5 Effective Self-Care Strategies for Addiction in the Family

Self-care is not a luxury; it’s necessary for survival when your loved one has a substance use disorder. By taking care of yourself, you gain the energy and patience to cope with your problems. Self-care promotes wellness and emotional intelligence; it puts you in a better space to interact with your loved one. Strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers.

Image by DanaTentis from Pixabay

When your loved one has a substance use disorder (SUD), it can be overwhelming, distressing, and all-consuming. When we’re stressed, we forget to practice basic self-care, which in turn makes us even less equipped to cope with the emotional chaos addiction generates. This post is about self-care strategies for when your loved one has an addiction.

In the book Beyond Addiction: How Science and Kindness Help People Change (A Guide for Families), the authors discuss the importance of self-care. This post reviews the authors’ recommended self-care strategies.

(Side note: I strongly recommend reading Beyond Addiction if your loved one has an SUD or if you work in the field. This book will increase your understanding of addiction and teach you how to cope with and positively impact your loved one’s SUD by using a motivational approach. This is one of the best resources I’ve come across, especially for family members/significant others.)

Image by Pexels from Pixabay

Based on the premise that your actions affect your loved one’s motivation, taking care of yourself is not only modeling healthy behaviors, it’s putting you in a better space to interact with your loved one. Chronic stress and worry make it difficult to practice self-care. Self-care may even seem selfish.

However, by taking care of yourself and thus reducing suffering, you gain the energy and patience to cope with your problems (and feel better too). Furthermore, you reduce the level of pain and tension in your relationships with others, including your loved one with a SUD.

Self-care strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers. Therapy and/or support groups are additional options.

“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.”

Unknown

Self-Care Strategies When Your Loved One Has an Addiction

Resilience

The definition of resilience is “the capacity to recover quickly from difficulties” (Oxford Dictionary). Doctors Foote, Wilkens, and Kosanke wrote that having resilience is a way to “systematically reduce your vulnerability to bad moods, lost tempers, and meltdowns.”

While you cannot “mood-proof” yourself entirely, resilience helps when facing life’s challenges, setbacks, and disappointments. To maintain resilience, one must practice at least the most basic self care practices, which are as follows:

  1. Eat well
  2. Sleep well
  3. Exercise enough
  4. Avoid mood-altering drugs (including alcohol)
  5. Treat illness (with prescribed medications, adequate rest, etc.)
Image by Irina L from Pixabay

Self-care is not something you can push in to the future. Don’t wait until you have more time or fewer obligations. Self-care is not a luxury; it’s a necessity. The authors of Beyond Addiction pointed out that self-care is something you have control over when other parts of your life are out of control. If you find it challenging to implement self-care practices, tap into your motivations, problem-solve, get support, and most of all, be patient and kind with yourself.

“Taking care of yourself is the most powerful way to begin to take care of others.”

Bryant McGill

Distress Tolerance

On tolerance, Doctors Foote, Wilkens, and Kosanke suggested that it is “acceptance over time, and it is a cornerstone of self-care.” Tolerance is not an inherent characteristic; it is a skill. And like most skills, it requires practice. However, it’s wholly worth the effort as it reduces suffering. By not tolerating the things you cannot change (such as a loved one’s SUD), you’re fighting reality and adding to the anguish.

Self-care strategies and techniques for distress tolerance include distracting yourself, relaxing, self-soothing, taking a break, and creating positive experiences. (The following skills are also taught in dialectical behavior therapy (DBT), an evidence-based practice that combines cognitive behavioral therapy techniques and mindfulness. For additional resources, visit The Linehan Institute or Behavioral Tech.)    

Distract Yourself

  1. Switch the focus of your thoughts. The possibilities are endless; for you, this could mean reading a magazine, calling a friend, walking the dog, etc. The authors of Beyond Addiction suggested making a list of ideas for changing your thoughts (and keeping it handy).
  2. Switch the focus of your emotions. Steer your emotions in a happier direction by watching corgi puppies on YouTube, reading an inspirational poem, or viewing funny Facebook memes. The writers of Beyond Addiction suggested bookmarking sites in your Internet browser that you know will cheer you up.
  3. Switch the focus of your senses. This could mean taking a hot shower, jumping into a cold pool, holding an ice cube in your hand, walking from a dark room to one that’s brightly lit, looking at bright colors, listening to loud rock music, etc. Also, simply walking away from a distressing situation may help.
  4. Do something generous. Donate to your favorite charity, pass out sandwiches to the homeless, visit a nursing home and spend time with the residents, express genuine thanks to cashier or server, etc. By redirecting attention away from yourself (and directing energy toward positive goals), you’ll feel better. In Beyond Addiction, it’s noted that this skill is especially helpful for individuals who tend to ruminate. Also, it’s important to brainstorm activities that are accessible in the moment (i.e. texting a friend to let them know you’re thinking about them) that don’t take multiple steps (such as volunteering).
Image by congerdesign from Pixabay

Relax

“Body tells mind tells body…” Relaxing your body helps to relax your mind. It also focuses your thoughts on relaxing (instead of your loved one’s addiction). What helps you to relax? Yoga? A hot bath? Mindful meditation? (I recommend doing a mindful body scan; it’s simple and effective, even for the tensest of the tense, i.e. me.)

Soothe Yourself

In Beyond Addiction, self-soothing is described as “making a gentle, comforting appeal to any of your five senses.” A hot beverage. Nature sounds. A cozy blanket. A scenic painting. Essential oils. A cool breeze. A warm compress. A massage. Your favorite song. Find what works for you, make a list, and utilize as needed. Seemingly small self-care strategies can make a big difference in your life by creating comfort and reducing out-of-control emotions.

Take A Break

“Taking a break” doesn’t mean giving up; it’s a timeout for when you’re emotionally exhausted and is one of the best self-care strategies you can have. Learn to recognize when you need to step away from a situation or from your own thoughts. Find a way to shift your focus to something pleasant (i.e. a romantic movie, a nature walk, a day trip to the beach, playing golf for a few hours, traveling to a different country, etc.)

Image by Free-Photos from Pixabay

Create a Positive Experience

Doctors Foote, Wilkens, and Kosanke refer to this as “making it better,” not in the sense that you’re fixing the problem (or your loved one), but that you’re making the moment better by transforming a negative moment into a positive one. Suggested self-care strategies for creating a positive experience include the following:

  1. Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
  2. Meditate or pray. As explained in Beyond Addiction, “meditation or pray is another word for – and effective channel to – awareness and acceptance. Either one can open doors to different states of mind and act as an emotional or spiritual salve in trying moments.”
  3. Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
  4. Find meaning. The authors of Beyond Addiction wrote, “Suffering can make people more compassionate toward others. Having lived through pain, sometimes people are better able to appreciate moments of peace and joy.” Suffering can also inspire meaningful action. What can you do to find meaning?
  5. Borrow some perspective. How do your problems look from a different viewpoint? Ask a trusted friend. You may find that your perspective is causing more harm than good.

Perspective

Perspective is “an understanding of a situation and your reactions to it that allows you to step back and keep your options open… [it’s] seeing patterns, options, and a path forward” (Beyond Addiction).

