From Survival to Endurance to Fulfillment: How I Found Meaning in Life

“I gave up on having a future. And I was strangely okay with it.”

By Cassie Jewell, M.Ed., LPC, LSATP

Without delving too deep into my past, I will tell you that my late teens and early to mid 20’s were not the best of times. They were dark. Lonely. Depressing. I was living a life of chaos and hopelessness. At one point, I didn’t think I was going to survive; I gave up on having a future. And I was strangely okay with it.

My turning point was a spiritual awakening of sorts. A near-death experience led to a realization that I didn’t want to die; and it was either die or change my life. I picked change.

What helped me to live again (and ultimately find fulfillment)? You might guess family or a relationship or God. But at the time, I wasn’t close with my family, I didn’t have any significant relationships/friendships, and God wasn’t a part of my life. It was the following that helped me become the person I am today:

A Therapist

Having not a single shred of self-esteem, I went to see a counselor. She created a safe space and then uplifted me, making me feel worthwhile. She normalized what I was going through; I felt less alone. She affirmed me for positive choices I made. She initiated the mending of my fragile self. I gradually gained confidence, not only in myself, but in the idea that I could live a better life.

My Dog

She loved me unconditionally… and she depended on me fully. If I died, she would think I purposely left her. I couldn’t bear the idea; I wouldn’t do that to her. She played a huge role in my recovery. I sometimes think she saved me.

My Potential

I’ve always known I have potential. I’m smart and creative. I’m motivated and driven. But that potential died somewhere along the way in young adulthood. In moments of clarity, I mourned my lost potential. I wanted to be better and to do better with my life. I was meant, maybe not for great things, but for better things than living out of my car, broke and friendless. When I decided to live, my potential reawakened; it became a driving force – a bright, glowing beacon that revitalized and inspired me.

“You have to forgive yourself.”

Self-Forgiveness

I couldn’t bear to tell my therapist about some of the things I’d done. I was ashamed; late at night, lying in bed, I would think about past events. I’d feel sick to my stomach – then, an unpleasant head rush heart racing not able to get enough air… (That’s the feeling of shame seeping from your mind into your being.) My therapist didn’t push me to share; instead, she said, “You have to forgive yourself.” It became my mantra, quietly uttered in the dark. I would repeat, “I forgive myself, I forgive myself, I forgive myself…” until I internalized it. (That being said, it didn’t happen overnight… it took weeks, months, years. But all was set in motion with that one simple statement.)

Education

I went back to school and was able to fully immerse myself in my studies. As a naturally curious person, learning is a sort of fuel for me. The more I learn, the thirstier I become. My classes provided me with not only knowledge, but with a spark that generated purpose.

Passion

While in school, I discovered a new passion; I fell in love with research. (#nerd) I thrived in my research/statistics class; my undergraduate study was even published in a national journal. It felt good to be passionate about something again; it stirred up (from the dust) long-forgotten loves, like reading and writing – passions I thought I’d left behind in childhood.

A Meaningful Career

After finishing college and starting graduate school, I became a counselor… and found meaning in helping others. My first job in the field was tough, heart-breaking at times, and deeply fulfilling. It solidified what my education had started to shape – I no longer needed to survive or endure life; I found my purpose for living.

Sites with Helpful Resource Lists

(Updated 5/4/20) A list with links to other sites’ resource pages

By Cassie Jewell, M.Ed., LPC, LSATP

I have a knack for finding resources. To compile the lists for this blog, I spend countless hours searching the Internet.

My main resource list has grown tremendously since I started blogging. In my quest to compile the most comprehensive resource list ever, I came across a few lists that rival my own.

This post will link you to a variety of resource pages (in case you can’t find what you’re looking for on this site!) If a link isn’t working, try going to the site’s homepage or sitemap to look for the resource section.


Community Resources (ADAA) From the Anxiety and Depression Association of America

DISCOVER AND RECOVER: Resources for Mental and Overall Wellness A blog with tons of resources

Expert Resources from JED and Others Resources for teens and young adults

Find Resources (CADCA) An extensive searchable resource list from CADCA (for substance use disorder-related resources)

Free Mental Health Resources A list compiled by blogger Blake Flannery (last updated 2015)

Links (Sidran Institute) From the Sidran Institute… tons of sites I’d never heard of!

Links to Other Empowering Websites From the National Empowerment Center

Mental Health and Psychology Resources Online A list of online resources from PsycCentral

Mental Health Resources for Therapists and Clients From the blog: Info Counselling – Evidence based therapy techniques. Compiled/last updated 2017.

Mental Health Resources List A fairly comprehensive list similar to mine. Updated 2018.

Resources Resources for child sexual abuse

Resources (Veto Violence) A searchable resource database from Veto Violence (a CDC organization)

Self-Injury and Recovery Research and Resources Resources for those who self-injure, their loved ones, students, and health professionals

Sites We Like From S.A.F.E. Alternatives – Resources related to self-harm

Veteran Resources A resource list from Lifeline for Vets (National Veterans Foundation)

Books & Resources for Therapists

(Updated 5/5/20) A resource list for therapists and other mental health professionals, including book recommendations and sites that link to (free!) printable worksheets, handouts, and more.

By Cassie Jewell, M.Ed., LPC, LSATP

This is a list of resources for mental health professionals. Please check back as I update regularly. If you have a suggestion, use the contact form on this site.


Books

Armstrong, C. (2015). The Therapeutic “Aha!” Strategies for Getting Your Clients Unstuck.

Belmont, J. (2015). The Therapist’s Ultimate Solution Book.

Buchalter, S. I. (2017). 250 Brief, Creative & Practical Art Therapy Techniques: A Guide for Clinicians and Clients

Rosenglen, D. B. (2018). Building Motivational Interviewing Skills: A Practitioner Workbook, 2nd ed.

The PracticePlanners Series


Websites & Blogs

ACEs Connection | An ACEs community for connecting with others who practice trauma-informed care. You can also access the latest news and research related to ACEs; this site also has a huge resource section with guides, surveys, webinars, and more.

ACT Mindfully | A variety of free worksheets, handouts, book chapters, articles, and more. Acceptance and Commitment Therapy (ACT) is a unique and creative model for both therapy and coaching; a type of cognitive behavioural therapy based on the innovative use of mindfulness and values.

Association for Behavioral and Cognitive Therapies | Info and clinical resources, including archived Webinars and podcasts

The Centre for Applied Research in Mental Health and Addiction – Tools and Resources | The Centre for Applied Research in Mental Health and Addiction (CARMHA) is an internationally recognized research centre based at the Faculty of Health Sciences, Simon Fraser University, Vancouver. CARMHA conducts innovative and interdisciplinary scientific research related to mental health and substance use, primarily in the areas of clinical or other intervention practice, health systems and population health and epidemiology. Access free downloadable workbooks for stress in the workplace, depression, coping with chronic pain, and other topics.

Character Lab | A collection of “playbooks” for character-building in children

Collaborative Mental Health Care: Child & Youth Mental Health Toolkits | Assessments, handouts, resources guides, links to relevant sites, and more

Compassion Fatigue & Healthcare Professionals: An Online Guide | Resources for coping with compassion fatigue

Confident Counselors | A collaborative blog written by school counselors, school psychologists, and school social workers

Counselling Resource | A resource site for mental health professionals and consumers. Includes interactive assessments, free PDF printables, and information related to online practice and clinical supervision.

Counselor: The Magazine for Addiction & Behavioral Health Professionals | Blog posts written by substance use and mental health providers

Education4Health | The resource section includes a variety of PDF booklets, guides, and workbooks

Evidence-Based Behavioral Practice | Information on evidence-based behavioral practices: includes tools, assessments, videos, and free online training modules

Expressive Art Inspirations: Free Expressive Arts Learning Library | A collection of creative art techniques

Expressive Therapist: Group Activities | A list of ideas for groups of children, teens, and adults

Guided Self-Change | A great resource for SUD assessments, group materials, and handouts

Get Self-Help – Free Resources | This website provides CBT self-help and therapy resources, including a large collection of worksheets and information sheets and self-help mp3s; a useful tools for therapists or individuals seeking to manage a mental health condition.

The Helpful Counselor | Resources for school counselors

National Center for PTSD for Professionals | Free handouts, toolkits, online trainings, and more

Personality Lab | Articles, assessments, dissertations, etc. on personality intelligence

Positive Psychology Program | This site contains a wealth of free assessments, PDF printables, activities, handouts, worksheets, and more. Search by category or browse blog posts.

