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

Sunday, November 17, 2019

Check-in Cheat Sheet

Check-In Cheat Sheet

Most counselors start group with a check in of some kind. This is a good practice because it helps everyone in the group to give a basic status report which can set the tone for the rest of the group, whatever the topic may be. It is even a good idea to do a check in during individual therapy as well as the counselor can use the check in period to review progress toward treatment plan goals and objectives.

A standard check in a substance use treatment program (with rolling admission and new members regularly) may consist of something like this:

1)    What is your name?
2)    Why are you here? (Why are you in this program – what brought you here?)
3)    What was/were your substances of choice?
4)    Have you used anything since last session – If so, what?
   5)    Briefly, how are you today? (Include any coexisting issues current being worked on in group as well as any co-occurring mental health symptoms or disorders if applicable)

A lot of counselors like to add an item 6) to this list which would be a thought-provoking ice breaker question of some kind. The purpose would be to get the group ready for sharing and expressing personal views, thoughts and feelings. Below is an extensive list of ice breaker questions that you, as a counselor/clinician or group leader, can choose from to add in an icebreaker to the check in:

What is one thing that you are grateful for today?
What is one goal that you have for this program today?
What is one thing (not substance related) that you do for fun?
What is one of your best memories of the last week?
How do you create more balance in your life?
What is one thing that is going right for you right now?
If you could go one place anywhere on earth this weekend for free where would you go?
What is one lesson you will never forget?
What is your favorite food?
What is your favorite color?
Who can you look for to get support in your life right now?
Who is one thing about one person that you would like to imitate in your life?
Who is one person, alive or dead, famous or not, who you find to be inspiring?
What is one thing from childhood that is a positive lesson that you would pass on to others?
Who is one person you love and why?
If you could wish something good to happen to one person today who would it be?
What is one thing that keeps you going every day?
If you could be famous for something what would you choose?
In what way are you different than most people?
What is one thing that you can say good about yourself today?
What is one positive thought that you can share with the group today?
What animal are you like and why?
If you could witness one past event firsthand which one would you pick?
If you could change one thing about yourself what would you pick?
If you could change one thing about the world what would you choose?
Who or what is something you would label as “amazing” and why?
What is one thing that will be happening in your life when you feel like you are on your way to achieving your goals
What is one thing that you feel like you deserve?
What is one thing you feel like you could give up and never look back?
What is one aspect of inner beauty in your opinion
What is something that gets you energized emotionally in a positive way
If you had the time and resources for one year to work on any project, what would you pick?
What is a simple thing that makes you happy?
What is one thing in the last week that made you smile?
You get to choose one unhealthy food and make it healthy which one does you choose?
What is one thing that you have learned in life about relationships?
What is one thing that you are unusually good at?
What is one thing that others may find boring, but you find interesting?
What is one thing that you feel like more people should know about?
If you ruled the world for one day, what is one thing that you would do?
What is a line in a book, movie, or song that you really like?
What is one of your favorite sayings? (Even if you don’t know it word for word – paraphrase)
Who or what do you feel like helps you feel inner strength?
What is one thing you do when you feel you need courage?
Where is one place that you can go to feel good for a little while every now and then?
What is one thing that you find to be good, that doesn’t cost anything?
What is one act of kindness you have done for someone?
What is one act of kindness from your past that you won’t ever forget?
If you could know the definite answer to one of life’s mysteries which one would you choose?
What is one thing that is worth the time and effort to you?
What is one thing that you could explain to others like an expert (or close to it)
What is a fact that you know that a lot of people do not?
Who is one of the most interesting people you have ever met?
What is one thing in life that you consider to be a “treat”
Who is one person who has been loyal in your life?
What is something that you have been doing for most of your life?
Who is your longest friendship?
What is one unusual positive thing that you experienced?
What is one experience you had which you would consider “a win”
What is one amazing idea you have had in your life (even if you never did anything about it)
What is a well-kept secret in this world?
What is one place that you know so well you could just about map it out from memory?
What is one of the most peaceful non drug related experiences you have ever had?
What is something you are proud to have let go of?
What is one (appropriate to discuss) thing that you like to think about when you daydream?
What is one memory that you still can laugh about?
Who is the most successful person you know personally and why?
What is one short story of bravery that stands out to you?
What helps you to keep from quitting?
What is one thing that you find to be amusing?
Who or what is something or someone you have compassion for?
If you had just a little more courage, what would you try?
What is one of the best decisions you have ever made?
What is something creative you have done?
What is one area of focus for you in life right now?
Who or what is something/someone you have faith in?
What makes someone a good person in your opinion?
What is one thing you have no problem being honest about?
What is one thing from your imagination you are willing to share?
Who is someone who has been kind to you in your life?
What is one thing that you are passionate about?
What is one thing you would describe as “powerful”?
What is one practical tip that can help someone get through a tough week?
What is one thing you have done that was romantic?
What is an area that you are very understanding about?
What makes someone tough in your opinion?
What is something witty you can share with the group?
What is one adventure you would like to go one?
Who or what is something you find it easy to have affection for?
What is a situation that you have a lot of empathy for?
What is something some did for you that was generous?
What is one invention this world needs?
What is something sensible you have heard in your life?
What is something that you would describe as awesome?
After a job interview, what is one positive person the interviewer should say about you?
What brings you joy?
What is adorable to you and what is deplorable?
What is one thing that you are confident that you could say from the heart?
Who or what has been a positive influence in your life?
How have you been a positive influence on someone else?
How do you relax?
What is something small that you appreciate?
What is one area of life that you have organized?
What is a topic you enjoy discussing (and why)?
What is one quality that you have that could make you a leader?
What is one area you feel self-confidence about?
What is something that you are a lot better at now than you used to be?
What is something that you achieved that you may not have believed you would when you were younger?
How are you still like yourself when you were a child?
What is one area which you have grown or matured in?
What is one thing you have seen that you would describe as beautiful?
What brings you comfort?
What is one thing you are curious about?
What is worth fighting for in life?
What brings harmony to people’s lives?
What is one thing you are motivated about today?
What is one thing that helps you be resilient?
If there was one app you could invent to make your life easier what would it be?
If someone made a movie of your life, what would they call it?
What is one thing that you want to know more about?
What are three words that describe you?
What is one thing that you strive to do on a daily basis?
What is one way that past failure was a learning experience for you?
How can you still find happiness even when you are bored or lonely?
What is something unique about you?
When are you happiest?
What is a recent accomplishment you’ve experienced?
What are three qualities of successful people in your opinion?
Besides luck, why do people succeed, what are some of the difference makers?
How would you describe your attitude toward why you are here?
What is an example in your life where you have refused to quit?
What are three things on your bucket list?
What are three habits that would improve your life?
What does a good relationship look like to you?
What is one thing worth waiting for?
What is one of your favorite memories?
What is your favorite thing about being you?
What would be your idea of paradise?
Why does love mean nothing to a tennis player?

