Sunday, January 19, 2020

Breaking the Ice

One of the goals of group therapy is to allow the opportunity for group members to get into deeper issues so as to increase self-awareness and promote positive change. However, in order to do that successfully it may be essential to "break the ice" and provide people in the group the chance to share freely their views on various topics.

With that in mind, through this blog, Taking the Escalator has added two new icebreaker activities. Click to view either or both of these easy to use group therapy icebreakers which are sure to inspire interesting group discussion and thereby build group trust and cohesion.

Wednesday, January 8, 2020


Motivated – adj. - having an incentive or a strong desire to do well or succeed in some pursuit

Perhaps you are in a substance use treatment program and you feel that you are motivated and you truly want to make changes and achieve goals with regard to any substance use or coexisting issues that you may be working on. You may find yourself in a program where your primary reason for being there is for your own personal good yet others in the program may seem that they are only attending because they are mandated. If you believe that you have a good degree of self-motivation for positive change, it may feel frustrating at times when others in the group appear to be less motivated. If you find yourself in this situation where you are one of the more motivated people in the group and there are others who are less serious, does that mean that all is lost and there is no way to benefit? No, you still can benefit from a group program even if others in the group have questionable internal desire for change. This activity is focused on making the most of your own motivation no matter what the situation may be.

“There will be obstacles. There will be doubters.
 There will be mistakes.
But with hard work, there are no limits.”
-       Michael Phelps

*One thing to note before moving forward is that it is important not to be judgmental of others during the following discussion and group exercises. This is not about pointing a finger at anyone else and labeling them as “unmotivated” or “wasting time” as that does not help anyone. Each person should focus on themselves including trying to be self-aware about your own desires, goals, and motives rather than assessing those things in other people. Motivation is great but keep in mind it can be dangerous to be overconfident and simply conclude that you have things all figured out just because you are motivated. To the contrary, sometimes people who struggle at first with motivation eventually end up doing well in the long term. Again, the point is to focus on yourself and not to judge others in the group in order to get the most out of this. Everyone can benefit from looking at their own motivation

Some Things to be Aware of When it Comes to Motivation
(Discuss as a group: Can you identify with any of these ideas or examples?)

Motivation is not a constant (it can vary with time and situation) -

Charlie – “I feel so motivated when I am on probation but once probation ends and I feel more freedom, that little voice inside my head that tells me to go back to my old lifestyle starts getting louder”

Kira – “When I am sitting in treatment during the day, I feel so motivated and determined to do what is right, but sometimes later at home when things around me are less positive, my motivation dies down”

Motivation can be deceiving especially when it is based on emotion

Karl – “When that amazing guest speaker came in and told his inspirational story I felt a powerful surge of motivation - but I have to admit, over time it wore off”

Trish – “When my fiancée broke off our engagement because of my drinking, I felt super motivated to finally stop drinking and change my life. But eventually after my emotions changed from inspiration to depression and guilt, my motivation took a nosedive”

Epiphanies, “spiritual awakenings” and magic moments do happen sometimes, but many people cannot afford to sit around and wait for that to happen.

Jemila – “I kept hearing about other people’s amazing stories where they hit bottom, they had enough and then it all came together for them. However, that never seems to happen to me, instead I just keep waiting and waiting for it…”

Scott – “I keep on thinking that one day it will all come together for me and I will finally get it, but in the meantime, I keep racking up new charges, problems and consequences of my while I’m waiting”

Stories of quick inspirational turnarounds may make the headlines, but more often “slow and steady wins the race”

Ruby – “The reason that I am still standing here is because I didn’t give up. I had my share of ups and downs, successes and relapse but no matter what I just kept pushing forward”

Frank – “I now know that I am never going to be that guy who blows everyone away with a sudden and drastic life change. Rather, I know that I can do this if I stay consistent and persistent – little by little”

If a person is not careful, feeling motivated can lead to overconfidence which can lead loss of focus which can lead to setbacks or relapse