PsyberGuide | A nonprofit organization that discovers and reviews mental health apps, which are rated as unacceptable, questionable, or acceptable. You can also search target conditions and treatments. Use this site to make recommendations to your clients.

PsychCentral | Articles, news, blogs, forums, interactive quizzes, and more

Self-Care Starter Kit from University at Buffalo School of Social Work | Designed to prevent/treat burnout, this kit includes info on vicarious trauma, assessments, meditations, and helpful links to additional self-care resources

SMI Adviser | Search topics and find resources for SMI. You can also access a variety of free online courses to earn CE credits.

Social Work Helper | Mental health articles and resources

Society for Adolescent Health: Mental Health (ADOLESCENT AND YOUNG ADULT CLINICAL CARE RESOURCES) | Toolkits, apps, guides, manuals, videos, reports, and more

Society for the Advancement of Psychotherapy | Articles, book reviews, and more on relevant topics

Society of Clinical Psychology (Division 12) | A division of the American Psychological Association, this site provides an up-to-date list of evidence-based treatments, and includes links to free assessments, manuals, handouts, etc. for many of the treatments

TherapyAdvisor.org | A searchable database of empirically supported treatments for SUD and MH

Therapy Worksheets | A blog by Will Baum, LCSW, with links to free therapy worksheets

Handouts & Worksheets

CBT for Psychosis & Trauma & Psychosis Handouts | A short list of helpful handouts; this site is also a source for blog posts on psychosis and trauma (by Ron Unger, LCSW)

Centre for Clinical Interventions | Free downloadable workbooks on anxiety, self-esteem, eating disorders, panic, perfectionism, and more

Kim’s Counseling Corner – Therapy and Self-Help Worksheets | Kim Peterson, LPC-S, specializes in child and teen issues, parenthood, play therapy and relationships. She provides links to online worksheets or PDF versions that she has collected over time as a therapist. Topics include abuse, depression, anxiety, self-harm, and more.

Marriage Intelligence: “Love Tools” | Free downloadable worksheets for surviving infidelity, forgiveness, communication, etc.

Mind Tools | Free management, leadership, and personal effectiveness worksheets and tools. (Join the Mind Tools Club for a fee to access additional tools and online courses.)

Oxford Clinical Psychology: Forms and Worksheets | A vast collection of forms, handouts, and assessments on anxiety, OCD, depression, parenting, substance use, and more

Psychology Tools | Psychology Tools is a leading online resource for therapists. Download free worksheets, assessments, and guides.

PsychPoint | Articles and worksheets

Therapist Aid | An extensive collection of free evidence-based education and therapy tools. Download customizable worksheets or access articles and treatment guides. An invaluable resource for therapists.

Ultimate Solution Handouts | Free printable handouts for therapists (from Judith Belmont)

UW Medicine: Harborview Medical Center (Center for Sexual Assault and Traumatic Stress) | Handouts/worksheets for clients on coping with challenging thoughts, anxiety, anger, etc. The site also includes a list of assessments.


For additional sites, see Sites with Free Worksheets & Handouts.

For free resources posted on this site, click here.

social media Groups & Forums

Continuing Ed Collective (Facebook)

Counseling Psychology (Reddit)

Marriage & Family Therapists (Facebook)

Professional Mental Health Counselors, Social Workers, & Psychologists (Facebook)

Psychology (Reddit)

Psychotherapy: A Place for Therapists (Reddit)

A Spot for Social Workers… (Reddit)

Therapist Toolbox (Facebook)

Training Resource Group for Mental Health Professionals (Facebook)

12-Step Recovery Groups

(Updated 5/21/20) An extensive list of support groups for recovery

Compiled by Cassie Jewell, M.Ed., LPC, LSATP

There are a variety of 12-step support groups for recovery. 12-step meetings are not facilitated by a therapist; they’re self-run. Support groups are not a substitute for treatment, but can play a crucial role in recovery.

The following list, while not comprehensive, will link you to both well-known and less-familiar 12-step (and similar) organizations and support groups for recovery.

Click below for a downloadable PDF version of this post.

Support Groups for Addiction

Alcoholics Anonymous (AA)

Narcotics Anonymous (NA)

heroin anonymous (HA)

pills anonymous (PA)

Cocaine Anonymous (CA)

Crystal Meth Anonymous (CMA)

Marijuana Anonymous (MA)

Nicotine Anonymous (NicA)

caffeine addicts anonymous (cafaa)

chemically dependent anonymous (CDA)

all addicts anonymous (AAA)

recoveries anonymous (R.a.)

pharmacists recovery network

international doctors in alcoholics anonymous (IDAA)

international lawyers in alcoholics anonymous (ILAA)

association of recovering motorcyclists (A.R.M.)

For Families and Others Affected by Addiction and Mental Illness

Al-Anon/Alateen (For Family and Friends of Alcoholics)

Nar-Anon (For Family and Friends of Addicts)

Adult Children of Alcoholics (ACA)/Dysfunctional Families

Families Anonymous (FA)

parents anonymous

NAMI Family Support Group (For Adults with Loved Ones Who Have Experienced Mental Health Symptoms)

S-Anon/S-Ateen (For Family and Friends of Sexaholics)

codependents of sexual addiction – COSA (for those whose lives have been affected by another’s compulsive sexual behavior)

gam-anon (for families and friends of gamblers)

Secular Alternatives

SMART Recovery (Self-Management and Recovery Training)

Women for Sobriety

Rational recovery

sECULAR aa

Secular Organizations for Sobriety (SOS)

LifeRing Secular Recovery

Religious Alternatives

Celebrate Recovery

Christians in Recovery

Addictions Victorious

alcoholics victorious

Alcoholics for Christ

overcomers in christ

overcomers outreach

the calix society

jewish alcoholics, chemically dependent persons and significant others (jacs)

BUDDHIST RECOVER NETWORK

REFUGE RECOVERY

Additional Support Groups & Organizations

violence anonymous (VA)

Adult Survivors of Child Abuse Anonymous (ASCAA)

Survivors of Incest Anonymous

lds family services

porn addicts anonymous (PAA)

Sex Addicts Anonymous (SAA)

Sexaholics Anonymous

Sex and Love Addicts Anonymous (SLAA)

sexual compulsives anonymous (SCA)

Sexual recovery anonymous (SRA)

Co-dependents Anonymous (CoDa)

Emotions Anonymous

Dual Recovery Anonymous

Depressed Anonymous

social anxiety anonymous (SPA/Socaa)

PTSD Anonymous

Self Mutilators Anonymous

obsessive compulsive anonymous

obsessive skin pickers anonymous (OSPA)

Clutters Anonymous (CLA)

Overeaters Anonymous (OA)

Food Addicts Anonymous (FAA)

Food Addicts in Recovery Anonymous

Recovery from Food Addiction

Eating Disorders Anonymous (EDA)

Debtors Anonymous (DA)

Underearners Anonymous (UA)

spenders anonymous

Workaholics Anonymous

Gamblers Anonymous

internet & tech addicts anonymous (ITAA)

Online Gamers Anonymous (OLGA)

offenders anonymous

reentry anonymous

GROw in america (peer support for mental illness)

hearing voices network

AA Sites for agnostics and atheists: AA Agnostica and AA Beyond Belief

Image by Jill Wellington from Pixabay

Do you know of a 12-step support group not listed here? Share in a comment!

Why Language Matters: 4 Words/Phrases to Stop Saying

Words have power. They are impactful. They can contribute to stigma and divide humanity. To help fight stigma, change your language.

By Cassie Jewell, M.Ed., LPC, LSATP

Have you ever been called a bitch? A creep? A whore? An idiot? Maybe someone said you were lazy or worthless or stupid. Words can hurt. They have power. (Consider the power of your name spoken aloud… you immediately respond by answering or turning your head… the sound commands your attention and response.)

Furthermore, words are impactful… not only for the person being labeled, but for an entire group of people. They contribute to stigma while fueling biases. They divide humanity. Retard. White trash. Crazy. Junkie. Nigger. Slut. Spic.

A while back, a colleague made a racial slur in my presence. He seemed unaware, so I gently corrected him; he immediately lashed back, calling me the “PC Police.” Not only did this person perceive the slur as perfectly acceptable, he seemed to have a negative perception of “political correctness.” It was a joke to him: “People need to stop being so sensitive!” (Um, no… maybe people need to stop being degrading to each other!)

Honestly, I have trouble understanding the negativity surrounding political correctness. Why strive for anything other than accuracy? (Especially knowing the power language holds.)