When Trish married Dave nearly 20 years ago, he rarely drank: maybe an occasional beer over the weekend or a glass of wine at dinner. After their fist daughter was born, his drinking increased to a few beers most nights. Dave said it helped him relax and manage the stress of being a new parent.

By the time their second daughter was born several years later, his drinking had progressed to a six-pack of beer every evening (and more on weekends). Currently, Dave drinks at least a 12-pack of beer on weeknights; if it’s the weekend, his drinking starts Friday after work and doesn’t stop until late Sunday night.

Dave no longer helps Trish with household chores or yardwork as he did early in their marriage. He rarely dines with the family and won’t assist with the cooking/cleanup; he typically eats in front of the TV. Dave occasionally engages with his daughters, but Trish can’t recall the last time they went on a family outing, and it’s been years since they went on a date.

Dave struggles to get out of bed in the mornings and is frequently late to work; Trish is worried he’ll get fired. They frequently argue about this. Dave is irritable much of the time, or angry. Most nights, he doesn’t move from his armchair (except to get another beer) until he passes out with the television blaring.

Trish is frustrated; she believes Dave is lazy and lacks self-control. When she nags about his drinking, he promises he’ll cut back, but never follows through. Trish thinks he’s not trying hard enough. She can’t understand why he’d choose booze over her and the kids; sometimes she wonders if it’s because she’s not good enough… maybe he would stop if she was thinner or funnier or more interesting?  At times she feels helpless and hopeless and others, mad and resentful; she frequently yells at Dave. She wonders if things are ever going to change.  

Image by Luis Wilker Perelo WilkerNet from Pixabay

A different perspective would be to recognize that Dave has an alcohol use disorder. He feels ill most of the time, which affects his mood, energy level, and motivation. He wants to cut back, but fails when he tries, which leads to guilt and shame. To feel better, he drinks. It’s a self-destructive cycle.

If Trish understood this, she could learn to not take his drinking personally or question herself. Her current reactions, nagging and yelling, only increase defensiveness and harm Dave’s sense of self-worth. Alternative options for Trish might include learning more about addiction and the reasons Dave drinks, bolstering his confidence, and/or creating a supportive and loving environment to enhance motivation.

Triggers

In recovery language, a “trigger” is anything (person, place, or thing) that prompts a person with SUD to drink or use; it activates certain parts of the brain associated with use. For instance, seeing a commercial for beer could be triggering for a person with an alcohol use disorder.

You have triggers too. For example, if your loved one is in recovery for heroin, and you notice that a bottle of opioid painkillers is missing from the medicine cabinet, it could trigger a flood of emotions: fear, that your loved one relapsed; sadness, when you remember the agony addiction brings; hopelessness, that they’ll never recover. It’s crucial to recognize what triggers you and have a plan to cope when it happens. Being aware of your triggers is a self-care strategy.

Therapy & Support Groups

Lastly, self-care strategies such as therapy and/or support groups can be a valuable addition to your self-care regime. Seeing a therapist can strengthen your resilience and distress tolerance skills. Therapy may provide an additional avenue for perspective.

(Side note: A good therapist is supportive and will provide you with tools for effective problem-solving and communication, coping with grief and loss, building self-esteem, making difficult choices, managing stress, overcoming obstacles, improving social skills/emotional intelligence, and better understanding yourself. A good therapist empowers you. A bad therapist, on the other hand, will offer advice and/or tell you what to do, disempowering you.)

Image by HannahJoe7 from Pixabay

Regarding support groups, there are many options for family members, friends, and significant others with a loved one who has a SUD, including Al-Anon, Nar-Anon, and Families Anonymous. Support groups provide the opportunity to share in a safe space and to receive feedback, suggestions, and/or encouragement from others who relate.


“I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival.”

Audre Lorde

In sum, self-care is not optional; it’s essential for surviving the addiction of a loved one. Self-care enhances both overall wellness and your ability to help your loved one; in order words, take responsibility for your health and happiness by taking care of yourself. Commit to engaging in at least one or two of the self-care strategies you learned about in this post.

For additional self-care strategies and more information on how you can help your loved one, visit The Center for Motivation and Change.

self-care strategies

Book Review: Staying Sober Without God

Munn wrote this book because, as a nonbeliever, he felt the 12 steps of AA didn’t fully translate into a workable program for atheists or agnostics. This inspired him to develop the Practical 12 Steps.

staying sober

I stumbled upon Staying Sober Without God while searching for secular 12-step literature for a client who identifies as atheist. Jeffrey Munn, the book’s author, is in recovery and also happens to be a licensed mental health practitioner.

Munn wrote the book because as a nonbeliever he felt the 12 steps of AA didn’t fully translate into a workable program for atheists or agnostics. (For example, the traditional version of Step 3 directs the addict to turn his/her will and life over to the care of God as they understand him. If you don’t believe in God, how can you put your life into the care of him? Munn notes that there’s no feasible replacement for a benevolent, all-knowing deity.)

The whole “God thing” frequently turns nonbelievers off from AA/NA. They’re told (by well-meaning believers) to find their own, unique higher power, such as nature or the fellowship itself. (The subtle undertone is that the nonbeliever will eventually come around to accept God as the true higher power.)

In Staying Sober Without God Munn asserts, “There is no one thing that is an adequate replacement for the concept of God.” He adds that you can’t just replace the word “God” with “love” or “wisdom.” It doesn’t make sense. So he developed the Practical 12 Steps and wrote a guide for working them.

The Practical 12 Steps for staying sober are as follows:

  1. Admitted we were caught in a self-destructive cycle and currently lacked the tools to stop it
  2. Trusted that a healthy lifestyle was attainable through social support and consistent self-improvement
  3. Committed to a lifestyle of recovery, focusing only on what we could control
  4. Made a comprehensive list of our resentments, fears, and harmful actions
  5. Shared our lists with a trustworthy person
  6. Made a list of our unhealthy character traits
  7. Began cultivating healthy character traits through consistent positive behavior
  8. Determined that the best way to make amends to those we had harmed
  9. Made direct amends to such people wherever possible, except when to do so would cause harm
  10. Practiced daily self-reflection and continued making amends whenever necessary
  11. We started meditating
  12. Sought to retain our newfound recovery lifestyle by teaching it to those willing to learn and by surrounding ourselves with healthy people

The Practical 12 Steps in no way undermine the traditional steps or the spirit of Alcoholics Anonymous. Instead, they’re supplemental; they provide a clearer picture of the steps for the nonbeliever.


Before delving into the steps in Staying Sober Without God, Munn discusses the nature of addiction, recovery, and the role of mental illness (which is mostly left untouched in traditional literature). He addresses the importance of seeking treatment (therapy, medication, etc.) for mental disorders while stressing that a 12-step program (secular or otherwise) is not a substitute for professional help. In following chapters, Munn breaks each step down and provides guidelines for working it.

The last few chapters of the book provide information on relapse and what the steps don’t address. Munn notes that sustainable recovery requires more than just working the steps, attending AA meetings, and taking a sponsor’s advice. For a balanced, substance-free lifestyle, one must also take care of their physical health, practice effective communication, and engage in meaningful leisure activities. Munn briefly discusses these components in the book’s final chapter, “What the Steps Miss.”