RJ – “I was so motivated that I was taking the world by storm with my amazing progress. The only problem was that I was doing so well that I got cocky and I thought I could start going back to clubs without getting high or drunk. That didn’t last too long unfortunately…”

Tara - “I was doing so well for so long that got overconfident and I started focusing more and more on telling other people in my program what I thought they should do. Meanwhile, I lost focus on myself and started sliding backward with my own progress as a result”

FINALLY – Everyone has the ability to increase their motivation. Motivation is a lifelong process

DISCUSS – What else have you learned that you can you do to increase your motivation?

Sunday, December 29, 2019

Goal Setting Go Fish

Intro: The following exercise is a fun way to identify and discuss goals. The game itself is more of an icebreaker however this will open up some positive discussion on goal setting for the upcoming year.

Directions: First, as a group, brainstorm 13 goals for the upcoming year. Goals can be in a variety of life areas including recovery, family, relationships, financial, physical/health, emotional, career/employment/educational, spiritual, legal, etc. - Keep in mind the following guidelines when setting goals:

The Three R's of Long-Term Goal Setting

Realistic having or showing a sensible and practical idea of what can be achieved or expected.
ReasonableAppropriate, based on good sense
ReachableAccessible, achievable, able to be reached at some point

On a board or somewhere everyone can see it, brainstorm and write down 13 goals that are realistic, reasonable and reachable. On the board, list one goal next to each one of the 13 following card types:
Aces –
Kings –
Queens –
Jacks -
Tens –
Nines –
Eights –
Sevens –
Sixes –
Fives –
Fours –
Deuces (2’s) – 

Next – Get a standard deck of cards. Remove any jokers or other non-standard cards. As a group, play a game of “Go Fish” with the deck of cards. Go Fish is a very easy game that takes 10-15 minutes to play. If you forget the rules, you can view them here. It’s easy -
*One minor rule change should be that the game play should continue until the draw pile is empty. Players that go out early should wait until the draw pile is done, which will give more people in the group a chance to win sets of 4.
When the game of Go Fish is done, each person should discuss which goals they have hypothetically “won” based on the sets of 4 cards that they were able to gather during the game of Go Fish.
For example, if at the end of the game of Go Fish, a player had all four of the Kings and all four of the 8’s then that person should discuss how he or she would feel if they achieved the corresponding goal for Kings and the corresponding goal for 8’s that the group came up with during the initial brainstorming session on the board.
Go around the room and discuss the goals that people may have won during the Go Fish game. Some players may not have won any goals, and some may have won more than one. Players who did not win any goals can pick from the list on the board and discuss the goal from the goal list that they wish that they would have won.

Final Discussion – Getting Down to the Basic Principles Goal Setting and Goal Attainment:

What are THREE PERSONAL GOALS that you want to have achieved by this time next year?

What is your PURPOSE for setting these goals? (Why did you choose the goals that you did?)

What do you think that you need to MOTIVATE you to get started and keep working on these goals?

What will help you to SUSTAIN motivation and not give up on your goals in the next year?

What specific kinds of ACTION do you need to take in order to achieve these goals?

Who or what can SUPPORT you in achieving your goals and in not giving up?

How do you SEE YOURSELF as your goals are achieved? (What will life be like? How will you feel?)

Monday, December 16, 2019

A Sudden and Tragic Loss...

Please take a moment to review this incredibly sad story. Missy Hamilton was a counselor and Taking the Escalator follower who was brutally murdered while at work at Crossroads Counseling in Madison, Tennessee on December 3, 2019. 