If you side against ignorance and want to end the stigma associated with mental illness, change your language. The following words or phrases contribute to stigma:

“Addict”

There are many negative connotations surrounding this word. Similarly, “alcoholic” can be demeaning. A person who is addicted to drugs or alcohol has a medical condition. Instead of calling them an addict (or junkie or tweaker or crackhead), say “individual with a substance use disorder.” Demonstrate the same empathy you would for a person who has cancer or MS or paralysis.

“Schizophrenic”

Don’t label a person who suffers from mental illness. They are more than the disorder they’re afflicted with. Calling someone “schizophrenic” or “borderline” or “bipolar” reduces them to an illness, not a person. It’s dehumanizing.

“Retarded”

True, “mental retardation” used to be the diagnostic terminology for classifying individuals with lower IQs. Today, however, it’s mostly used as an insult. The American Psychiatric Association has eliminated the term as a classification; the correct term is “intellectual disability.”

“Committed suicide”

This phrase suggests that the person who dies by suicide is criminal. Criminals commit crimes. An individual who dies by suicide should not be placed in the same category. Instead, say “died by suicide.” This demonstrates respect for both the individual and their loved ones.


Words have the power to influence and shape the world. You have power. Be a positive influence and choose to fight stigma instead of contributing to the toxicity.

#JunkieLivesDontMatter

A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more DESERVING lives.) “Junkies” don’t deserve second chances because #JunkieLivesDontMatter

By Cassie Jewell, M.Ed., LPC, LSATP

Disclaimer: If you happen to believe that addiction is a choice – “They’d quit if they really wanted to” or “They made the choice to use; they made the choice to die” – then scroll on to the next blog. You’d only scoff at this post because #JunkieLivesDontMatter

This blog post is inspired, in part, by a Facebook meme.

The meme said,

“So if a kid has an allergic reaction the parents have to pay a ridiculous price for an Epi pen. But a junkie who has OD’d for their 15th time gets Narcan for free? What a screwed up world we live in.”

Implications: “Junkies” don’t deserve a second chance at life. They’re a waste of resources because they lack the willpower to stop using. A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more deserving lives.)

If you believe it’s screwed up for a “junkie” to have a chance at life (and recovery) because they “chose addiction,” your opinion is contrary to the National Institute of Health, the American Medical Association, the American Psychiatric Association, and decades of scientific research. You’re either ignorant (maybe willfully so) or impressively arrogant. (Alternately, you could just be a jerk.) You’re a part of the movement: #JunkieLivesDontMatter

Many have joined the movement, as evidenced by the following Facebook posts:

“Out of all of the houses, 2 hobos decided to overdose on my front steps… thank god the medics got here in time to ensure they could die another day…”

“I think we had less ODs before Narcan came on board. They realize they can be saved if gotten to in time. Maybe they need to be locked up & not let out until they attend rehab while in jail.”

“If it can be easily established that they have a recent history of drug [abuse]… then yes… withhold the lifesaving drug because they chose this. It’s harsh, but justice is not served by saving them.”

“If you don’t have it figured [out] by the 3rd overdose, you are just prolonging the inevitable and wasting tax payers money.”

“If we are repeatedly saving your life and you are not willing to change this behavior, why should we be obligated to keep saving you?”

“My personal opinion is we can’t keep letting people overdose and saving them just so they can repeat the cycle.”

“By continuously administering Narcan, sure, we’re saving their life, but are they really living? I don’t think so.”

#JunkieLivesDontMatter

“No CPR for You, Fatty — You Chose Soda and Fast Food… Now Suffer the Consequences!”

According the the American Psychiatric Association,

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems.

Addiction is a scientifically proven brain disease. Despite this, many persist in the belief that it’s a choice, or worse… a moral failing. (Note: This notion comes from an early model of addiction, “the moral model,” which was deeply rooted in religion. Addiction was attributed to a sinful nature and weakness of character. Therefore, the addict must repent… or suffer the consequences of his/her actions; addiction warranted punishment, not empathy. Unsurprisingly, this created stigma. It also prevented those struggling with addiction from seeking treatment. Centuries later, many hold on to the view that an individual suffering from a substance use disorder is lazy or weak.)

Today, in the midst of the opioid epidemic, stigma’s unrelenting grip perseveres. Stigma is a poison; it’s dehumanizing. It’s easy to forget a person is a person when you view them as garbage, trash… a “junkie.” Stigma tells us, “Take out the trash.”

To fully recognize stigma’s impact, compare addiction to other diseases. Consider common medical emergencies; many are related to lifestyle. Imagine being hospitalized after your third stroke, and the doctor telling you, “This is the third time I’ve saved your life, yet you refuse to exercise. I shouldn’t be obligated to continue to provide life-saving care.” Or, imagine a long-time smoker who develops lung cancer; they’re not demeaned, called names, or denied treatment. Moreover, an EMS worker wouldn’t withhold CPR from an individual in cardiac arrest if they were obese. It’s not a debate.

If You’re Dead, You Have a 0% Chance of Recovery

We’re in the midst of an epidemic.

According to the CDC, 115 Americans die from an opioid overdose every day.

In 2016, over 42,000 individuals died from opioid overdose.

Life expectancy in America is actually declining due to an increase in fatal overdoses.

Narcan does not enable addiction. It enables life. (A dead addict can’t recover.)

#Recovery #Empathy #FightStigma #EndTheEpedemic #SaveALife


If you live in Fairfax County, sign up for a free REVIVE! Training!

Helping Vs. Enabling: How to Tell the Difference

If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity.” When applied to substance use, it means a person in active addiction is provided with the means to continue to use. With substance use disorders, how can you know the difference between helping and enabling? This post explains how to tell the difference and provides 7 tips for helping a loved one who struggles with addiction.

By Cassie Jewell, M.Ed., LPC, LSATP

With substance use disorders, how can you know the difference between helping and enabling? I’ve worked with family members who inadvertently fueled their loved one’s addiction. They “helped” by bailing them out of jail, giving them money, etc., which only permitted the individual to continue to get high. It’s hard for family members to differentiate between behaviors that help versus enable.

If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity” or “to make possible, practical, or easy” (according to Merriam-Webster). When applied to substance use, it means a person in active addiction is provided with the means to continue to use.

When I worked at a substance use treatment center, I taught families and loved ones that helping a person in active addiction means supporting their basic needs, such as food, water, shelter, and clothing. (If someone is in jail or treatment, their basic needs are met; therefore, bailing them out would be enabling.) Thinking in terms of “needs vs. wants” helps you to recognize enabling.

Recently, I answered a woman’s question on Quora about how to distance herself from her heroin-addicted daughter. The following paragraph is from my response:

Distancing yourself (or setting a boundary) with your daughter will be difficult because you want to help. In the past, by “helping” her, you’ve enabled her addiction (which hurts her in the long run) and leaves you emotionally depleted. There’s a very fine line between helping and enabling; it’s not clear-cut. (Plus, it can be counterintuitive for a parent whose job has always been to protect your child.)

When a parent has a son or daughter who struggles with addiction, it’s especially difficult to make the distinction between helping and enabling. A parent’s natural inclination is to nurture and protect from harm. It’s heart-wrenching to see your child in pain. But if a parent doesn’t set (and adhere to) healthy boundaries, they will quickly become emotionally drained (as they enable their child’s addiction).

Here are some suggestions for helping (instead of enabling) a loved one who’s actively using:

  1. Never (ever) offer money.

If asked for cash for food, for example, buy groceries instead (or offer to take them to lunch). I worked with a father who bought a bag of groceries for his son, who struggled with severe alcoholism and was homeless, on a weekly basis. This is an excellent example of helping a loved one versus enabling their addiction.

  1. If asked for help paying bills, say no. 

If your loved one doesn’t have to pay the electric bill, they’ll spend the money on drugs or alcohol. Furthermore, if you protect them from the consequences of not paying bills (i.e. having the power shut off), your loved one is less likely to see a need for change. (People don’t change when they’re comfortable.)

  1. If your loved one is addicted to opioids (heroin, morphine, hydrocodone, etc.), attend a training or take an online course on opioid overdose reversal (Narcan [naloxone] administration).

If you’re unsure where local trainings are offered, a Google search for “Narcan training” or “opioid reversal training” will link you to resources in your area. Most trainings are free. Keep a Narcan kit on your person at all times. Provide your loved one with a kit (or two) as well. This is not enabling. This is potentially saving a life and offering an opportunity for recovery. (A dead opioid-user will never recover.)