Staying Sober Without God is well-written and easy to read. The author presents information that’s original and in line with current models of addiction treatment, such as behavioral therapy (an evidence-based approach for substance use disorder). Working the Practical 12 Steps parallels behavioral treatments; the steps serve to modify or discontinue unhealthy behaviors (while replacing them with healthy habits). Furthermore, a 12-step network provides support and meaningful human connection (also crucial for recovery).

In my opinion, the traditional 12 Steps reek of the moral model, which viewed addiction as a moral failure or sin. Rooted in religion, this outdated (and false) model asserted that the addict was of weak character and lacked willpower. The moral model has since been replaced with the disease concept, which characterizes addiction as a brain disorder with biological, genetic, and environmental influences.

The Practical 12 Steps are a better fit for what we know about addiction today; Munn focuses on unhealthy behaviors instead of “character defects.” For example, in Step 7, the addict implements healthy habits while addressing unhealthy characteristics. No one has to pray to a supernatural being to ask for shortcomings to be removed.

The Practical 12 Steps exude empowerment; in contrast, the traditional steps convey helplessness. (The resulting implication? The only way to recover is to have faith that God will heal you.) The practical version of the steps instills hope and inspires the addict to change. Furthermore, the practical steps are more concrete and less vague when compared to the traditional steps. (This makes them easier to work!)


In sum, Munn’s concept of the steps helped me to better understand the 12-step model of recovery; the traditional steps are difficult to conceptualize for a nonbeliever, but Munn found a way to extract the meaning of each step (without altering overall purpose or spirit). I consider the practical steps a modern adaptation of the traditional version.

I recommend reading Staying Sober Without God if you have a substance use disorder (regardless of your religious beliefs) or if you’re a professional/peer specialist who works with individuals with substance use disorders. Munn’s ideas will give you a fresh perspective on 12-step recovery.


For working the practical steps, download the companion workbook here:

Note: The workbook is meant to be used in conjunction with Munn’s book. I initially created it for the previously mentioned client as a format for working the practical steps. The workbook is for personal/clinical use only.

15 Sites with Helpful Resource Lists

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

This is a list of links to resource pages for wellness, mental illness, addiction, and self-help. (For resources posted on Mind ReMake Project, click here.)


15 Sites with Helpful Resource Lists

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

Links to Other Empowering Websites | From the National Empowerment Center

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

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. 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)


Post your suggestions for resource links in a comment!

resource lists

80 Powerful 12-Step Groups for Recovery

(Updated 5/15/21) 12-step recovery groups, while not a substitute for treatment, can play a crucial role in recovery and continued sobriety. AA/NA (and similar) meetings are available all over the world and are open to anyone with a desire to stop using or drinking.


12-Step Recovery Groups

The following list is comprised of links to both well-known and less-familiar 12-step and similar support groups for recovery.

Support Groups for Addiction


For Families & Others Impacted by Addiction & Mental Illness


Secular Alternatives


Faith-Based Alternatives


Additional Support Groups & Organizations


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


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

12-step

Click below for a downloadable PDF version of this post.

6 Tips for Developing Healthy Boundaries

Why is it important to set and adhere to healthy boundaries? How can you tell if yours are weak?

When I picture a boundary, I imagine drawing a circle with a stick in the dirt… with me in the middle. I stay in; everyone else stays out. Boundaries are protective; they keep us safe. Without boundaries, you have no limits, no sense of direction. Without boundaries, you open yourself up… anyone can come in, with good or bad intentions.

If you have poor boundaries in a dating relationship, you could end up doing things you’re not comfortable with. Or, another example might be with your boss; if you don’t set firm limits, you could end up taking one extra tasks.

“Good fences make good neighbors.”

Robert Frost

Thoughts on Building & Maintaining “Good Fences”

I once worked with a client who regularly violated his partner’s boundaries by yelling, “Phone check!” whenever he wanted to check his girlfriend’s cell. She’d hand it over and he’d review her calls/read her texts. It was a boundary violation for sure. Everyone has a right to privacy.

Another way to conceptualize a boundary is to picture mosquito netting. It keeps the mosquitoes out, but it’s flexible and lightweight. It lets in air, sunlight, a cool breeze… A mosquito net is a healthy boundary. If you were to instead build a brick structure, you’d be doing a lot of unnecessary work and you’d probably still get bit.  

It’s best to be up front and honest about the boundaries you set (which requires assertiveness). With your boss, the first time he asks if you can stay late on a Friday, you might end up saying yes. (It’s probably just a onetime thing, right?) Seeing that you don’t say no the first time, he may continue to ask you to stay late or take on extra work.

The alternative (boundary-setting) option would be to say (when he first asks), “I’m sorry, although I’d love to be able to, I have a policy against being away from home on Fridays. It’s family night at my house.” It’s unlikely he’ll ask you again because you very firmly (and politely) set a boundary.

On the other hand, if you’re passionate about your career, you could be flexible and stay late (especially if you’re hoping for a promotion or a raise) without feeling as though your boundaries have been violated. The important thing is to know where you stand (i.e. what your boundary is).

Equally important to setting boundaries is adhering to them once they’re established. There are people out there who love to test boundaries. A boundary is useless without follow through. Your boundary becomes meaningless if you say you’re not going to do something and then you do it anyway.

If you tell your child “no candy before dinner,” but then finally give in after several bouts of dramatic tears, you’re sending a message. The message is “When I say no, I don’t mean it.” It’s important to be consistent with boundaries.

Signs of Weak Boundaries

  • A lack of assertiveness
  • Altering your personal values for someone (especially in a romantic relationship)
  • Having a sexual relationship with someone when you’re not ready
  • Not being able to say “no”
  • Trusting others quickly (when it’s not warranted)
  • Falling in love quickly or believing an acquaintance is your best friend when you only met the day before

Rigid boundaries, on the other hand, are at the opposite end of the spectrum. A person with rigid boundaries doesn’t trust easily or let others in. It would be difficult to be in an intimate relationship with a person with rigid boundaries.

6 Tips for Healthy Boundaries

Firstly, know that it will take time. Be patient with yourself and don’t criticize yourself if you fall back into old habits.

Recognize (and accept) your right to establish and adhere to personal boundaries. Read one of Dr. Cloud’s books on boundaries or Melody Beattie’s Codependent No More. Personally, I like Co-dependents Anonymous’ recovery literature. It’s an easy read (four pages) and you can access it for free.

If you haven’t already, take time to clarify your values. You can do a values sort – there are plenty of free resources online. It’s something I frequently do with my clients. What’s most important to you? Family? Integrity? Kindness? Have unhealthy boundaries affected this value in the past? (If kindness is most important to you, and you identify as a “people pleaser,” consider all the times you’ve been unkind to yourself. Explore ideas for practicing kindness to both others and self.)

Also, deliberate on the behaviors you find unacceptable (in terms of how you’re treated). Looking back on past relationships, I dated men who cheated on me, called me names, were mean to my friends, and yes, even checked my phone. Completely unacceptable. At this point in my life, I have a zero tolerance policy.

When you establish boundaries, especially with those who don’t expect it (i.e. your mother-in-law or the neighbor who regularly lets his dog romp through your garden), anticipate some push back. It probably won’t feel good in the moment.