Below is a quote directly from Missy which shows what kind of person she was:

Melissa "Missy" Hamilton - October 1, 2019

"11 years ago, I surrendered, pleaded for God to relieve me of my addiction or let me die because death looked better than living in the darkness of my demise. I entered a women’s transitional recovery living and they asked me at 90 days clean to write out a one year goal, 5 year and ten year. After reflecting back a few weeks ago on what I wrote for those goals, I was overwhelmed with emotions to see how far God had brought me. At ten years I just wanted to be clean and sober, reunited w my family and not waiting tables for a career. God gave me those back in the first year with the exception of the job. At two years I went back to school to get my bachelors degree in psychology with a minor in substance abuse counseling. I wanted to help others with drug and alcohol issues.11 years ago today, God delivered me and in 11 days I will finish a year long internship at Cumberland Heights inpatient treatment and finish my Master’s degree in clinical mental health counseling. What I asked for was so very small in comparison to what he gave me. So this is to all those suffering/ we can’t but God can !"

Click here to view Missy Hamilton's Fundraiser page 

Click here to read the latest news article on this horrific crime which took Missy's life

Thank You

Saturday, December 7, 2019



Mandate -n. - an official order or commission to do something

It is a reality that in substance use treatment programs, quite often many program participants are mandated or otherwise coerced, forced, or ordered to attend. For some, even if they are not legally mandated, it may feel the same way if a family member or employer is stipulating or demanding a substance use program be completed. This group exercise is specifically for people in this situation*

*If you are participating in this exercise and you are not mandated or otherwise forced into treatment, you can still benefit by trying to think about how you can increase your motivation to succeed in the program through this discussion. For example, if you are in the program on your own volition, think about how you are in a sense “mandating” yourself to complete the program

Some Paths…

When someone is mandated into a treatment program, there are a number of ways to try and handle the situation. Consider a few:

Biding Time (aka “On Standby”) The person who chooses this path is cooperating with the program for now with the eventual goal of going back using once the mandate is over.

  • For example: “I’ll abstain from substances while I am on probation, but the minute probation is over I am going to enjoy getting high again”

Partially Progressing – The person who chooses this path follows the program to some degree but not all the way. This person may choose to hide some of the things that the authorities may not like

  • For example: “I am going to avoid using substances that can show up in my urine while I am being tested but when the opportunity is there between tests, I’ll sneak a little drug or drink here and there”

Catch Me if You Can - The person who chooses this path is making a full investment into the game of trying to keep getting high but not getting caught. The focus is on beating the system

  • For example: “Probation starts next week so I got my stuff to flush out my system for urine tests, I got some of my sober friend’s urine just in case I need to sneak that in and I got some fake weed which I don’t think they are testing for”

Calmly Cooperate (aka If you can’t beat ‘em, join em) – The person who chooses this path recognizes there is no use trying to fight the system when mandated. This person is choosing to give in and instead do their best to make the most out of the program even if they are mandated

  • For example: “I am not sure whether or not I really need this, but while I am here, I might as try to learn something and see if it helps”

Self-Motivated (aka I don’t mind the mandate) The person who is in this situation may be mandated but on an equal or even stronger level there is a personal desire to change. This person plans to do their best even when the mandate ends because on some level, they know they need it

  • For example: “There is a chance my court case is going to get dropped but even if it does, I am going to stay and complete this program because I need this for myself

REVIEW: Think to yourself, which of the above honestly describes your situation? 
Discuss what you are willing to share about on this topic.
 If you have another answer not listed, what is it?

Go with the flow

DISCUSS - How does it feel to be mandated, forced or otherwise directed to complete a program? Be honest with how you think and feel about the situation. (If you are not mandated, how do you think it would feel if you were?)

Three Ways to Make the Best of Any Situation

1.    Accept – Recognizing that “It is what it is” 
can save a lot of wasted time and energy 
trying to fight against reality
2.    Learn – You don’t have to like something to learn from it. 
See what you can get from this situation
 regardless of whether or not you agree with it.
 There is something to be learned
 from every situation in life
3.    Flex and Flow – You can swim against the current in life 
but that can be very tiring. Sometimes it is better
 to surrender and see where the 
proverbial river takes you.
 In this case, even if you are mandated, 
why not go with it and 
see what happens rather than fight it?