  1. Offer to help them get into treatment.

Become familiar with the different treatment options in your area. Don’t give ultimatums (i.e. “If you don’t get treatment, I’ll divorce you”) or make threats (especially if you’re not willing to follow through). Be supportive, not judgmental. Be patient; when your loved one is emotionally and physically drained from addiction’s painful consequences (or when they hit “rock bottom”), they may decide it’s time to get help. And you’ll be ready.

  1. Recognize that your loved one is not the same person they were before addiction.

Substance use disorder is a debilitating disease that damages the brain; it changes how a person feels and thinks. With addiction, the brain’s reward center is rewired, resulting in a biological “need” for drugs/alcohol. (Compare this to your need for food or water or air.) Your loved one’s addiction will lie to you; they will do whatever it takes to get their “needs” met. Your loved one’s addiction will steal from you. (Lock up your valuables if they have access to your home… and even if they don’t. I’ve worked with more than a few individuals who have broken into their parents’ home for either money for drugs or valuables to pawn for money for drugs.) Your loved one’s addiction will betray you. Accepting the nature of addiction allows you to set healthy boundaries.

  1. Attend Al-Anon or Nar-Anon meetings.

By engaging with others with similar struggles, you’ll learn more about supporting your loved one (without enabling their addiction). You’ll also build a supportive network by connecting with others, strengthening your emotional health.

  1. When in doubt, try asking yourself one (or all) of the following questions:

Will my actions allow my loved one to continue to drink or use? Is this a “want” versus a basic need? Will my actions prevent them from experiencing a natural consequence? If the answer is yes, it’s probably enabling.

Addiction is a devastating, but treatable, disease. The road to recovery is difficult and long (with many detours). If your loved one has a substance use disorder, be kind and compassionate; they’re in an unthinkable amount of pain. They didn’t choose addiction. The best way to support them is by setting healthy boundaries to ensure you’re not enabling continued use. Boundaries allow you to help them without furthering their addiction. Boundaries also serve as protection for you and your emotional health; you’re in no position to help if you’re emotionally, financially, and spiritually depleted.


Please share in a comment your suggestions for helping a loved one who is struggling with addiction.

Free Online Assessment & Screening Tools for Mental Health

(Updated 5/4/20) A list of sites with a variety of assessment tools for mental health and related issues, including mood disorders, relationship attachment styles, suicide risk, communication skills, and domestic violence. This list includes both self-assessments and screening tools for clinicians to administer and score.

Compiled by Cassie Jewell, M.Ed., LPC, LSATP

The following list will link you to a variety of mental health assessments and screenings for clinicians or for self-assessment. While an assessment cannot take the place of a clinical diagnosis, it can give you a better idea if what you’re experiencing is “normal.” (For additional screening tools to use with couples, see Marriage & Relationship Assessment Tools.)

Free Online Assessment & Screening Tools for Mental Health

The 5 Love Languages | A PDF assessment

20 Questions: Are You a Compulsive Gambler? | A short interactive self-assessment  

20 Question Self-Assessment for Healthy Boundaries | Downloadable PDF assessment created by Dr. Jane Bolton, scoring instructions not included

ACE Questionnaire | Adverse childhood experiences (ACEs) are associated with a variety of health (both physical and mental) conditions in adults. To find your ACE score, take an interactive quiz. Learn more about ACEs on the CDC’s violence prevention webpage. You can also download the international version (PDF) from the World Health Organization’s Violence and Injury Prevention webpage.

ADAA Screening Tools | The Anxiety and Depression Association of America provides links to both printable and interactive tests for depression, generalized anxiety disorder, OCD, panic disorder, PTSD, social anxiety disorder, and specific phobias. This site does not provide test results. (It’s recommended that you print your results to discuss with a mental health practitioner.) This is an excellent resource for clinicians to print and administer to clients.  

The Addiction Severity Index (ASI) – 5th Edition | PDF version, scoring instructions not included

Adult ADHD Assessment Tools | Links to a PDF toolkit for clinicians. Includes Adult ADHD Self-Report Scale-V.1.1. (ASRS-V1.1) Symptom Checklist,  Adult ADHD Self-Report Scale-V1.1. (ASRS-V1.1) Screener (English), Adult ADHD Self-Report Scale-V1.1. (ASRS-V1.1) Screener (Spanish),  Barkley’s Quick-Check for Adult ADHD Diagnosis (Sample),  Brief Semi-Structured Interview for ADHD in Adults,  Weiss Functional Impairment Rating Scale Self-Report (WFIRS-S), ADHD Medication Side Effects Checklist, Medication Response Form, Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HDRS), and CAGE Questionnaire Adapted to Include Drugs

AlcoholScreening.org | An interactive test that gives personalized results based on age, gender, and drinking patterns

Assessment Instruments Developed at the Center for Trauma and the Community | Access the Trauma History Questionnaire and the Stressful Life Events Screening Questionnaire

The Attachment Style Assessment | Interactive assessment; you must submit your email to see your results

Attachment Styles and Close Relationships | Interactive surveys to determine attachment style

Behavioral Activation for Depression Scale | PDF assessment with scoring instructions

Berkeley Personality Lab Measures

Borderline Symptom List and Scoring Instructions | (Source: University of Washington Center for Behavioral Technology) Citations: Bohus M., Limberger, M. F., Frank, U., Chapman, A. L., Kuhler, T., Stieglitz, R. D. (2007). Psychometric Properties of the Borderline Symptom List (BSL). Psychopahology, 40, 126-132.

The Brief Fear of Negative Evaluation Scale (BFNE) | A one-page PDF that can be completed online or printed, scoring instructions not included

Buss Lab Research Instruments | Assessments on friendship, sex, jealousy, etc.

Career Assessments | Self-assessments to assess interests, skills, and work values

Child and Adolescent Instruments (Bipolar Spectrum Services: University of Pittsburgh) | Assessments for mania, depression, and mood

The Clinical Anger Scale (CAS) | A PDF scale to measure anger; scoring instructions are not included

Clutter Image Rating | A PDF interactive test to assess for hoarding disorder

Columbia-Suicide Severity Rating Scale | A PDF version of the scale

Communication Research Measures | A collection of assessments

Communications Style Questionnaire | Determine if you’re an activist, a pragmatist, a theorist, or a reflector (PDF with scoring instructions)

The COPE Inventory | A PDF scale to assess the different ways people respond to stress

The Couples Satisfaction Index (CSI) | A PDF assessment to measure relationship satisfaction

CSDS DP Infant-Toddler Checklist | A PDF printable checklist for identifying early warning signs of autism

The Decision Making Individual Differences Inventory

Demographic Data Scale | (Source: University of Washington Center for Behavioral Technology) A self-report questionnaire used to gather extensive demographic information from the client. Citations: Linehan, M. M. (1982). Demographic Data Schedule (DDS). University of Washington, Seattle, WA, Unpublished work.

Depression Self-Assessment | A simple self-assessment tool from Kaiser. Results are provided on a spectrum, ranging from “None” to “Severe” depression.

Diane Poole Heller’s Attachment Styles Test | Interactive assessment; you must submit your email to see your score

Diary Cards NIMH S-DBT Diary Card NIDA Diary Card CARES Diary Card | (Source: University of Washington Center for Behavioral Technology)

Domestic Violence Screening Quiz (from PsychCentral) | Interactive test to determine if you’re involved in a dangerous abusive relationship

DrugScreening.org | An interactive test that provides feedback about the likely risks of your drug use and where to find more information, evaluation, and help

Danger Assessment Screening Tool | Clinicians can download this PDF version of the assessment, which helps predict the level of danger in an abusive relationship; this screening tool was developed to predict violence and homicide.

DBSA Mental Health Screening Center | The Depression and Bipolar Support Alliance offers screening tools for both children and adults (including versions for parents to answers questions about their child’s symptoms). Take an online assessment for depression, mania, and/or anxiety.

DBT-WCCL Scale and Scoring | (Source: University of Washington Center for Behavioral Technology) Citations: Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010). The Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL).: Development and Psychometric Properties. Journal of Clinical Psychology, 66(61), 1-20.