Practice assertiveness. Don’t back down. If someone is particularly resistant, don’t engage in an argument.  You don’t owe an explanation. You don’t even have to respond. Remain calm; walk away if needed. If it helps, pre-plan your exact wording. (“I’m sorry, but I’m no longer able to stay till 9 on Fridays. Unexpected circumstances at home won’t allow it.”) Be concise. Don’t be overly apologetic.

If the person you’re setting boundaries with is a significant other or family member, I’d recommend transparency. Let them know that you’re going to make some changes. Share how unhealthy boundaries have negatively impacted you. (Give specific examples if you can.) Don’t place blame. Talk about how healthy boundaries will positively impact not just you,but the relationship. It may still be difficult. There may be some tension; the relationship might feel strained. (And it’s okay.)

If you set boundaries and find them repeatedly violated; firstly, take a step back and reevaluate the situation. Have you been clear and consistent? If so, you may want to consider spending less time with this person or even ending the relationships. Unfortunately, while you can set boundaries, you can’t force someone to respect them.


In sum, boundaries are imperative. Skin is a boundary that keeps other organs in place; it shields our body systems from toxins, viruses, and bacteria that would otherwise be deadly. It keeps the bad stuff out (and the good stuff in). Healthy boundaries are our emotional skin.

If you need a boundaries tune up, it could take some effort, but is well worth it. You’ll experience increased satisfaction in your relationships and will feel more confident. Your overall well-being will improve; boundaries are freeing – by communicating your needs, it’s less likely you’ll feel angry or resentful. And lastly, you’ll find that others have a greater level of respect for you. “Good fences,” it would seem, are not limited to neighbors!


boundaries

75+ Free Mental Health Worksheets & Handouts

75+ free mental health worksheets, handouts, and forms for mental health professionals or self-help.

(Updated 2/13/24) This is a list of nearly 100 mental health worksheets, handouts, forms, and more for substance use, mental health, and wellness.

Please repost and share with anyone who might benefit! New resources are added on a regular basis.


For more free downloads, click here for a list of PDF workbooks, manuals, and self-help guides.

For free mental health worksheets and resources from other sites, check out TherapistAid, GetSelfHelpUK, and Taking the Escalator.


Mental Health Worksheets & Handouts


Group Ideas & Topics

A 3-page handout for group facilitators with strategies for managing resistance, disruptive behaviors, and a lack of engagement in group therapy.

A list of topics for substance use groups.

A 2-page handout for clinicians who facilitate group therapy with (adult) clients and their families. The questions were developed for an inpatient SUD setting.

A list of specific topics for substance use groups, such as refusal skills, the difference between a lapse and a relapse, and fun in recovery.

A list of group openers for substance use groups; can also be used in individual counseling sessions.

A list of questions for exploring the following topics: Conversation starters, mental health, addiction, personal development, values, family, relationships, and emotions. These questions can be used in a group setting, individually, or as journal prompts.

🔝

Group Activities

A worksheet with prompts for writing a short autobiography to be presented to the group.

Intended audience: Adults

A worksheet for clients to pass around to group members so each person can write a positive affirmation.

Intended audience: Adolescents, Teens, Adults

Good for newly formed groups. Each group member writes down their “first impression” of other group members. The facilitator then reads off the different categories and group members have the opportunity to share their answers.

Intended audience: Adults

An icebreaker activity, good for new groups. Give group members 15-20 minutes to collect signatures. The first person to collect all signatures wins.

Intended audience: Adolescents, Teens, Adults

Clinical Film Discussion Questions

🔝

Card Decks

A printable deck of cards with 128 coping skills for managing stress, anxiety, and other difficult emotions. Each card includes one simple coping skill.

Print/cut the cards, fold, and place in a container. Group members take turns drawing the cards and answering the questions.

A printable deck of cards with 40 positive quotes that can be used as affirmations.

A printable card deck with 27 affirmations for healing and empowerment.

These cards can be used in a SUD inpatient or outpatient setting to facilitate group discussions about recovery. Group members take turns drawing a card and answering questions. The facilitator can vary things up by letting group members pick someone else to answer their question once they’ve finished sharing. Alternatively, group members can take turns drawing cards, but all group members are encouraged to share their answers. This activity works best with a working group.

This is a revised version of the Recovery Question Cards.

Rumi Quote Cards

25 cards with Rumi quotes on love, suffering, and healing.

A card deck with 104 cards with thought-provoking questions intended to promote discussion. Topics include goals, values, emotions, relationships, spirituality, and more.

These cards can be used in a group or individual setting. The last page of the PDF includes additional values exercises for journaling, clinical supervision, couples, and groups. Tip: Print the cards on patterned scrapbook paper (blank on one side).

🔝

Mental Health Handouts

4 Ways to Stay Calm Before a Stressful Event

A 1-page handout with simple “in-the-moment” calming strategies for anxiety-provoking events.

A simple 1-page handout that shows the 6 basic emotions.

A comprehensive list of 12-step and other support groups, such as AA, NA, SMART Recovery, Dual Recovery Anonymous, NAMI, etc.

A 1-page DBT-based handout with 25 examples of dialectics (i.e., two things that seem opposite and are at the same time both true).

These journal prompts can also be used in a group setting. The prompts include questions about values, potential, expectations, and more.

Instructions for Living from the Dalai Lama

A 1-page handout with 25 quotes from the Dalai Lama on topics such as kindness and happiness. Can be used in a group setting.

A 1-page handout that debunks five common grief myths and provides the truth about each one.

A 2-page handout with nine creative and soothing outlets for grief, such as music, dance, light therapy, and aromatherapy.

A 2-page handout with journal prompts for recovery, based on material from The Sober Survival Guide (created with the author’s permission).

Kindness To-Do List

A to-do list of kind deeds with blank spaces to write in your own ideas for spreading kindness.

A colorful 3-page handout with ideas for hobbies that fall under the following categories: Animals/nature, arts/crafts, collections, cooking/baking, entertainment, home improvement/DIY, outdoor/adventure, self-improvement, sports, travel, and misc.

A list with links to online grief support groups, forums, and communities.

A 1-page handout on PTG and how it may impact a person’s life, and the factors that contribute to PTG.

A 1-page handout with resources for suicide, including recommended books, apps, crisis lines, and suicide warning signs.

A 2-page handout that describes seven uncommon grief experiences, such as delayed or disenfranchised grief.

A list of 38 unique coping skills for managing difficult emotions.

A 2-page handout that lists values. Can be used as a standalone handout or with the values card deck.

A 2-page handout with two exercise routines, one designed for beginners and the other for more advanced exercisers.

🔝

Mental Health Worksheets

A 1-page worksheet for identifying things to be grateful for in different life areas.

A 1-page checklist with 30 ideas for spreading kindness.

A 1-page worksheet for exploring what makes someone a good friend.

Art Activity: H-T-P Test

In the House-Tree-Person Test, the picture of the house is supposed to represent how the individual feels about their family. The tree elicits feelings of strength or weakness. The person represents how the individual feels about themselves. (Source: How Projective Tests Are Used to Measure Personality – Simply Psychology)

Art Activity: Outer & Inner Masks

This art activity can be done in a group setting or individually. Clients design both outer – what the world sees – and inner – the hidden self – masks. The third page has questions for discussion. This activity can be used to target all sorts of issues from body image to values to character defects (in addiction) and more.