Friday, November 29, 2019

Adolescent Substance Use (Multiple Choice)

Adolescent Substance Use Group (Multiple Choice)

This is a Kahoot exercise which can be done online using smart phones by clicking the link below and following the instructions (It’s a lot of fun). If you do not have access to the online kahoot exercise, the questions and answers are all listed below and can be done through discussion instead

Ø  Correct answers are in red below

1 - Quiz
Warm up 1 - Who is this?

  • Arachnid Arnie
  • Incredible Bug Snuffer
  • Batman's mother in tights
  • Spiderman

Discussion: Yes, it’s the non-other than the Amazing Spiderman

2 - Quiz
Warm up 1 - Are you ready to play?

  • Yes
  • I like turtles
  • I dunno
  • Nope and I never will be
Discussion: Hopefully everyone was ready to play. The game is just for fun, but the discussion is what matters. The goal is to learn something.

  • False
  • True
Discussion:  Even though some people may feel energized or enthusiastic when drinking, biologically alcohol is a depressant (the opposite of a stimulant) because it slows down the brain and central nervous system

4 - True or False
Using inhalants (or huffing) just one time can kill you

  • False
  • True
Discussion – Sudden Sniffing Death Syndrome refers to abrupt death caused by inhalant use. The body can go into shock when inhalants are used which can cause the heart to stop. This can happen within minutes after any single use of inhalants
5 - True or False
When you have TOLERANCE you need more of a drug to get the same high

  • False
  • True
Discussion: Drug tolerance “occurs when a subject's reaction to a drug decreases so that larger doses are required to achieve the same effect. In addicted patients, the resulting pattern of uncontrolled escalating doses may lead to drug overdose.” ( Drug tolerance is one of the main factors that can fuel addiction because of the increasing need for more substances to achieve the desired “high”

6 - True or False
Addiction negatively impacts the part of our brain that makes decisions

  • False
  • True
Discussion: In the brain, drugs and alcohol affect the basal ganglia, which plays a role in motivation, pleasure and the formation of habits and routines. This area of the brain is often referred to as the brain’s “pleasure center”. Also affected in the brain is the extended amygdala, which plays a role in stressful feelings and anxiety, and also the prefrontal cortex, which “powers our ability to think, plan, solve problems and exert self-control over impulses.” (

7 - Quiz
Which of the following is NOT a symptom of addiction

  • Increasing risks to obtain and use substances
  • Good health and happiness
  • Legal, social and family problems
  • Difficulty stopping once starting
Discussion: Addiction often increases risk taking behavior (especially as it progresses), leads to problems with the law and difficulties with families and friends. Further, addiction is often defined by difficulty stopping once starting. All of these can make life more difficult especially over time as these issues increase. Addiction, however, rarely, if ever, leads to good health and happiness.

8 - Quiz
Something that initiates an impulse, craving, thought or desire to get high is called a....

  • Intervention
  • Infatuation
  • Trigger
  • The Munchies
Discussion: Triggers (often referred to as relapse triggers) can be people, places, things, thoughts, mood states, events, or other experiences that somehow cause a desire or urge to get high. Someone can be doing well not using, but then face a trigger (like an old friend who has drugs and is willing to share) then drug or alcohol use may continue once again. Triggers can also be internal (come from within) as feelings and mood states, like depression or anxiety, can set off a desire to get high. It is extremely important to be aware of your triggers

9 - Quiz
Which type of prescription drug can often be the start of an opioid addiction down the line

  • Painkillers
  • Anti-convulsant
  • Anti-psychotics
  • Chewable Vitamins
Discussion: Opioid painkillers are often the starting point for opioid addiction. It is a very common story, unfortunately, that when someone gets an injury or goes to the dentist and gets a prescription for opioid pain medication this can later lead to dependence. If addiction has taken hold of a person, often when the prescription runs out and there is no way to get any of the substance legally, then illegal means are at times used to obtain opioids. Some people sadly turn to heroin because it is cheaper. This does not mean that you should never take prescribed opioid pain medication. Not everyone who is prescribed pain medication becomes addicted but there is always some potential risk involved Therefore, if you are ever in a situation where you are prescribed opioids, you should be very careful, make sure your parents/guardians are aware of how much you are taking, and you all should keep a close eye on if any addictive behaviors or signs of dependency are starting to occur.