Deliberate Self-Harm Inventory | Measurement of deliberate self-harm (PDF)

The Drinker’s Checkup | Interactive screening tool

Drinking Patterns Questionnaire | A 28-page PDF assessment, can be completed online or printed. No scoring instructions, find more information here

Drug Abuse Screening Test DAST-10 | For clinician use, a PDF version of the DAST-10 – does not give results or scoring instructions

EAP Lifestyle Management Self-Assessments | A small collection of screening tools

Emotional Regulation Questionnaire (ERQ) | A short PDF scale to assess emotional regulation

Family Accommodation Scale – Anxiety | Family Accommodation Scale – Anxiety (Child Report) | PDF scales, scoring instructions not included

Financial Well-Being Questionnaire | Take this 10-question interactive test and receive a score (along with helpful financial tips)

The Gottman Relationship Checkup Sign up for a free account to access the online interactive assessment

Grief and Loss Quiz (from PsychCentral) | Take this test to learn if you may be suffering from complicated grief

Grit Scale | Several versions available

Happiness Test (from Psychology Today) | A 20-minute interactive test – free snapshot report with the option to buy the full report for $4.95

Helpful Questionnaires from James W. Pennebaker | Topics are varied

The HEXACO Personality Inventory – Revised | Download either the 60-item or 100-item version to assess for six personality dimensions.

Hoarding Rating Scale | A PDF scale to assess for hoarding symptoms

Imminent Risk and Action Plan | Assessment/plan from the University of Washington Center for Behavioral Technology

Interactive Behavioral Couple Therapy Questionnaires | 5 downloadable PDF assessments for couples

Initial Trauma Review – Revised (ITR-R) | A behaviorally-anchored, semi-structured interview that allows the clinician to evaluate most major forms of trauma exposure

Instruments from Foley Center for the Study of Lives

Integrated Biopsychosocial Assessment Form | A 16-page PDF assessment form

Interpersonal Communication Skills Inventory | A PDF self-assessment designed to provide insight into communication strengths and areas for development. Includes scoring instructions.

Introversion Scale | PDF questionnaire for introversion

Inventory of Depressive Symptomatology (Self-Report) (IDS-SR) | Quick Inventory of Depressive Symptomatology (Clinician-Rated) (QIDS-CR) Two versions of the this assessment, both PDF, scoring instructions not included

Keirsey | Take this interactive assessment to learn your temperament. (There are four temperaments: Artisan, Guardian, Idealist, and Rational.) My results were consistent with my Myers-Brigg personality type. (Note: You must create an account and enter a password to view your results.)

Lamar Soutter Library: Behavioral Tests | A collection of psychiatric assessments

Learn Your Love Language | Choose your version: Couples, Children’s Quiz, Teens, or Singles. An online assessment to determine your primary love language. (You are required to enter your information to get quiz results.)

Library of Scales (from Outcome Tracker) | 25 psychiatric scales (PDF documents) to be used by mental health practitioners in clinical practice. Includes Frequency, Intensity, and Burden of Side Effects Ratings; Fagerstrom Test for Nicotine Dependence; Fear Questionnaire; Massachusetts General Hospital Hair Pulling Scale; and more. (Note: Some of the assessments have copyright restrictions for use.)

Liebowitz Social Anxiety Scale | Take an interactive self-assessment (from the National Social Anxiety Center) to assess for social anxiety (PDF version)

Lifetime – Suicide Attempt Self-Injury Count (L-SASI) Instructions Scoring | (Source: University of Washington Center for Behavioral Technology) The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citations: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work.

Lineham Risk Assessment and Management Protocol | (Source: University of Washington Center for Behavioral Technology) Linehan, M. M. (2009). University of Washington Risk Assessment Action Protocol: UWRAMP, University of WA, Unpublished Work.

Love Attitudes Scale | Link to a Word version of this scale that measures different love styles

Marital Satisfaction Scale | A PDF assessment to evaluate marital satisfaction; click on link listed in “Interactive Section for Couples”

Measurement Instrument Database for the Social Sciences | A searchable database

Measure of Attachment Qualities | Measures adult attachment styles (PDF)

Measures and Scales by University of Utah Psychology Faculty

Measures from Self and Social Motivation Lab | Assessments for self-worth and compassion

Mental Health Screening Tools | Online screenings for depression, anxiety, bipolar, psychosis, eating disorders, PTSD, and addiction. You can also take a parent test (for a parent to assess their child’s symptoms), a youth test (for a youth to report his/her symptoms), or a workplace health test. The site includes resources and self-help tools.

Mid-Ohio Psychological Services, Inc. Assessment Tools | A modest collection of assessments and screening tools on aggression, family violence, sobriety, etc.

Modified Checklist for Autism in Toddlers, Revised, with Follow-Up | Free download and scoring instructions

The Mood Disorder Questionnaire | A PDF screening tool for clinicians to assess symptoms of bipolar disorder

The National Sleep Foundation Sleepiness Test | An interactive test to assess if you are more or less sleepy than the general population

Need to Belong Scale | Link to a PDF version of this short assessment for measuring the need to belong

NORC Diagnostic Screen for Gambling Disorders Self-Administered (from the National Council on Problem Gambling) | An interactive 10-question test to assess gambling behaviors

Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool created by Cornell Research Program on Self-Injury and Recovery

Open Source Psychometrics Project | This site provides a collection of interactive personality and other tests, including the Open Extended Jungian Type Scales, the Evaluations of Attractiveness Scales, and the Rosenberg Self-Esteem Scale. On the whole, I’m doubtful of the scientific accuracy of the assessments. (For example, I took the site’s DISC assessment; my score did not match the score I received when I took the certified test through my employer.) Furthermore, the site’s “About” section maintains, “[The site] exists to educate the public… and also to collect research data.” (Collect research data? For who/what?) I would recommend using the site mainly for entertainment purposes (or not at all if you’re concerned about how your personal data is handled).

Parental Affect Test | (Source: University of Washington Center for Behavioral Technology) The Linehan Parental Affect Test is a self-report questionnaire that assesses parent responses to typical child behaviors. Citations: Linehan, M. M., Paul, E., & Egan, K. J. (1983). The Parent Affect Test – Development, Validity and Reliability. Journal of Clinical Child Psychology, 12, 161-166.

Patient Health Questionnaire Screeners | This is a great diagnostic tool for clinicians. Use the drop down arrow to choose a PHQ or GAD screener (which assesses mood, anxiety, eating, sleep, and somatic concerns). The site generates a PDF printable; you can also access the instruction manual. No permission is required to reproduce, translate, display or distribute the screeners.

Perceived Stress Scale (PSS) | Links to Word version of this assessment and scoring information

Personal Anger Assessment | An online interactive assessment to determine your anger style. (You must enter your personal information to view the results.)

Personality Scales | 2 Word-document assessments

Personality Tests | A collection of assessments

Project Implicit | A variety of interactive assessments that measures your hidden biases

Psychological Tests from Delroy L. Paulhus | A modest collection of tools

Psychology Scales from Stephen Reysen | Topics are varied

Psychology Tools | Online self-assessments for addiction, ADHD, aggression, anxiety, autism spectrum, bipolar, depression, eating disorders, OCD, and personality.

Reasons for Living Scale Scoring Instructions | RFL Scale (long form – 72 items) | RFL Scale (short form – 48 items) | RFL Scale (Portuguese) | RFL Scale (Romanian) | RFL Scale (Simplified Chinese) | RFL Scale (Traditional Chinese) | RFL Scale (Thai) | (Source: University of Washington Center for Behavioral Technology) The RFL is a self-report questionnaire that measures clients’ expectancies about the consequences of living versus killing oneself and assesses the importance of various reasons for living. The measure has six subscales: Survival and Coping Beliefs, Responsibility to Family, Child-Related Concerns, Fear of Suicide, Fear of Social Disapproval, and Moral Objections. Citations: Linehan M. M., Goodstein J. L., Nielsen S. L., & Chiles J. A. (1983). Reasons for Staying Alive When You Are Thinking of Killing Yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51, 276-286.

Recovery Assessment Scales | A variety of assessments for individuals recovering from psychiatric illnesses

Relationship Assessment Scale | PDF assessment with scoring instructions; pages 11-13 of the PDF

Revised Gratitude Resentment and Appreciation Test | Access Word versions of the revised or short GRAT to measure dispositional gratitude

Risk-Taking Test (from PsychTests) | Self-test to assess your risk-taking behaviors – Receive a snapshot report with an option to buy the full report

Romantic Attachment Quiz (from PsychCentral) | A 41-item quiz to help you determine your romantic attachment style in relationships

Rosenberg Self-Esteem Scale | PDF scale with scoring instructions; interactive version here

SAMHSA Screening Tools | Valid and reliable screening tools for clinicians. This sites links you to PDF versions of assessments/screenings for depression, drug/alcohol use, bipolar disorder, suicide risk, anxiety disorders, and trauma.