Fill in the blank options:

It’s time to quit when _____
It would be a dream come true if ____
The day I find out _____ is when I will finally ____
If I only could _____ a little better, then I would finally _____
The key to being able to ______ is to first learn not to _____
I have heard them say that ____ is true, but if you ask me, I would say _____
The only thing better than _____ is ______
More people would be friendly if ______
People could say I am versatile because I can do ____ and ____
People would say I am a hard worker if they could see me ____
My intuition often tells me _____ but still I end up _____
Sometimes I ____ just to ____
I want to say thank you to ____ for _____
I feel that I don’t judge others for ____ because ____
People can depend on me for ____
One area of life that I am decisive is ____
I am determined not to ____ at this point in my life
One thing that I need to get through today is ____
If I had the time and the money, I would ___
I would much rather ____once than ____ a dozen times
You will know I have made it finally when I ____
If I could build up the courage, I would____

Rating Scale Check in Options
  • START WITH: “Using a scale of 0 to 10” …

How would you rate your current overall progress?
How satisfied are you right now with where you are in life?
How important is sobriety to you right now?
How confident that you will one day realize your goals?
How likely are you to successfully complete this program?
How good of a day are you expecting to have today in this program?
How would you rate how your morning went so far?
How excited are you for the weekend, any why?
How easily influenced are you by others?
How strong of a person do you feel you are?
What was the strongest love you ever felt?
How focused on success are you right now in your life?
How important is it to you that you get regular exercise?
How creative are you?
How motivated are you at this point in your life?
How important to you is it to be self-aware?
How productive have you been this week?
How comfortable are you with your life?
How patient of a person are you?
How much do you need the internet?
How good is your imagination?
How positive is your attitude?
How dedicated are you at this point in life?
How resilient of a person are you?
How hard of an effort do you put in on most days?
Where are you in “the process”?