10 - Quiz
Which of these are risk factors for addiction? (Choose the best answer)

  • Genetics (Family history)
  • Early onset (Starting using when young)
  • Co-occurring mental health issues
  • These are all considered to be addiction risk factors
Discussion: Genetics, early onset, and co-occurring mental health issues are all proven risk factors for addiction. Having one or more of these risk factors does not mean that someone is destined to become addicted however it just means that the chances are higher. We know from adoption studies that addiction can pass from one generation to the next genetically. We know that more people who become addicted started using early in life than those who didn’t. Struggling with mental health issues such as depression, anxiety, ADHD, or Bipolar disorder can increase the likelihood of addiction especially when someone gets high to try to manage these symptoms instead of learning health coping skills. Again, even if you have risk factors, you still can make healthy decisions now to prevent addiction from occurring in your life

11 - Quiz
The vast majority of adults who are addicted to a substance started getting high....

  • In their 20's
  • In their teens or younger
  • In the womb
  • In their car
Discussion: When you are young, this is the time when you are just learning to cope with the challenges and stresses of life. If you are already using non-prescribed substances as a way to escape or self-medicate problems at an early age, this can be a hard habit to break later on down the line which can lead to an unhealthy dependence on mood-altering substances. Carefully prescribed medications for mental health conditions are different when overseen by a qualified prescriber who understands addiction

12 - Quiz
Another name for insight is...

  • Growth
  • Self-destruction
  • Indigestion
  • Self-awareness
Discussion: Insight or self-awareness is one of the key aspects of personal growth. The ability to look inside yourself and recognize your true thoughts, feelings and motives can be so important in defining who you really are as a person and it is a strong determining factor with regard to where you will end up in life. It can be so helpful in a substance use program to do your best to try to gain insight by being open to learning and talking about who you really are on the inside instead of trying to put up a front or mask.

13 - Quiz
What you consider to be most important in your life are called your...

  • Values
  • Circumstances
  • Fears
  • Conspiracies
Discussion: Our values are a huge part of defining who we are. What we think about, how we spend our time and what we often focus on is directly tied to our values. When something is important to us, we value it, and therefore we make these values a priority in our lives. If we value constructive and positive things, it is more likely we will have positive outcomes in life. If our values are misguided, this can be problematic in life. It is important to examine what is most important to you because we all have a limited amount of time and other resources, so it is best to have positive values and positive priorities. Just about everyone who gets older who has lost track of their lives will say something like “I wish I had my values and priorities in order when I was younger, then I wouldn’t be in this situation now”

14 - True or False
People become addicted to substances usually because they are just weak minded

  • False
  • True
Discussion: People can be strong, intelligent, and determined but still fall prey to the power of addiction. Often it is the people who think that they are too strong minded for it to happen to them who find out before it is too late that addiction took control when they were not expecting it. Instead it is important to be honest with yourself about the risk factors associated with addiction and never let yourself fall into the trap that “it can never happen to me” It is better to focus on making positive life choices about who you associate with and how and where you spend your time to prevent addiction from becoming an issue in your life.

15 - Quiz
Which of the following are helpful in preventing addiction (Best answer)?

  • Learning good decision-making skills
  • Learning positive coping skills for stress and anxiety
  • Resist social peer pressure and negative influences
  • All of these are helpful in preventing addiction
Discussion: Hopefully this one was obvious. If you can make good decisions and you have positive coping skills to deal with life stress and anxiety, and when you avoid negative peers and places, then your chances of avoiding addiction have increased greatly. It is important to take the time to learn these skills as a young person as this can benefit you for the rest of your life.