The SAPA Project | SAPA stands for “Synthetic Aperture Personality Assessment.” This online personality assessment scores you on 27 “narrow traits,” such as order, impulsivity, and creativity in addition to the “Big Five” (Agreeableness, Conscientiousness, Extraversion, Neuroticism, and Openness). You’re also scored on cognitive ability. This test takes 20-30 minutes to complete and you will receive a full report when finished.

Saving Inventory – Revised | A PDF interactive inventory to assess for hoarding

Scales from the Motivated Cognition Lab

SCOFF (A Quick Assessment for Eating Concerns Based on the SCOFF) | A screening tool for eating problems

Screening and Brief Interventions Tools | Several PDF screening tools for substance use

Self-Compassion Scale | Links to a PDF version of the SCS (which assesses self-kindness, self-judgment, mindfulness, and more)

Self-Injury Questionnaire | To assess self-harm (PDF, assessment in appendix)

Severity Assessment | A PDF assessment tool from the Cornell Research Program on Self-Injury and Recovery to assess the severity of non-suicidal self-injury

Sexual Addiction Screening (from PsychCentral) | A brief screening measure to help you determine if you are struggling with sexual addiction

Shyness Scale | Measures shyness (PDF)

Shyness Surveys | Several assessments

Similar Minds | A fun site for personality tests (for entertainment purposes only!)

Sleep Assessments from Sleep and Chronobiology Center (University of Pittsburgh) | Download PDF versions of instruments to assess sleep quality, including the Pittsburgh Sleep Quality Index and the Insomnia Symptom Questionnaire

Sleep Disorders Screening Survey | A short, interactive test to screen for sleep disorders

Social Anxiety Questionnaire for Adults | A PDF questionnaire to assess for social anxiety

Social History Interview (SHI) | (Source: University of Washington Center for Behavioral Technology) The SHI is an interview to gather information about a client’s significant life events over a desired period of time. The SHI was developed by adapting and modifying the psychosocial functioning portion of both the Social Adjustment Scale-Self Report (SAS-SR) and the Longitudinal Interview Follow-up Evaluation Base Schedule (LIFE) to assess a variety of events (e.g., jobs, moves, relationship endings, jail) during the target timeframe. Using the LIFE, functioning is rated in each of 10 areas (e.g., work, household, social interpersonal relations, global social adjustment) for the worst week in each of the preceding four months and for the best week overall. Self-report ratings using the SAS-SR are used to corroborate interview ratings. Citations: Weissman, M. M., & Bothwell, S. (1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111-1115. Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E. C., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987).  The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540-548.

Social Interaction Anxiety Scale (SIAS) | A one-page PDF assessment, scoring instructions not included

Social-Personality Psychology Questionnaire Instrument Compendium (QIC) | A collection of assessments and screening tools

Social Phobia Scale (SPS) | A one-page PDF assessment, scoring instructions not included

SOCRATES | A PDF version of the Stages of Change Readiness and Treatment Eagerness Scale for clinicians to assess readiness to change in alcohol users

Somatoform Dissociation Questionnaire | A PDF assessment, scoring information here

Sorenes Self-Esteem Test | A PDF assessment with scoring instructions

The Spann-Fischer Codependency Scale | A 16-item scale (PDF) to measure codependency

Stanford Medicine WellMD | Self-tests for altruism, anxiety, burnout, depression, emotional intelligence, empathy, happiness, mindfulness, physical fitness, PTSD, relationship trust, self-compassion, sleepiness, stress, substance use, and work-life balance

The Strengths and Difficulties Questionnaire | Links to several downloadable versions of the SDQ, which is designed to measure behavioral issues in children ages 4-17

Stress Self-Assessments (from The American Institute of Stress) | A variety of self-assessments to measure stress

Stress Test (from PsychCentral) | A 5-minute interactive test to measure your stress level

Substance Abuse History Interview | (Source: University of Washington Center for Behavioral Technology) The SAHI is an interview to assess periods of drug use (by drug), alcohol use, and abstinence in a client’s life over a desired period of time. The SAHI combines the drug and alcohol use items from the Addiction Severity Index (ASI) and the Time Line Follow-back Assessment Method to collect information about the quantity, frequency, and quantity X frequency of alcohol and drug consumption. Citations: McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168, 26-33.

Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citations: Addis, M. & Linehan, M. M. (1989). Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy, Washington, D.C.

Suicide Attempt Self-Injury Interview (SASII) SASII Instructions For Published SASII | SASII Standard Short Form with Supplemental Questions | SASII Short Form with Variable Labels | SASII Scoring Syntax | Detailed Explanation of SPSS Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SASII (formerly the PHI) is an interview to collect details of the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of non-suicidal self-injury and suicidal behavior during a target time period. Major SASII outcome variables are the frequency of self-injurious and suicidal behaviors, the medical risk of such behaviors, suicide intent, a risk/rescue score, instrumental intent, and impulsiveness. Citations: Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, Reliability, and Validity of a Scale to Assess Suicide Attempts and Intentional Self-Injury. Psychological Assessment, 18(3), 303-312.

Suicide Risk Screening Tool | One-page PDF screening tool for clinicians (from the National Institute of Mental Health)

Supervisory Relationship Questionnaire (SRQ) | PDF scale with scoring instructions

Survey Instruments and Scales | (Source: CAPS) To assess risky sexual behaviors

Talkaholic Scale | Measures compulsive communication (PDF)

Therapist Interview | (Source: University of Washington Center for Behavioral Technology) The TI is an interview to gather information from a therapist about their treatment for a specific client. Citations: Linehan, M. M. (1987). Therapist Interview. University of Washington, Seattle, WA, Unpublished work.

The Toronto Empathy Questionnaire | Click the link to access a Word version of this assessment

Treatment History Interview | Appendices | (Source: University of Washington Center for Behavioral Technology) The THI is an interview to gather detailed information about a client’s psychiatric and medical treatment over a desired period of time. Section 1 assesses the client’s utilization of professional psychotherapy, comprehensive treatment programs (e.g., substance abuse programs, day treatment), case management, self-help groups, and other non-professional forms of treatment. Section 2 assesses the client’s utilization of inpatient units (psychiatric and medical), emergency treatment (e.g., emergency room visits, paramedics visits, police wellness checks), and medical treatment (e.g., physician and clinic visits). Section 3 assesses the use of psychotropic and non-psychotropic medications. Citations: Linehan, M. M. &, Heard, H. L. (1987). Treatment history interview (THI). University of Washington, Seattle, WA, Unpublished work. Therapy and Risk Notes – do not use without citation. For clarity of how to implement these items, please see Cognitive-Behavioral Treatment of Borderline Personality Book, Chapter 15.

TTM Measures from the HABITS Lab | To assess for self-efficacy, decision-making, process of change, etc.

University of WA Suicide Risk/Distress Assessment Protocol | (Source: University of Washington Center for Behavioral Technology) Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky Assessments: Participant Suicidality and Distress Associated with Research Assessments in a Treatment Study of Suicidal Behavior. Suicide and Life-Threatening Behavior (36)1, 19-33. Linehan, M. M., Comtois, K. A., &, Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232.

Wellness Self-Assessment | A PDF-version of Princeton University’s tool to measure your wellness in seven dimensions (emotional, environmental, intellectual, occupational, physical, social, and spiritual) – Calculate your results and then create an action plan.

Work-Life Balance Scale | An online interactive tool to assess your work-life balance

The World Sleep Study | Take this short test to learn your sleep score and then answer additional questions to create a sleep profile

Yale Food Addiction Scale | PDF scale and scoring instructions


If you know of a free online assessment for mental health that’s not listed in this post, please share in a comment! Contact me if a link is not working.

Where Can I Find Help?

Where can you find the help you need? While there are plenty of resources out there for mental health and recovery, they’re not always easy to find… or affordable. (Plus, the Internet is full of scams!) This article is a starting point for getting help when you aren’t sure where to turn. This post offers practical guidelines; all of the resources in this article are trustworthy and reliable… and will point you in the right direction.

By Cassie Jewell, M.Ed., LPC, LSATP

This post is not comprehensive; rather, it’s a starting point for getting the help you need. There are plenty of resources out there for mental health and recovery, but they’re not always easy to find (or affordable). The resources in this post are trustworthy and reliable… and will point you in the right direction.

