	F.

Past experience: Describe a time in the past when one of these warning signs happened to you when you were sober and clean. Describe it as a story with a beginning, middle, and end. Include who was there, what happened, and where and when it happened. Also state what you were feeling, thinking, and wanted to do.
Key ideas: List the key ideas from the story of your past experience.
1. It happened at (where and when)
2. I was with
3. What was going on was
4. I thought
5. I felt
6. I wanted to
7. The next thing I thought was
8. The next thing I felt was
9. The next thing I did was
Future Experience: Think about a time in the future when this warning sign might happen to you while you are sober and clean. Describe it as a story with a beginning, middle, and end. Include who might be there, what might happen, and where and when it might happen. Also state what feelings and thoughts you might have and what you would want to do.
Key Ideas: List the key ideas from the story of your future experience.
1. It happened at (where and when)
2. I was with
3. What was going on was
4. I thought
5. I felt
6. I wanted to
7. The next thing I thought was
8. The next thing I felt was
9. The next thing I did was
Reactions to this exercise: During this exercise . . .
1. I thought
2. I felt
3. I wanted to
Finish the following sentence five times, each time giving it a new ending.
I am now beginning to realize . . .

Exercise No. 12: Combined Warning Sign List

Purpose. This exercise will help you to see things that happen to you over and over again and that lead you to relapse into alcohol or drug use or breaking the law.

Instructions. Go back to Exercise No. 11 and take all of the key ideas, warning signs, and reactions listed in sections 2a, 4, 6, and 7. Combine them into one list below. If any of the items on the list are similar, write only one of them. Check them off on Exercise No. 11 as you write them here.

Exercise No. 13: First Ordered Warning Sign List

Purpose. This exercise will help you to put the warning signs in the order that they happen to you. This will help you to learn how to stop them from causing a relapse.

Instructions. Go back to the combined warning sign list (Exercise No. 12) and put the signs in the order that they happen to you. Write down a few key words that will help you to remember each warning sign on the line labeled Summary Title.

Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title:
Warning Sign:

Summary Title: