Taking the Escalator
Substance Use Therapy Tools
Harm Reduction
12 Step Alternatives
Non 12 Step Motivational Harm Reduction Tools for Substance Use & Mental Health

    Addiction and Substance Use Resources   

Group Activities by Topic


NEW: Ideas, News and Suggestions for Counselors:

FACEBOOK USERS - New group for collaborating with colleagues
 Join Co-Occurring Disorders Tools for Clinicians and Case Managers
Share information, tools, feedback, with peers in this challenging field


Low Hanging Fruit - (For people just getting started)

Text Yourself Before Your Wreck Yourself
(Group close-out homework and follow-up activity)  

 Goodbye Group - An outline for group when someone is leaving, graduating or moving on


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Unless otherwise specified, all materials on this page are Taking the Escalator originals. At the end of each subheading section are some additional resources from around the web for Taking the Escalator users to look through and download. These materials are open source for public use

  • Materials that are from outside sources are marked with a square bullet point as done for this line. It is our policy not to violate other source's copyrights, so if you notice a potential conflict, please email us at takingtheescalator@gmail.com

Materials marked "CCI" are from a large collection which comes generously from the Centre for Clinical Interventions (CCI)  in Western Australia, who has allowed these mental health worksheets and activities to be uploaded and shared for counselors by Taking the Escalator. 

To view the CCI website directly go to -  https://www.cci.health.wa.gov.au/Resources/Overview


Alphabetical Listings by Topic:

< To search by word anywhere on this page press: CTRL F >

Accountability and Responsibility

Responsibility Road - Looking at the critical concept of increasing responsibility

Addiction and the Brain

Adolescent/Young Adult Specific 

Adolescent Activities List - A guide with recommendations from this website for clinicians working with adolescents

ADOLESCENTS:  RISK FACTORS  - Exploring risk factors for substance use issues with young people

Adolescent Substance Use  - A basic educational outline for those working with adolescents and parents

Adolescent Substance Use Group (Multiple Choice) -  This is a kahoot activity for adolescent substance use groups

Anger Management

Anger Discussion Sentence Completion - Simple questions for opening up discussion on anger

  • SAMHSA Anger Management for Substance Use and Mental Health Clients (2 links)  - MANUAL  - WORKBOOK


READ - Coping with an Overactive Mind - (Inspirational reading submitted by Nicole Tierney)

Assessment and Sceening Tools

Assessing Your Change Initiative - Getting started learning about insight, internal motivation and external motivation

VIDEO LINK - "Understanding Insight and Motivation for Positive Change" - (Corresponds with Assessing Change Initiative)

Attention, Concentration and ADHD


CBT Specific

REBT - Overview of Rational Emotive Behavioral Therapy skills for group

Change Planning

Change Analysis - Examining the actual, the real and the ideal
A Journey Through Change - Looking at change from various perspectives

Outside In - Building yourself up on the inside by developing a solid plan

Checking In

Check In - A basic tool for checking in where you are today
Check In Cheat Sheet - A comprehensive list of information and ideas for the check in process in therapy
Progress Report - Basic progress report worksheet for getting relevant discussion started

Systems Check - A comprehensive review of where you are in the change process

Closing Group - Ideas, Activities and Worksheets for the End of the Session

Goodbye Group - An outline for group when someone is leaving, graduating or moving on

Text Yourself Before You Wreck Yourself(Group close-out homework and follow-up activity)

Cohesion Building for Groups

Brief Group Module and Icebreaker Collection 1 - Multiple shorter activities to choose from in this collection

Care or Don't Care Icebreaker - Another basic tool for starting group discussion

Choose or Lose Icebreaker   - Some basic multiple choice questions for opening up discussion 
Declare-Disclose-Display -  A variety of ways to get the group talking and interacting
Deep and Personal - Some in depth personal questions for opening people up

Describe - Draw - Describe - Get group sharing thoughts and feelings with art

Escalator Jeopardy - A comprehensive educational review - (Also see "Life Jeopardy" under the Coping Skills heading)
Grab Bag - A great list of interesting, questions and other situations to get people talking
Grading the Group Interactive group report card

Group Glue - This one has a little bit of education because it explains the power and value of group cohesion

Group Member Fill In the Blank  - A great exercise to have fun and make group interactive

Icebreakers for Break Time - Short but interesting group assignments for breaks in between groups

The League of Just Us - A basic fun activity focused on superheros

Making the Most out of Substance Use Treatment - This is unique because it is an interactive Kahoot activity

Majority - Interactive exercise, better for an established group than a new one

Pointless Pursuits - (Warning: only try this if you and the group members have established a degree of comfort with one another)

Slips of Paper - A quick and easy icebreaker that gets a group talking with no prep time

Social Media Icebreaker - Exercise for self expression based on social media

Telehealth Specific Group Cohesion Building Activities - Ideas specifically for virtual video groups
Unique - Discussing what you would and wouldnt do


Communication and Social Skills


Complacency - (Submitted by Laura  Laura Hennessy, LCSW. LCADC)

Co-Occurring Disorders/Coexisting Mental Health Issues 

COD - Co Occurring Disorders - An older outline about COD's and addiction 

Coexisting Mental Heath Issues - A checklist for starting to look at mental health


Powerlessness and Willpower - Looking beyond powerlessness to examine where we can build willpower

Power and Control - (Submitted by Caitlin Kennedy, LCSW, LCADC)

Coping Skills - General

Accept-Cope-Adapt - An approach for dealing with life struggles

Pet Appreciation - Discussing how animals can help us cope

Use Your Brain and Not Your Pain - Another simple but effective strategy for coping with challenging emotions

COVID-19 Specific

Additional COVID-SPECIFIC resources from the web listed below:


Coping with Cravings - An essential list of tools for understanding and managing cravings and urges

Cross Addiction

Cross Addiction - Education and exercise on substituting addictive behaviors

Decision Making and Ethics

Decision-Making and Ethics - Examining what is behind making the right choices

Ethical Decision-Making 2 - Using insight and ethics to make tough choices

Making the Right Choice - Another look at making decisions starting from good solutions

When All Else Fails: The Costanza Principle - (Literally only use when all else fails)

Defense Mechanisms

Shielding - Looking at how we may try to protect ourselves from incomfortable realities

Group Roles  - Outline of different ways individuals may protect themselves in group settings


Depression and Alcohol Quiz - A very basic quiz focused on opening up a basic discussion on this topic

Developmental Disabilities

  • Tips4Inclusion - Tim Rohrer is a young man who grew up with disabilities who now shares his own tools and resources

Disease Concept of Addiction

The Disease Concept of Addiction - Review of "symptoms" of addiction

Distress Tolerance

Eating Disorders and Body Dysmorphia


Excuse Making

Or READ - The Subterfuge Exclusion - (Similiar to Circumventing Excuses in different format)

Families, Support and External Motivation

External Motivation - Looking at what pushes us to change and ways to increase support
Family Match Game - An icebreaker discussion for multii-family therapy group

Healthy Families - Looking at positive family qualities

Helpers - Identifying who is out there to help you with the change process

The Pendulum - Examining Common Family Issues - Examining some common family challenges

Support Report  - Assessing and maximizing exisiting potential support system
Support Zones & Interpersonal Boundaries - Stepping outside of your comfort zone to build support


Feelings, Thoughts and Emotions (General)

Dealing with Feelings  -  Coping with feelings from three viewpoints

READ: Emotional Self-Prevention - Looking at sensitive areas

Feeling Under the Weather A brief true-false list to open an honest discussion about feelings

Happiness Factor -  (Submitted by Lesley SanFilippo, LCSW)
The IDEA Technique - A tool for coping with challenging thoughts and feelings

READ: Please Dont Feed the Monster - An illustration about negative thoughts and feelings

Thinking About Thinking - Looking at the link between thinking, feeling and behaving

Thinking Styles - Tool for self-analyzing how we think

Thoughts and Feelings - Gaining an improved understanding how our thoughts and feelings affect us



Giving Activities - There is more happiness in giving than receiving

Goal Setting

Four Year Prediction Time Capsule - An interactive exercise on long term goal setting
Goal Setting - Using goals to build motivation
PCRP - Person Centered Recovery Plan - (Submitted by Katie Tracy, LCSW) 


Grief and Loss

Coping with Death and Dying - A simple outline for discussing coping with a recent loss without abusing substances
Grief and Loss Cycle    (Submitted by Caitlin Kennedy, LCSW, LCADC)

Guilt and Shame

Guilt and Shame - Understanding and learning to cope with these challenging feelings
Understanding and Coping with Guilt and Shame -  Similar to the other but in a different format

Harm Reduction Specific

Understanding Harm Reduction - The Podcast  - (Based on the above outline - click title to listen)


Insight Building - Basic, (Early Stage)

How High was I..How Low did I Go? Assessing highs and lows of getting high 
Labels - For lower insight levels, comparing what is using, abusing and addiction
Point of View Adjustment - Looking at other viewpoints to gain awareness
Taking a Trip to the Other Side - Again exploring insight and motivation building from new perspectives
Insight Building - Advanced
The Insight GameWho knows the group?