If you need treatment for mental health or substance use, but aren’t sure how to find it…

If you have insurance, check your insurer’s website.

For substance use and mental health disorders, you can access the SAMHSA treatment locator. You can find buprenorphine treatment (medication-assisted treatment for opioid addiction) through SAMHSA as well.

Consider using Mental Health America’s interactive tool, Where to Get Help. NeedyMeds.org also has a locator to help you find low-cost mental health and substance abuse clinics.

Additionally, you could contact your local Mental Health America Affiliate for advice and/or referrals.

If you can’t afford therapy…

EAP (employee assistance programs) frequently offer free (time-limited) counseling sessions.

At campus counseling centers, grad students sometimes offer free or low-cost services.

You could look into community mental health centers or local churches (pastoral counseling).

In some areas, you may be able to find pro bono counseling services. (Google “pro bono counseling” or “free therapy.”) You may also be able to connect with a peer specialist or counselor (for free) instead of seeing a licensed therapist.

As an alternative to individual counseling, you could attend a support group (self-help) or therapy group; check hospitals, churches, and community centers. The DBSA peer-lead support group locator tool will help you find local support groups. Meetup.com may also have support group options.

Additional alternatives: Consider online forums or communities. Watch or read self-help materials. Buy a workbook (such as The Cognitive Behavioral Workbook for Depression: A Step-By-Step Program) from amazon.com. Download a therapy app.

Lastly, you could attend a free workshop or class at a local church, the library, a college or university, a community agency, or a hospital.

If you’re under 18 and need help, but your parents won’t let you see a counselor (or “don’t believe in therapy”)…

Some, but not all, states require parental consent for adolescents to participate in therapy. Start by looking up the laws in your state. You may be able to see a treatment provider without consent from a legal guardian. If your state is one that mandates consent, consider scheduling an appointment with your school counselor. In many schools, school counseling is considered a regular educational service and does not require parental consent.

Self-help groups, while not a substitute for mental health treatment, provide a venue for sharing your problems in a supportive environment. (If you suffer from a mental health condition, use NAMI to locate a support group in your state. If you struggle with addiction, consider AA or NA.)

Alternatively, you could join an online forum or group. (Mental Health America offers an online community with over 1 million users and NAMI offers OK2Talk, an online community for adolescents and young adults.)

You could also contact a Mental Health America Affiliate who would be able to tell you about local resources and additional options.

If you’re in crisis, call the Boys Town Hotline at 1-800-448-3000 or the National Suicide Prevention Hotline at 1-800-273-TALK. Alternatively, you can text HOME to 741741 to text with a trained crisis counselor.

Lastly, consider talking with your pastor or a trusted teacher, reading self-help materials, downloading a therapy app, journaling, meditation or relaxation techniques, exercising, or therapy podcasts/videos.

If a loved one or friend says they’re going to kill themselves, but refuses help…

Call 911. If you’re with that person, stay with them until help arrives.

If you are thinking about or planning suicide…

Call the National Suicide Prevention Lifeline or Veterans Crisis Line. Alternatively, you can text HOME to 741741 to text with a trained crisis counselor. Call 911 if you think you might act. 

If you are grieving…

Check local hospitals and churches for grief support groups; some areas may have nonprofits that offer free services, such as Let Haven Help or Community Grief and Loss Center in Northern Virginia.

Additionally, a funeral home or hospice center may be able to provide resources.

If you are a veteran, you and your family should be able to access free counseling through the VA.

The Compassionate Friends offers support after the loss of a child. Call for a customized package of bereavement materials (at no charge) or find a support group (in-person or online).

GRASP is a grief and recovery support network for those who have lost a loved one through substance use. You can find suicide support groups using the American Association of Suicidology’s directory or the American Foundation for Suicide Prevention’s support group locator.

Hello Grief provides resources and education for children and adolescents who are grieving.

There are also online communities, forums, and support groups, including groups for suicide survivors such as Alliance of Hope and Parents of Suicides – Friends and Families of Suicides.

If you are a victim of sexual assault or domestic violence…

If you are sexually assaulted, call 911 or the National Sexual Assault Hotline at 1-800-656-4673 (or live chat). Find help and resources at National Sexual Violence Resource Center.

For male survivors of sexual abuse: MaleSurvivors.org

For domestic violence: The National Domestic Violence Hotline

For gender-based violence: VAWnet

For teen dating abuse: LoveIsRespect or Break The Cycle

LGBTQ: National Coalition of Anti-Violence Programs for LGBT Communities

If you’re a victim of sex trafficking…

Access Coalition to Abolish Slavery and Trafficking or call National Human Trafficking Hotline at 1-888-373-7888 (or text 233733).

 

If you’re a victim of or stalking…

If you believe you are in immediate danger, call 911. Find help and info at Stalking Resource Center and Stalking Awareness Month.

 

If you can’t stop gambling…

Call or text the National Problem Gambling Helpline at 1-800-522-4700. Access screening tools and treatment at National Council on Problem Gambling. Attend a Gamblers Anonymous Group or other support group for problem gambling.

If you or a loved one has an eating disorder…

If you want to approach a loved one about his or her eating disorder, start by reading some guidelines (such as Helping Someone with an Eating Disorder from HelpGuide.org).

Contact the National Eating Disorders Helpline at 1-800-931-2237. (Alternatively, there’s a “live chat” option.) For support, resources, screening tools, and treatment options, explore the National Eating Disorder Association site.

Find support groups, recovery tools, and local treatment centers at Eating Disorder Hope.

Attend an Eating Disorders Anonymous meeting (in-person or online). You may also want to consider an Overeaters Anonymous meeting.

 

If you are engaging in self-harm and can’t stop…

Call 1-800-DONT-CUT or attend an online support group, such as Self Mutilators Anonymous.

Read personal stories, learn coping skills, and access resources at Self-injury Outreach and Support.

Join an online community like RecoverYourLife.com.

Try one of these 146 things to do instead of engaging in self-harm from the Adolescent Self Injury Foundation.

 

If you’re concerned about the drinking or drug use of a friend or family member, but they don’t want help…

If you’re considering staging an intervention, know that there’s little to no evidence to support the effectiveness of this tactic. 

Instead, read guidelines for approaching the issue (like What to Do If Your Adult Friend or Loved One Has a Problem with Drugs or How to Talk about Addiction). Learn everything that you can about addiction. Explore treatment centers in the area; if your loved one changes their mind, you’ll be prepared to help.

Explore Learn to Cope, a peer-led support network for families coping with the addiction of a loved one. Alternatively, you could attend Al-Anon or Nar-Anon.

Keep in mind that it’s almost impossible to help someone who doesn’t want it. You can’t control your loved one or force them into treatment. Instead, find a way to accept that there’s no logic to addiction; it’s a complex brain disorder and no amount of pleading, arguing, or “guilting” will change that.

If a friend or family member overdoses on heroin or other opioid…

Call 911 immediately.

How to recognize the signs of opiate overdose: Recognizing Opiate Overdose from Harm Reduction Coalition

You can receive free training to administer naloxone, which reverses an opioid overdose. Take an online training course at Get Naloxone Now. You can purchase naloxone OTC in most states at CVS or Walgreens.

For more information about how to respond to an opioid overdose, access SAMHSA’s Opioid Overdose Prevention Toolkit (for free).

 

If you want to quit smoking…

In addition to talking to your doctor about medication, the patch, and/or nicotine gum, visit Smoke FreeBe Tobacco Free, or Quit.com for resources, tools, and tips.

Call a smoking cessation hotline (like 1-800-QUIT-NOW) or live chat with a specialist, such as LiveHelp (National Cancer Institute).

Download a free app (like QuitNow! or Smoke Free) or sign up for a free texting program, like SmokefreeTXT, for extra support.

Attend an online workshop or participate in a smoking cessation course; your insurance provider may offer one or you may find classes at a local hospital or community center. You could also contact your EAP for additional resources.

If you or a loved one have a hoarding problem…

Read guidelines for approaching a hoarding issue with someone such as Hoarding: How to Help a Friend.

Learn more about hoarding and find help (support groups, treatment, etc.) at Hoarding: Help for Hoarding.

 

If your therapist is making unwanted sexual remarks/advances…

Contact the licensing board to file a complaint. Each state has a different licensing board. Additionally, contact the therapist’s professional association (i.e. American Counseling AssociationAmerican Psychological Association, etc.) Provide your name, address, and telephone number (unless filing anonymously). Identify the practitioner you are reporting by his or her full name and license type. Provide a detailed summary of your concerns. Attach copies (not originals) of documents relating to your concerns, if applicable.

