CBT psychoeducation guide
If you’re looking for a list of coping skills for addiction PDF to share with clients, this article includes coping skills in recovery worksheets.
Substance use disorder is a significant public health concern in the United States. However, research shows that 1 in 10 Americans report having resolved a significant substance use problem, according to the Recovery Research Institute.
This article explores the key coping skills for addiction recovery, examples of coping skills in recovery worksheets, and more.
We’ve also included a free downloadable list of coping skills for addiction PDF to save to your electronic health record (EHR) and share with clients.
The importance of coping skills for substance abuse recovery
Recovery from substance use disorder is complex and similar to other chronic diseases.
Some people achieve lasting recovery and remission, while others may achieve a period of recovery, return to use, and eventually resolve their drug or alcohol problem.
Rates of relapse are similar to those of other chronic conditions, according to the National Institute on Drug Abuse (NIDA).
For example:
Asthma: 50% to 70% of people with asthma experience relapse.
Hypertension: Rates of relapse among patients with hypertension range from 50% to 70%.
Substance use disorders: Rates of returning to use among people in recovery range from 40% to 60%.
As substance use disorders affect many aspects of a person’s life, treatment may need to address specific medical, social, mental health, occupational, legal, and family needs to support their recovery.
This includes developing effective coping mechanisms to manage these stressors to sustain long-term recovery.
Examples of coping skills in recovery worksheets
Coping strategies are the essential tools, skills, and techniques that help maintain recovery.
They should form part of a comprehensive relapse prevention plan that pulls together the coping strategies in advance so that the person is prepared to handle situations that may lead to relapse.
This section details the components of coping skills in recovery worksheets such as a relapse prevention plan and provides a comprehensive list of coping strategies.
Relapse prevention plan
A relapse prevention plan helps a person cope with stressors to reduce the risk of relapse.
It incorporates:
1. Personal triggers: Situations, people, emotions, or environments that make you more vulnerable to relapse.
Examples include:
Being around friends who use substances
Celebrations involving alcohol
Feeling lonely, rejected, or overwhelmed
Payday or having extra cash on hand
Boredom or unstructured time
2. Early warning signs: These are subtle signs that you might be slipping toward relapse, often emotional or behavioral.
Examples include:
Skipping therapy or support group meetings
Isolating from loved ones
Romanticizing past substance use (“I was more fun back then”)
Increased irritability or mood swings
Losing interest in self-care or hobbies
3. Internal coping strategies: When triggered or distressed, these are your go-to actions.
Examples include:
Practice mindfulness or grounding techniques (e.g., 5-4-3-2-1 sensory exercise)
Cognitive restructuring that challenges distorted thinking (“Just one won’t hurt” to “One often leads to more, and I’ve worked too hard for that.”)
Distraction through exercise, music, puzzles, art, a cold shower, etc.
Journaling your thoughts and emotions
Using self-soothing skills (warm bath, comfort food, cuddling a pet)
4. External coping strategies: Relying on people, environments, or systems to support yourself.
Examples include:
Call a friend, therapist, or sponsor
Text a therapist or crisis line
Attend a support group or meeting (e.g., AA, SMART Recovery)
Go to a public place (library, coffee shop) to avoid isolation
Ask a family member to help remove access to harmful substances
5. Support system: List people or services you can contact for help, including name and contact details.
6. Emergency plan (If you return to use): Plan ahead for what to do if a lapse or relapse happens.
Examples include:
Call your therapist
Speak to a person in recovery
Write down what led to the slip (What happened? How did I feel? What will I do differently?)
Attend a support group, if appropriate
Recommit to your plan and recognize that slips are data, not a sign of weakness or failure
7. Motivators for staying on track: List your “whys”—things that matter deeply to you.
For example:
“To be present for my children.”
“To be healthy.”
“To break the cycle of addiction in my family.”
“Because I deserve a peaceful, stable life.”
List of coping skills for addiction recovery
The list of coping skills for addiction PDF includes the following techniques, along with space for clients to reflect on their own recovery.
