Substance Misuse Diary
Substance Abuse Diary
When? Where?
What was happening ?
Who was I with?
0% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
What did I drink or use?
How much?
16% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
Thoughts / Images
What went through my mind at the time?
33% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
Feelings
What emotions or physical sensations did I feel?
50% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
Outcome
How did it affect me
How did it affect others?
How much did I spend?
Short and long term consequences?
66% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
Alternative, more healthy response
What could I have done differently? What would have helped?
84% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
To learn more about Addictions and to get in touch with one of iTherapy's counselors visit our Education and Resources Page for Addictions
| When? Where? | What did I drink or use? | Thoughts / Images | Feelings | Outcome | Alternative, more healthy response |
|---|---|---|---|---|---|
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
| When? Where? |
|---|
Answer Question to Complete Worksheet |
| What did I drink or use? |
Answer Question to Complete Worksheet |
| Thoughts / Images |
Answer Question to Complete Worksheet |
| Feelings |
Answer Question to Complete Worksheet |
| Outcome |
Answer Question to Complete Worksheet |
| Alternative, more healthy response |
Answer Question to Complete Worksheet |
100% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Addictions to learn more about Addictions and to get in touch with one of iTherapy's counselors.
Thanks to www.getselfhelp.co.uk for this template.