Read NAMI’s How Do I File a Complaint against a Mental Health Care Facility or Professional?

 

If you want to take a confidential online assessment for mental health or substance use disorders…

Free and anonymous screenings: Screening for Mental Health, Inc. or Depression and Bipolar Support Alliance Mental Health Screening

For additional sites, self-help guides, literature, etc., check out the resource page.

If you know of a great resource, post in the comments below!


9 Myths & Misconceptions About Mental Illness

Are mentally ill people violent? Can mental illness be overcome through willpower? Is addiction a choice? This post addresses some of the myths and misconceptions about mental illness.

By Cassie Jewell, M.Ed., LPC, LSATP

In this post, I’ll address some of the myths and misconceptions about mental disorders. There continues to be stigma attached to mental illness; and the media is partly to blame. Every time (yet another) mass shooting occurs, the media attributes the act of violence to mental illness. This message is repeated by various news sources and then spread through social media.

Acts of senseless violence are for sure a “sickness,” but they’re not criteria for a diagnosable mental disorder. It’s not fair to compare violent criminals to individuals who struggle with depression, anxiety, schizophrenia, etc.

Mental illness misconceptions run rampant, even within the healthcare professional field. For example, I know a surgeon who believes mental illness isn’t real and a neurologist who uses words like “crazy” and “retarded.” I came across a substance abuse counselor (on Facebook) who believes addiction is a moral failing. I know a social worker who believes that severely mentally ill individuals are more likely to be violent.


Ignorance is at the root of stigma. The more you know, the less you fear, and the less you’ll stigmatize. Read on to learn what’s myth versus fact.

1. Bad parenting causes mental illness.

Even today, there is no single identified cause when it comes to mental illness. Instead, there are multiple risk factors that contribute to mental disorders. The biggest risk factor is genetics. Genes frequently determine whether or not a person develops schizophrenia, depression, substance use disorder, etc. Physiological factors (such as abnormalities in the brain) are a second risk factor.

Environmental factors, such as fetal exposure to a toxin or childhood abuse, are a third risk factor. Childhood abuse undoubtedly falls into the “bad parenting” category, but as a standalone, it can’t cause mental illness.

It’s more likely that a combination of risk factors will lead to the development of a mental disorder.

2. Mental illness is not a medical disease.

Heart disease affects the heart. Colon cancer affects the colon. Autoimmune disorders affect the immune system. Brain disorders (i.e. mental illness, addiction) affect the brain.

You can’t “see” mental health symptoms the way you can see physical health symptoms, but mental illness is without a doubt physiological in nature.

Like other organs, the brain can become diseased, and it manifests as symptoms of mental illness. You can’t “see” mental health symptoms the way you can see physical health symptoms, but mental illness is without a doubt physiological in nature.

3. All sociopaths are dangerous.

The term “sociopath” (or psychopath) is frequently associated with serial killers. The reality is that you probably know a sociopath and he/she isn’t a murderer.

In fact, “sociopathy” and “psychopathy” are no longer recognized diagnoses in the mental health world due to negative connotations. The correct term is “antisocial personality disorder” (ASPD), a mental illness characterized by an ongoing disregard for and violation of the rights of others. An individual with ASPD may also be exceptionally charismatic. (Some of the most charming and engaging clients I’ve ever worked with had ASPD.)

However, research indicates that an individual with ASPD is more likely to become involved in criminal activity,to have a substance use disorder, and to be aggressive; about 50% of individuals with ASPD have some sort of criminal record. While it’s a misconception to say all individuals with ASPD are dangerous, the link between ASPD and crime is not unfounded.

4. Mental illness can be overcome with willpower.

This is 100% myth and a huge pet peeve of mine. It goes hand-in-hand with the belief that mental illness is not a “real” medical condition. A mental disorder typically requires treatment, such as medication and therapy, and ongoing illness management. 

All the willpower in the world won’t help someone “overcome” heart disease. And it doesn’t work that way with mental illness either.

5. Addiction is a choice.

Substance use disorder is no more of a choice than diabetes or cancer. Like most diseases, addiction develops when a combination of genetic, physiological, and environmental factors are present. Lifestyle choices also play a role. Unfortunately, the myth that addiction is a moral failing persists.

An individual who struggles with addiction receives more blame than someone with a heart condition, even though lifestyle choices heavily impact both disorders. I’ve even heard it said that addicts who overdose shouldn’t be revived because it was their “choice” to use. If that’s the logic, then should we stop providing life saving care to someone who’s having a heart attack or to a smoker with lung cancer? Of course not. At times, we all make poor decisions. For someone with a predisposition for addiction, the choice to drink may lead to alcohol use disorder. For the person with a predisposition for diabetes, eating an unhealthy diet or living a sedentary lifestyle will result in consequences.

Furthermore, once a person develops a substance use disorder, physiological and structural changes in the brain dissolve the element of choice. The brain misinterprets a craving for drugs or alcohol. (Remember the last time you experienced extreme thirst? That’s what it’s like to be addicted to something.)

Having a substance use disorder is miserable, lonely, and shameful. No one would choose that.

6. People with mental illness are violent.

A person with mental illness is no more likely to be violent than someone in the general population. In fact, acts of violence are not diagnostic criteria for any of the known mental disorders.

If I had to choose someone to hold a loaded gun, I’d pick the person with schizophrenia over someone who’s prone to anger or has poor self-control.

I work with clients who hear “command” voices (auditory hallucinations that tell them to harm or kill); yet I’ve never felt unsafe. In my experience, it’s uncommon for an individual to obey the voices. If I had to choose someone to hold a loaded gun, I’d pick the person with schizophrenia over someone who’s prone to anger or has poor self-control.

While the media would have us believe that mental illness is at the root of every mass shooting, that isn’t the case. (Not to say that mental illness can’t play a role, but it’s not always the trigger.) The biggest risk factor for violence is a history of violence, especially domestic violence, or crime.

Regarding violence, what’s true is that individuals with mental illness are more likely to die by suicide. Persons with schizophrenia have higher rates of suicide than the general population. Depression, bipolar disorder, and borderline personality disorder are also linked to suicide.

Don’t confuse mental illness with a lack of morals.

A mental disorder is a medical condition; having weak morals is a personality trait, and while it seems mentally sick, it’s not fair to compare a lack of morals to a condition like depression or anxiety.

7. Mental illness is the same thing as mental retardation.

I’m friends with a nurse who didn’t even know the difference (until I pointed it out). A person with a mental illness may seem less intelligent due to various factors, but mental illness is not comparable to mental retardation. Today, we refer to mental retardation as intellectual disability (due to the negative connotations attached to the word “retarded”).

A person with an intellectual disability (ID) struggles to understand, comprehend, and/or form memories. A person with mental illness, on the other hand, may have superior intelligence, but could seem “slow” due to distractions brought on by their illness. (For example, it’s difficult to focus on a conversation when you’re having racing thoughts or hearing voices.)

8. A person with schizophrenia has multiple personalities.

Nope; total myth. In fact, multiple personality disorder (MPD) doesn’t exist (technically). What was formally known as MPD in the DSM-IV TR (the previous version of the Diagnostic and Statistical Manual) is now termed disassociative identity disorder [DID]. A person with DID has at least two distinct personality “states” and suffers from gaps in memory. DID is incredibly rare.

A person with schizophrenia, on the other hand, has one personality state. However, he/she may hear voices that take on distinct identities.

In addition to auditory hallucinations, someone with schizophrenia may experience visual hallucinations, delusions, disorganized thoughts, cognitive deficits, and/or what’s referred to as “negative” symptoms. (A negative symptom is a lack of something that’s typically present in someone without schizophrenia. For example, a person with schizophrenia may be socially withdrawn or he/she may seem very “flat” [without emotion]).

9. Alcohol makes you depressed because it’s a depressant.

Yes, alcohol is a depressant; but as a “depressant,” it depresses your central nervous system, leading to slurred speech, trouble with coordination, etc. The “depressant” effects of alcohol are unrelated to clinical depression.

However, heavy alcohol use is associated with depression and other mental disorders. Someone who is struggling with depression or anxiety may drink as a way to self-medicate. Alternatively, someone with an alcohol use disorder may develop depression, as alcohol upsets the chemical balance in the brain. The lifestyle of someone with alcohol use disorder may also lead to intense guilt, shame, and/or hopelessness, which can in turn lead to depression.


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