Art Activity: Self-Portraits

This worksheet can be used in groups or as a homework assignment. Encourage clients to be creative; instead of just drawing or coloring, they can use magazine cutouts, stickers, photos, etc. Suggested questions for discussion: How did you decide which identities to portray? Which portrait best represents your true self? Which portrait do others see the most? What, if anything, would you like to change about your portraits?

A 2-page worksheet for exploring the consequences of addiction.

Coping with Cravings

A 3-page worksheet with DBT-based skills for coping with cravings.

Coping with Jealousy

A worksheet for understanding jealousy, its impact, whether it’s pathological, and how to manage jealous feelings.

Couples Exercise: Affirmations

A 3-page worksheet for sharing self-affirmations and partner affirmations, including suggested questions for discussion.

Couples Exercise: Our Bucket List

A 3-page worksheet for couples to create a shared list of meaningful “bucket list” items to do together.

Couples Exercise: Our Bucket List (with dates)

A shared bucket list that includes spaces to write in when an item was added to the list and when it was completed.

A 1-page worksheet for affirmations, positive self-talk, and problem-solving strategies for daily challenges.

A basic mood tracker with emoji faces.

A blank schedule with hourly slots starting at 6:00 a.m. and ending at 10:00 p.m. Can be used as part of a relapse prevention, for depression management, or as a planner.

A 3-page worksheet for substance use recovery for planning leisure activities and enhancing wellness/spirituality.

A letter template for individuals entering long-term residential treatment for substance use, to be opened and read at treatment completion.

An 8-page goal-setting worksheet for health/wellness, relationships/social health, emotional wellness, intellectual wellness, education/career, financial health, spirituality, and leisure.

A 3-page worksheet for identifying and managing substance use relapse triggers.

A 1-page worksheet for identifying things that promote addiction and ways to get rid of or avoid these things.

A 3-page goal-setting worksheet for short-term and long-term goals.

A 12-step-based worksheet for identifying and exploring resentments.

A worksheet for creating poetry; print, laminate, and cut out the words.

A 1-page worksheet for examining past substance use relapses and strategies for avoiding future relapses.

A 5-page template for creating a substance use relapse prevention plan.

A 1-page worksheet for exploring ways to resist urges to use in early recovery.

A 1-page checklist with quick tips, self-soothing, and indulgent ideas for self-care.

A 3-page worksheet for developing a colorful self-care “map” to explore patterns and identify new practices.

A 3-page template for creating a self-care “menu.”

A 2-page writing assignment for self-discovery and awareness.

A 2-page worksheet for developing self-esteem.

A 1-page worksheet for exploring motivation for substance use recovery.

A fun worksheet for creating a bucket list of things that are only possible in sobriety.

Stress Management Worksheet

This 6-page worksheet helps with identifying and exploring stressors. From there, the worksheet can be used to build a stress management plan.

7 pages of feelings words.

A 6-page worksheet for describing problem areas, identifying goals, and exploring what has (and has not) been helpful in the past. This worksheet can be used to develop a collaborative treatment plan.

A 2-page worksheet for identifying and exploring wants and needs.

A simple form for tracking daily meals and snacks for one week.

A 2-page worksheet for identifying things that are controllable versus things that can’t be controlled.

A 3-page narrative therapy worksheet for exploring a past substance use relapse.

Laminate and use with fine-tip dry erase markers.

🔝

Workbooks & Bonus Materials

100-page printable workbook for working through grief and loss.

A companion workbook meant to be used with the book Staying Sober Without God (created with the author’s permission).


Daily Self-Inventory for Mental Health Professionals

A 10th step-based inventory for self-reflection for counselors and other mental health workers.

Free Coloring Pages for Adults

Links to 15 websites with free printable coloring sheets for adults.

Miscellaneous Printables

A list of 20 openers for individual therapy sessions.

A 2-page form for case conceptualization with sections for demographics, key findings, background info, case formulation, interventions/plans, and requested feedback or suggestions.

A list of interventions (action words) for clinical documentation.

A template for tracking attendance, cases discussed, and any other group topics.

A foldable coloring book with eight different designs.

🔝


mental health worksheets

500 Free Printable Workbooks & Manuals for Therapists

A list of over 500 free printable workbooks, manuals, toolkits, and guides for mental health professionals or self-help.

(Updated 4/9/23) The following list is comprised of links to over 500 free printable workbooks, manuals, toolkits, and guides that are published online and are free to use with clients and/or for self-help purposes. Some of the manuals, including Individual Resiliency Training and Cognitive Behavioural Therapy for Psychotic Symptoms, are evidence-based.

Please repost this and/or share with anyone you think could benefit from these free printable workbooks and clinical tools!


For free printable workbooks and guides designed especially for youth/family, click here. For additional free printable workbooks and resources on a variety of mental health topics, see 200+ Sites with Free Therapy Worksheets & Handouts and 50 Free Mental Health Worksheets & Handouts.


Free Printable Workbooks, Manuals, & Self-Help Guides for Mental Health Professionals & Consumers

Disclaimer: Links are provided for informational and educational purposes. I recommend reviewing each resource before using for updated copyright protections that may have changed since it was posted here. When in doubt, contact the author(s).


Substance Use Disorders & Addiction

Free printable workbooks, manuals, toolkits/self-help guides for substance and behavioral (i.e., food, gambling, etc.) addictions and recovery


There are several SAMHSA workbooks listed below; you can find additional free publications on SAMHSA’s website. For fact sheets and brochures, go to the National Institute on Drug Abuse website or the National Institute on Alcohol Abuse and Alcoholism. If you’re looking for 12-step literature, many 12-step organizations post free reading materials, workbooks, and worksheets; don’t forget to check local chapters! (See 12-Step Recovery Groups for a comprehensive list of recovery support group sites.)

Other great places to look for free printable workbooks and resources for addiction include education/advocacy and professional membership organization sites. (Refer to the Resource Links page on this site for an extensive list.)


💜 = Resource for Veterans
🏳️‍🌈 = LGBTQ+ Resource

Anxiety & Mood Disorders

Free printable workbooks and other resources for anxiety (generalized, social phobia/anxiety, panic attacks), depressive and bipolar disorders, and prenatal/postpartum anxiety and depression


For more factsheets, brochures, and booklets, see SAMHSA, National Institute of Mental Health, NHS UK, CMHA, and education/advocacy sites listed on the Resource Links page on this site.


💜 = Resource for Veterans

Anxiety Disorders
Depressive & Bipolar Disorders
Postpartum Anxiety & Depression

Schizophrenia & Psychotic Disorders

A small collection of free printable workbooks, manuals, toolkits, and guides for schizophrenia spectrum and related disorders

Obsessive-Compulsive & Hoarding Disorders

Free printable workbooks, manuals, and guides for obsessive-compulsive, hoarding, and related disorders and issues

Trauma & PTSD

Free printable workbooks, manuals, and guides for trauma (including vicarious trauma) and PTSD

💜 = Resource for Veterans

Eating Disorders

Free printable workbooks and toolkits/guides for anorexia, bulimia, and binge eating disorders

Suicide & Self-Harm

Free printable workbooks and toolkits/guide for suicide prevention and recovery and for non-suicidal self-injury

For additional resources for suicide, see 100+ Resources for Suicide Prevention & Recovery.