Pick a Card  - A variety of questions for insightful discussion

Simple Insight Inventory - Strengthening existing insight to build motivation

Simple Insight Inventory II - (External/Support) - Working on external motivators and supports

READ - Unfollowing the Nonsense - A brief discussion on how media can influence perception

Why am I Here? - Getting honest about the real reasons for coming to treatment


READ - Integrity - (Reflective reading submitted by Charles Radiola, MA, LCADC)

Life Story

Life Story Outline - An outline for presenting life stories in substance use treatment groups

Living Up to Your Potential

Mental Health and Substance Use Treatment 

 Mind on Mental Health (Podcast), has an engaging host and knowledgeable speakers on MH topics

Mood Swings/Bipolar Disorder

Motivation Building (Internal) 

Decreasing the Negative & Increasing the Positive - (Love the Good, Hate the Bad)
Dissecting the Heart - Enhanced internal motivation building
Flammable Areas - Early stage insight and motivation building


Music and Recovery   -   (Submitted by Caitlin Kennedy LCSW, LCADC)

Obsession, Compulsion, OCD

Overcoming Obstacles

Strengths and Weaknesses Examining strengths we have and weaknesses we need to work on in the change process


Personality Issues and Manipulation


Protective Factors


Relapse - See "Setbacks"


Guilt and Relationships - Coping with the challenges of guilt in relationships

The Ideal Partner - Looking at what you want out of relationships
Readjusting Your Relationship Radar  - Adjusting the way you choose relationships
Rules of "Fighting Fairly" - Some basic rules for conflict resolution in relationships



Self Care

Self Esteem

Insecurity - Everyone has them, is the group ready to share them? 

Maintaining a Balanced Ego - Looking at a balanced view of self

Self Esteem II  - More self esteem, continued...

The Truth about Self Esteem - An in depth look at Self Esteem from a realistic perspective

Self Value - (Submitted by Lesley Sanfilippo, LCSW)

Self Esteem and Affirmation Development (Submitted by Caitlin Kennedy, LCSW, LCADC)

Self Awareness -  (Submitted by Caitlin Kennedy, LCSW, LCADC)

Setbacks and Relapse

Associations - Honestly considering how your choice of associations affect you

Getting Over the Hump  - An activity for those who have been at this a long time
Holiday Survival Plan - Planning ahead to get through any holiday without setbacks or relapse - 

Plan to Avoid Relapse - (Submitted by Caitlin Kennedy, LCSW, LCADC)

UNG- Unnecessary Grief - Thinking and planning ahead to avoid trouble later

Weekend Plan - A basic planning tool for surviving weekends


Smoking Cessation Specific Worksheets:
Spirituality - Gaining a basic understanding of spirituality regardless of how or what you believe


Stimulant Use Disorders

Stress Management

Coping with Stress - A comprehensive list of effective coping skills 

Stress PowerPoint Slides -  (Submitted by Laura Hennessy, LCSW, LCADC) - CLICK HERE FOR ACTUAL POWERPOINT VERSION

Stories of Recovery 




  • Dissociation - UW Medicine - Harborview Abuse and Trauma Center

Values, Honesty and Integrity

Lifeboat Activity - Lifeboat exercises are nothing new but this one has had good success

VIDEO LINK -  VALUES - WHAT'S IMPORTANT <Click to View>  (Corresponds to the above worksheet)



Rashida Cartwright: African Americans and Mental Health - Featuring Rashidah Cartwright LCADC

Supported Employment: Caring for the Whole Person - Interview with Supported Employment Specialist Ayla Fleming LCSW

Treatment Videos - Interviews for individuals and families inquiring about seeking substance use/co-occurring treatment 

Created by Tigger House Foundation:

Treatment Options

Co Occurring Disorders

The Conversation

Family Loved Ones

Getting Discharged


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For Counselors - READ: What are Coexisting Issues?

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