Coping Skills for Addictions: PDF Worksheet, Tools and Exercises

Patients in early sobriety rarely lack motivation. What they lack is a repertoire: a set of skills concrete enough to deploy when a craving peaks at 2am. Explaining this orally in session is possible, but the information scatters. This PDF worksheet anchors the conversation in a shared visual structure patients can take away and actually use.

Why the "try harder" frame keeps failing in session

The single most common cognitive obstacle in addiction work is the willpower attribution. Patients who relapse read it as moral failure; clinicians who collude with that framing inadvertently reinforce shame and reduce the probability of return. Reframing sobriety as a skills acquisition problem, not a character problem, is the therapeutic pivot, and it maps cleanly onto the Marlatt and Gordon relapse-prevention model.

The difficulty is that the reframe sounds abstract when stated verbally. Patients hear it, nod, and leave without anything to hold. The same week, a craving arrives, the patient has no organised response, and the implicit conclusion is that their willpower failed again. What the fiche PDF does is externalise the skills map so that the reframe becomes visible, not just audible. You can point to it, walk through it together, and hand it over as a practical reference, not a homework form.

This is especially relevant for patients who present with maladaptive coping patterns (substance use as the default regulation strategy) or for those whose emotional drivers remain unaddressed beneath the addictive behaviour.

What the fiche contains, and what the visual layout shows

The fiche is organised around six panels, each doing a distinct clinical job.

• Panel 1: The five families. "Sobriety isn't one rope. It's a safety net woven from five families." The five categories, Social, Diversions, New Habits, Prevention, and Emotions, are presented side by side with a one-line functional description for each. The layout makes explicit that no single category is sufficient: "Build two or three from each, not all from one." Showing this visually prevents the common pattern of patients over-relying on one strategy (typically avoidance of triggers) while leaving the emotional regulation and social support columns empty.
• Panel 2: The craving arc. A simple time-course diagram showing a craving peaking around 20 to 30 minutes and fading inside one hour. This panel does work that verbal explanation rarely achieves: it concretises the finite, wave-like quality of craving, which is the physiological underpinning of urge surfing and confronting avoidance. Patients who can see the arc are more likely to commit to outlasting it.
• Panel 3: A ready-to-use diversion menu. Fourteen specific activities (walk, cook, journal, play music, swim, and others) presented as options the patient can pre-select. The note is precise: "Pick ones you genuinely like. A boring distraction won't hold against a real craving." This panel supports building a personalised activity menu as a collaborative in-session task.
• Panel 4: Support mapping (daily and crisis). The fiche distinguishes steady daily support from crisis-level support, and provides a concrete prompt: three to five names written down with a pre-decided opening line. "I'm having a craving and I need to talk for ten minutes." Scripting the opening line in advance is a low-effort but high-yield intervention that most patients would not think of alone.
• Panel 5: Trigger mapping. A structured breakdown of people, places, and things, including specific examples (old using partners, routes past a dealer, paraphernalia at home). This feeds directly into building new behavioural habits and is aligned with decision-making at critical moments in ACT-informed practice.
• Panel 6: Emotion regulation. Four brief exercises (4-4-6 breathing, three-line journaling, safe-place imagery, movement) framed explicitly around the function the substance was serving. The panel states plainly that "the substance was muffling something" and names the target directly: regulate that something directly.

> Key point: this fiche is a visual support that facilitates the explanation of coping skills in session. It is not a self-directed questionnaire. The clinician walks through it with the patient, using the diagrams and categories as a shared reference, then leaves it as a concrete take-home anchor.

When and how to introduce it in session

The fiche fits naturally in the early stabilisation phase, once the anamnèse is complete and the therapeutic alliance is established enough for psychoeducation. It is particularly well-suited to sessions where you are working on building discrepancy and motivation for change, or when a patient is moving from contemplation to active engagement with their sobriety.

You can introduce it with a simple frame: "I'd like us to map out what you'll actually do the next time a craving comes. Not willpower, concrete tools." Walking through the craving arc first tends to reduce shame and increase receptivity; most patients have never seen their experience described as a wave that peaks and passes.

For the debrief, ask which families are already populated, which are thin, and which feel most threatening to build. Patients with high emotion regulation deficits will typically have an empty Panel 6 and benefit from pairing the fiche with structured work on that gap. The trigger-mapping panel can seed a graded exposure plan for patients whose avoidance of high-risk contexts has become functionally disabling.

One contraindication worth noting: in acute ambivalence or pre-contemplation, the fiche may arrive too prescriptively. In those cases, motivational interviewing remains the priority, and the fiche is better held until the patient is genuinely asking for the skills layer.

The fiche does not replace the formulation or the relational frame. It makes the skills map visible, gives patients something to return to between sessions, and keeps the conversation grounded in competence rather than character.

Sources

• Marlatt, G. A., Gordon, J. R. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.
• Witkiewitz, K., Marlatt, G. A. (2011). Relapse Prevention for Addictive Behaviors. Substance Abuse Treatment, Prevention, and Policy, 6(1), 17.
• Recovery Research Institute. Relapse Prevention (RP / MBRP).