Grief & Loss

Free printable workbooks and toolkits/guides for grief and loss

For additional resources for grief and loss, see Grief & Loss: A Comprehensive Resource Guide and 3 Powerful TED Talks on Grief.

Anger

Free printable workbooks, manuals, and guides for coping with anger

For additional anger management tools, see 75 Helpful Anger Management Resources.

Self-Esteem: Free Printable Workbooks & Guides

Healthy Relationships & Communication

For additional related tools, see 50 Free Marriage & Relationship Assessment Tools.

Meditation & Mindfulness

Resiliency, Personal Development, & Wellness

Free Printable Workbooks for Forgiveness
  • DIY Workbook Series from the Positive Psychology Research Group at Virginia Commonwealth University (All of the following workbooks can be accessed through this link)
    • The Path to Humility: Six Practical Sections for Becoming a More Humble Person (84 pages)
    • The Path to Forgiveness: Six Practical Sections for Becoming a More Forgiving Person
    • Your Path to REACH Forgiveness: Become a More Forgiving Person in Less Than Two Hours
    • Moving Forward: Six Steps to Forgiving Yourself and Breaking Free from the Past (70 pages)
    • Experiencing Forgiveness: Six Practical Sections for Becoming a More Forgiving Christian
    • The Path to Patience: Six Practical Sections for Becoming a More Patient Person
    • The Path to Positivity: Six Practical Sections for Becoming a More Positive Person
  • Moving Forward: Six Steps to Forgiving Yourself (Self-Directed Learning), 2nd Ed. | (Printable workbook) Source: Virginia Commonwealth University/ForgiveSelf.com, 69 pages) 2015
Free Printable Workbooks & Guides for Sleep
Free Printable Workbooks & Guides for Stress

Self-Care

Free printable workbooks, toolkits, and guides for self-care

Nutrition & Exercise

Free printable workbooks, manuals, and guides for diet, physical activity, and health


CBT, DBT, & MI

Note: The free printable workbooks and other resources listed in the following section may also be listed in other sections of this post.


CBT: Free Printable Workbooks & Manuals
DBT: Free Printable Workbooks & Manuals
Motivational Interviewing

Additional Free Printable Workbooks, Manuals, & Self-Help Guides

🔝

free printable PDF workbooks

Please comment with links to additional free printable workbooks and PDF resources for therapy or self-help!

500 Free Online Assessment & Screening Tools

A list of over 500 free online assessment and screening tools for mental health professionals or self-help.

(Updated 9/20/22) This is a list of over 500 free online assessment screenings for clinical use and for self-help purposes. While an assessment cannot take the place of a diagnosis, it can give you a better idea if what you’re experiencing is “normal.”

Image by GuHyeok Jeong from Pixabay

For additional online assessment tools to use with couples, see Free Marriage & Relationship Assessment Tools.


500 Free Online Assessment & Screening Tools


Addiction & Substance Use Disorders

PDF and interactive online assessment tools for substance use disorders and other addictions


Anxiety & Mood Disorders

PDF and interactive online assessment tools for anxiety, depression, and bipolar disorders


Trauma, Stress, & Related Disorders Online Assessment Tools


Obsessive-Compulsive & Related Disorders Online Assessment Tools


Online Assessment Tools for Eating Disorders


Online Assessment Tools for Personality Disorders


Boundaries & Attachment Styles


Relationships & Communication


For additional relationship and communication assessments, see Free Marriage & Relationship Assessment Tools.


Anger


For additional online assessment tools and resources, see Resources for Anger Management.


Violence & Sexual Assault


Suicide Risk & Self-Injury

  • Columbia-Suicide Severity Rating Scale | PDF scale
  • Deliberate Self-Harm Inventory | Measurement of deliberate self-harm (PDF)
  • Imminent Risk and Action Plan | Assessment/plan (Source: University of Washington Center for Behavioral Technology)
  • Lifetime – Suicide Attempt Self-Injury Count (L-SASI) Instructions Scoring | The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citation: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Lineham Risk Assessment and Management Protocol | Citation: Linehan, M. M. (2009). University of Washington Risk Assessment Action Protocol: UWRAMP, University of WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool (Source: Cornell Research Program on Self-Injury and Recovery)
  • NSSI Measures Archives | A collection of instruments for self-harm (Source: International Society for the Study of Self-Injury)
  • NSSI Severity Assessment | A PDF assessment tool to assess the severity of non-suicidal self-injury (Source: Cornell Research Program on Self-Injury and Recovery)
  • 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) | 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. Citation: 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. (Source: University of Washington Center for Behavioral Technology)
  • Self-Injury Questionnaire | To assess self-harm (PDF, assessment in appendix)
  • Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citation: 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, DC. (Source: University of Washington Center for Behavioral Technology)
  • 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 | 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. Citation: 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. (Source: University of Washington Center for Behavioral Technology)
  • Ask Suicide-Screening Questions (ASQ) Toolkit | Source: National Institute of Mental Health
  • University of WA Suicide Risk/Distress Assessment Protocol | Citations: 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. (Source: University of Washington Center for Behavioral Technology)

For additional resources for suicide risk, see Resources for Suicide Prevention & Recovery.


Self-Esteem & Self-Compassion


Online Assessment Tools for Personality & Temperament


Emotional Intelligence


Health & Wellness

PDF and interactive online assessment tools for happiness, resiliency, exercise, sleep, nutrition, and other health/wellness topics


Additional Online Assessment & Screening Tools

PDF and interactive online assessment tools for various topics related to mental health, addiction, and other topics

