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.