16 - Quiz
Which is the best way to prove yourself in life?

  • Your words
  • Your appearance
  • Your actions
  • Who you know
Discussion: You’ve heard it before that “actions speak louder than words” because the saying is true. Talk is cheap so saying things like “This can’t happen to me” or “I know I’ll never let that happen” may sound good and it is nice to have confidence in these areas but just saying it alone does not mean much. Many people who became addicted swore that they would never let it happen, however their actions did not support that. Instead, focus on letting your actions do the talking by making positive choices and reaping the benefits

17 - Quiz
If you can still keep going even after mistakes, failure or adversity you are:

  • Resistant
  • Rebellious
  • Simple minded
  • Resilient
Discussion: To be resilient literally means to “bounce back”. People who are resilient in life are often more successful. It is inevitable that we all fall and fail at times but how you handle failure and adversity says a lot about who you are as a person. If you can get up and keep going when trouble comes your way you are resilient. You can build resilience by increasing your level of support and your ability to use effective coping skills. If you do not feel you are resilient, do not worry, resilience can be learned, practiced and increased

18 - Quiz
Detox from which of these substances is most dangerous?

  • Opioids and Heroin
  • Cocaine and Methamphetamine
  • Alcohol and Benzodiazepines
  • None - Detox is never dangerous
Discussion: Withdrawal and detoxification for any substance has its risks and dangers. However, withdrawal related specifically to alcohol or benzodiazepine (Xanax, Valium, Klonopin, Ativan) dependence brings with it a seizure risk that can be deadly. Therefore, detoxification from these substances should take place in a setting which is monitored by trained medical staff who are aware of the risks. Sadly, young people may experiment with benzodiazepines (aka “benzos”) such as Xanax, thinking that there is little risk or harm, but in reality, if you become dependent there is a significant health and safety risk.

19 - Quiz
If you are going to make progress, learn and grow in life, it helps to be:

  • Open-minded
  • Rageful
  • Argumentative
  • Stubborn
Discussion: To be open-minded means “willing to consider different ideas or opinions” ( When you think about it, how is someone supposed to learn and grow if they are not willing to change their mind and consider different viewpoints? Surely you now see things differently than when you were a child, and this is because you opened your mind to new ideas and experiences along the way. Becoming an adult and beyond also requires an open mind to grow. Being stubborn or argumentative or getting angry when someone questions you about what you believe is sure to keep you stuck in the same place for years on end.

20 - Quiz
Which of the following is the most valuable to your growth as a person in the long term?

  • Blaming others
  • Scamming the system
  • Apathy
  • Taking Responsibility
Discussion: To be responsible is to be able to answer for your actions and to be accountable. Closely aligned with being responsible is to be reliable and trustworthy. People can get over and even temporarily get ahead by lying, deceiving, or scamming the system but over time that tends to catch up with you. Learning responsibility in your youth will be of lasting value throughout your lifetime as you will learn to be self-sufficient and to take care of business when needed instead of avoiding problems or waiting for someone else to save you.

21 - Quiz
Finally, if you are going to get the most out of this program, you should...(best answer)

  • Try to learn something about positive coping skills
  • Try to learn more about yourself
  • Learn about what it takes to succeed as an adult
  • Do all of these things
Discussion: Some people enter a substance use program thinking that they will use their time and energy to try to get over and to avoid having to change. That, of course is your right, but you should ask yourself if that is the best way to choose to participate in the program. Instead, doesn’t it make more sense to try to use the time in the program to learn more about yourself, learn about ways to deal with life (because life is rarely  if ever easy for anyone) and then use what you learn to work toward self-improvement? Regardless of why you may be in the program, everyone has room for growth and learning. It makes sense to make the best of your situation by being as positive as possible and by trying to get something out of the experience