  • Abnormal Involuntary Movement Scale | 2-page PDF (Source: UMASS Medical School) (1998)
  • Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | A 3-page PDF with scoring instructions (Source: UMASS Medical School/ADD.org)
  • Affect Intensity Measure (AIM) | 40-question and 20-question PDF versions of the assessment (Citation: Larsen, R. J. (1984). Theory and measurement of affect intensity as an individual difference characteristic. Dissertation Abstracts International, 85, 2297B.)
  • APA Online Assessment Measures | PDF screening tools (Source: American Psychiatric Association)
  • Behavioral Tests | A collection of psychiatric assessments (Source: Lamar Soutter Library)
  • Brief Fear of Negative Evaluation Scale (BFNE) | 1-page PDF that can be completed online or printed, scoring instructions not included
  • Brief Psychiatric Rating Scale (BPRS) | 1-page PDF (Source: Psychiatric Times)
  • Buss Lab Research Instruments | Assessments for friendship, sex, jealousy, etc. (Source: Buss Lab)
  • Career Assessments | Self-assessments to assess interests, skills, and work values
  • Clance Impostor Syndrome Scale | 3-page PDF, includes scoring information (Source: The Impostor Phenomenon: When Success Makes You Feel Like A Fake (pp. 20-22), by P.R. Clance, 1985, Toronto: Bantam Books.)
  • Communication Research Measures | Source: James McCroskey, West Virginia University
  • CSDS DP Infant-Toddler Checklist | A PDF printable checklist for identifying early warning signs of autism
  • DBT-WCCL Scale and Scoring | Citation: 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. (Source: University of Washington Center for Behavioral Technology)
  • Decision Making Individual Differences Inventory
  • The Defeat Scale (D Scale) | 2-page PDF (Source: The Compassionate Mind Foundation)
  • Demographic Data Scale | A self-report questionnaire used to gather extensive demographic information from the client. Citation: Linehan, M. M. (1982). Demographic Data Schedule (DDS). University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Diary Cards NIMH S-DBT Diary Card NIDA Diary Card CARES Diary Card | Source: University of Washington Center for Behavioral Technology
  • Division 12 Assessment Repository | Source: Society of Clinical Psychology
  • EAP Lifestyle Management Self-Assessments | A small collection of screening tools
  • Emotional Regulation Questionnaire (ERQ) | A short PDF scale to assess emotional regulation
  • The Entrapment Scale | 2-page PDF with scoring information, 1998 (Source: The Compassionate Mind Foundation)
  • 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)
  • Focus on Emotions | PDF assessment instruments for children and adolescents from 9 to 15 years. Includes Empathy Questionnaire (EmQue), Mood List, Alexithymia Questionnaire for Children, Emotion Awareness Questionnaire (EAQ), BARQ, Behavioral Anger Response Questionnaire, Worry / Rumination, Somatic Complaint List, Instrument for Reactive and Proactive Aggression (IRPA) Self-Report, Brief Shame and Guilt Questionnaire for Children, Coping Scale, and Social-Emotional Development Tasks
  • Grief and Loss Quiz | Interactive quiz (Source: PsychCentral)
  • Guilt and Shame Proneness scale (GASP) | 4-page PDF with scoring information, 2011 (Source: Taya R. Cohen)
  • HealthyPlace Psychological Tests | Interactive tests for abuse, anxiety, depression, personality disorders, and more (Source: HealthyPlace)
  • Helpful Questionnaires | Topics are varied (Source: James W. Pennebaker/University of Texas at Austin)
  • IDR Labs Tests | Interactive psychology tests
  • Integrated Biopsychosocial Assessment Form | 16-page PDF assessment form
  • Intellectual Humility Quiz | Online interactive test (Source: Greater Good Magazine) 🆕
  • Internalized Stigma of Mental Illness Inventory (ISMI) | 2-page PDF (Source: J. Ritsher, University of California, San Francisco)
  • Library of Scales | 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.) (Source: Outcome Tracker)
  • Measurement Instrument Database for the Social Sciences | A searchable database (Source: MIDSS)
  • Measures and Scales | Source: University of Utah Psychology Faculty
  • 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.
  • Military Health System Assessments | Interactive tests for PTSD, alcohol/drug use, relationships, depression, sleep, anxiety, anger, and stress
  • Mind Diagnostics
  • Mindset Assessment: What’s My Mindset? | Online interactive test, requires email sign-up to view results (Source: Mindsetworks) 🆕
  • Modified Checklist for Autism in Toddlers, Revised, with Follow-Up | Free download and scoring instructions
  • The Multidimensional Experiential Avoidance Questionnaire (MEAQ) | 3-page PDF with scoring information, 2011 (Citation: Gamez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (in press). Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire (MEAQ), Psychological Assessment.)
  • 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.
  • Other as Shamer Scale (OAS) | 2-page PDF with scoring information, 1994 (Source: The Compassionate Mind Foundation)
  • Parental Affect Test | The Linehan Parental Affect Test is a self-report questionnaire that assesses parent responses to typical child behaviors. Citation: Linehan, M. M., Paul, E., & Egan, K. J. (1983). The Parental Affect Test – Development, validity and reliability. Journal of Clinical Child Psychology, 12, 161-166. (Source: University of Washington Center for Behavioral Technology)
  • 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.
  • Project Implicit | A variety of interactive assessments that measures your hidden biases
  • Project Teach Rating Scales | PDF assessments for children and youth
  • Psychological Self-Tests and Quizzes | Interactive tests (Source: Counselling Resource)
  • Psychologist World Personality & Psychology Tests | Interactive tests
  • Psychology Scales | Topics are varied, including likability, honesty, expertise, etc.) (Source: Stephen Reysen)
  • Psychology Tools | Online self-assessments for addiction, ADHD, aggression, anxiety, autism spectrum, bipolar, depression, eating disorders, OCD, and personality.
  • PsychTests | Interactive tests for intelligence, personality, career, health, relationships, and lifestyle & attitude
  • PsychTools | Searchable database
  • Psymed Psychological Tests | Interactive tests for addiction, anxiety, mood disorders, personality disorders, and more
  • Questioning Reality Self-Check | Interactive questionnaire (Source: Foundry)
  • Recovery Assessment Scales | A variety of assessments for individuals recovering from psychiatric illnesses
  • Research-Based Psychological Tests | Questionnaires for anxiety, depression, personality, etc. (Source: Excel At Life)
  • Revised Beliefs About Voices Questionnaire (BAVQ-R) | Citation: CHADWICK, P., LEES, S., & BIRCHWOOD, M. (2000). The British Journal of Psychiatry, 177, 229-232.
  • Ruminitive Responses Scale | 1-page PDF (Source: Treynor, Gonzalez, and Nolen-Hoeksema, 2003)
  • Self-Assessment Checklist for Personnel Providing Behavioral Health Services and Supports to Children, Youth and their Families | 4-page PDF (Source: Tawara D. Goode, National Center for Cultural Competence) (1989, revised 2009)
  • Scales | 3 assessments available (Need for Closure, Locomotion, and Assessment) (Source: Motivated Cognition Lab
  • Science of Behavior Change Measures | Assessments for stress, communication, relationships, emotional regulation, and more
  • Screening Tools – Autism Canada | Interactive screening tools for autism for toddlers, children, teens, and adults (Source: Autism Canada) 🆕
  • Sensitivity Test for Adults | A carefully designed questionnaire to measure sensitivity in adults. (There is also a version for children.) 🆕
  • The Shame Inventory | 3-page PDF (Citation: Rizvi, S. L. (2010). Development and preliminary validation of a new measure to assess shame: The Shame Inventory. Journal of Psychopathology and Behavioral Assessment, 32(3), 438-447.)
  • Social History Interview (SHI) | 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. (Source: University of Washington Center for Behavioral Technology)
  • Somatoform Dissociation Questionnaire | A PDF assessment, scoring information here
  • Soul Shepherding Assessments | Assess for emotional intelligence, life stress events, and stress overload (3 PDF assessments)
  • 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
  • Supervisory Relationship Questionnaire (SRQ) | PDF scale with scoring instructions
  • Survey Instruments and Scales | To assess risky sexual behaviors (Source: CAPS)
  • Therapist Interview | The TI is an interview to gather information from a therapist about their treatment for a specific client. Citation: Linehan, M. M. (1987). Therapist Interview. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Treatment History Interview | Appendices | The THI is an interview to gather detailed information about a client’s psychiatric and medical treatment over a desired period of time. Citation: 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. (Source: University of Washington Center for Behavioral Technology)
  • TTM Measures | To assess for self-efficacy, decision-making, process of change, etc. (Source: HABITS Lab)
  • Voice Hearing: A Questionnaire | 17-page PDF questionnaire for hearing voices (Source: South Bay Project Resource)
  • Whirlwind of Psychological Tests | A modest collection of tools (Source: Delroy L. Paulhus)
  • Why Do You Lie? | Interactive quiz (Source: WebMD)

online assessment

If you know of a free assessment for mental health or addiction that’s not listed here, 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.

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

If you need treatment for mental distress or substance use but are not sure where to start…

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. 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 don’t want your parents to know…

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 are 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 friend or loved one says they’re going to harm or kill themselves…

Call 911 or 988. If you are with that person and are able to, stay with them until help arrives.

If you’re thinking about hurting or killing yourself…

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’re grieving a loss…

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’re sexually assaulted or being abused…

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 have a problem with 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 self-injure and can’t seem to 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 worried about a loved one’s drinking or drug use, but they don’t think they have a problem…

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 loved one overdoses on opioids…

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 problem with hoarding…

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 or 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 find out if you may have a mental disorder or addiction…

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., see Resource Links.

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

find help

4 Keys to a Positive Mindset

This is a list of four simple keys to developing a more positive mindset.

What are the keys to a positive mindset? In this article, I’ll discuss four simple ways for improving efficacy and managing expectations, and as a result, developing a more balanced outlook.

keys to a positive mindset

Upon learning I’m a therapist, people like to ask for advice. “What do you think I should do about _______________________________?

Unfortunately, I don’t have the answer you’re looking for. And contrary to popular belief, a counselor won’t tell you how to fix your problems.

You are the expert on you. When you bring that expertise with you to therapy and begin to form a collaborative partnership with your therapist, that’s when the process of growth happens.

While I could provide you with a piece of advice, it wouldn’t be what you wanted to hear; counter-arguments would be forming in your head while I speak.

Instead of me telling you what to do, you decide what to do. Not only are you the expert on all things you, you hold the answers to all your problems; they’re just locked away.  And sometimes, all it takes is a simple remark from your therapist for everything to click into place. You have a sudden epiphany or a lightbulb moment of clarity. You realize you’ve known what you need to do; it just took a bit of guidance and support to get there.

While particularly effective at generating lightbulb moments, therapy is not the only way. The “Aha!” moment can be anything, and it can happen in a classroom, while reading a book, at a concert, etc. Sometimes all it takes is a simple remark to change your mindset.


The following is a list of keys that clicked for me. They’re simple – yet lifechanging – keys to a positive mindset.

Four Keys to a Positive Mindset

1. Say what you mean.

How many times have you provided an explanation using partial truths? For example, you cancel on a friend, claiming a migraine. Your head may hurt, but at the same time, you’re embarrassed to go to the bar with her. She can’t seem to go out without getting obnoxiously drunk. Another example would be a wife who tells her husband, “I’m fine,” when she’s not. In both examples, truth is avoided.

When you don’t say what you mean, you deprive yourself. You’ll feel frustrated, and you may lose the chance to explore deeper issues. Your communication becomes second-rate. And if you find yourself saying what you think someone wants to hear, that’s not communicating; the point is to understand each other, not to mislead or appease.

Saying what you mean is one of the keys to a positive mindset; it’s freeing and it allows you to live an authentic life.

2. Just say, ‘okay.’

This is about not engaging with that one person who pushes your buttons (or with your own irrational thoughts).

I’ll use myself as an example. One day, I received an email from my supervisor, instructing me to complete a task ASAP… a task I knew I had finished three days ago. Initially, I panicked, second-guessing myself.

After some investigating, I found that I had indeed completed the task. So, why, why would he send that email? I started silently fuming to myself. How dare he?! Of course I’d completed the task… three days ago when it was due. What, does he think I sit around all day doing nothing? Why would he think I hadn’t done it? Crap… maybe he thinks I’m incompetent? And why wouldn’t he check before sending an email?

I was on an emotional roller coaster. In the span of 5 minutes, I went from panic to self-doubt to a brief moment of relief to self-righteousness to a sense of indignation and then fell to a state of irritation.

I typed and retyped my response to my supervisor.

Draft 1: “Yes, the task was completed three days ago when it was due. Had you checked, you would have known this.” (Too passive aggressive.)

Draft 2: “Thanks for the reminder, but it was completed on [date] at [time]. I can show you how to access the file to view it in case you don’t know how.” (Condescending.)

Draft 3: “Thanks for your email. The project was completed on [date] at [time]. Let me know if you need a copy.”

I asked a co-worker to look it over; I didn’t want my indignation to somehow spill over. (But I needed it to be clear to my boss that I had completed my assignment. On time. Without him asking me to.)

My colleague laughed and asked, “Why don’t you just tell him, ‘okay,’ and leave it at that?”

And she was right. I had allowed myself to get all worked up over something small. I allowed my irrational self (and insecurities) to take over, completely taking me out of my space. Why did I feel like I had to prove myself? The project was done, which is what mattered.

Another case for “okay” is the unhappily married couple who fight constantly. They argue to the point of shouting because neither wants the other to “win.” They can’t let the other have the last word because it would mean admitting defeat, that they were in the wrong. They have to prove themselves, no matter the cost. Instead of arguing every little thing, they could save their energy (and peace of mind – possibly, their marriage) by just saying, “okay,” and leaving it at that.

By linking your self-concept to how others perceive you, your identity is threatened by the idea of admitting defeat. (But you don’t have to live that way anymore!) Instead of feeding into the argument, especially when you’re provoked, just say, “okay,” and leave it at that.

Furthermore, if there’s a toxic person in your life, for example, an ex that you co-parent with, don’t respond to a provoking text or to a barb. You gain nothing by proving you’re right (other than maybe a self-important spark of satisfaction). In the end, you’re still the loser because you took the bait and allowed someone else to orchestrate your emotions.

Don’t sacrifice your peace of mind; just say, “okay,” one of the keys to a positive mindset.

3. This is nothing you can’t handle.

It may not seem like much, but this key lays the foundation for change. It empowers you. A seemingly unsolvable problem can be broken down into manageable solutions. A catastrophe becomes a challenge, not defeat. You don’t have to be a victim when you can be a survivor.

When faced with the impossible, we panic. Our emotional mind has all the control while the rational mind fades to the background. However, the rational mind can be coaxed back from hiding with guidance.

The next time you feel helpless and are thinking, “This is impossible,” remind yourself it’s nothing you can’t handle. This is one of the keys to a positive mindset. Once you’re in that frame of mind, the solutions will come more easily.

4. Always take ownership.

I’ve made many mistakes. It’s uncomfortable to admit when I mess up. Sometimes there are even consequences.

This fourth key is about owning your actions, especially when you make a poor decision. You’re going to make mistakes. Don’t make excuses. Admit fault and apologize when needed.

By placing the blame on someone or something else, you stunt personal growth. You’ll continue to make the same mistakes (because it will never be your fault).

You can’t live an authentic life without taking ownership, nor will you gain the respect of others. Be authentic; take ownership of your mistakes (and achievements!)


If reading about these four keys to a positive mindset “sparked” something for you, think about the changes you need to make in your own life to experience a positive mindset.

key statements