Cognitive behavioral therapy (CBT) coping strategies
1. Identify triggers: Recognizing the specific situations, people, emotions, thoughts, or environments that increase the urge to use or engage in addictive behavior.
For example:
Activating event (external trigger): What happened just before the urge? Example: “I argued with my partner.”
Internal trigger: What thoughts or emotions came up?
Example: “I felt rejected and like I’ll never say the right thing.”
Behavioral response: What action followed?
Example: “I went to the liquor store.”
2. Challenge unhelpful thoughts (cognitive restructuring): Catching negative thinking and replacing it with more helpful alternatives.
For example:
Spotting automatic thoughts like “I’ll never change,” “I’ve already relapsed so I might as well keep using,” or “No one cares anyway.”
Identifying cognitive distortions (e.g., all-or-nothing thinking, catastrophizing)
Evaluate the evidence for and against those thoughts
Reframe them into more balanced, helpful thoughts, such as “I’ve coped before without using substances. I can try one of those strategies again.”
Dialectical behavioral therapy (DBT) skills
Dialectical behavioral therapy (DBT) uses practical distress tolerance and emotional regulation skills to help cope with challenging situations and difficult emotions.
These include:
Distress tolerance skills
ACCEPTS skill: The ACCEPTS tool is one of several practical techniques for managing stress and difficult emotions. It helps you accept present conditions as they are. ACCEPTS stands for activities, contribution, comparisons, emotions, pushing away, thoughts, and sensations. You’ll find an ACCEPTS worksheet in the handouts below.
TIP: A tool to quickly calm an overwhelmed body using temperature, exercise, and breathing techniques. TIP stands for temperature, intense exercise, and paced breathing.
IMPROVE skill: Replaces a distressing environment with a more positive one by focusing on imagery, meaning, prayer, relaxation, focusing on one thing, vacation, and encouragement.
Ride the wave: This skill teaches you to ride waves of intense emotions. Like urge surfing, riding the wave acknowledges the emotion and encourages mindful observation—where it is felt in the body and how it could be described—while focusing on the breath. After 10-15 minutes, the idea is that the feeling or intensity of the emotion has passed.
Emotional regulation skills
STOP: This acronym stands for:
Stop: When feeling intense emotions, the idea is to pause to prevent reactions.
Take a step back: Take a breath and figure out the situation.
Observe: Once calm, you can observe thoughts, check facts, and ensure you don’t jump to conclusions or overreact.
Proceed mindfully: Consider possible outcomes from a place of calm and mindfulness.
Opposite action: This skill encourages responding differently to a feeling you’ve come to rely on. For example, if you feel depressed, you could move your body and socialize. When you feel anger, you could consider the situation from another perspective and find ways to emphasize or show compassion.
PLEASE: This tool emphasizes healthy habits to improve emotional regulation. The acronym stands for:
PL: Attend to physical illness.
E: Eat healthy and nutritious food.
A: Avoid substances.
S: Get enough sleep.
E: Exercise.
Distraction skills
Distract yourself from harmful urges:
Make a warm cup of tea instead of reaching for alcohol.
Go for a run or lift weights at the gym.
If you feel the urge to self-harm, try holding an ice cube tightly or snapping a rubber band on your wrist—safer ways to release tension.
Distract with pleasurable activities:
Take a walk outdoors or go on a hike somewhere new.
Call or video chat with a friend.
Listen to music or try a new podcast.
Take photographs, tend to your garden, or work on a creative project.
Play a puzzle game, tackle a jigsaw, or start a new online game.
Try working from a different location, like a coffee shop or library.
Learn something new—take a class or explore a hobby you’ve been curious about.
Visit family or elderly relatives and offer to help around the house.
Plan a mini adventure, like a trip to an art gallery, museum, or beach.
Distract by focusing on others:
Offer to run errands or help out a friend or family member.
Shift attention outward by doing something interactive—drive somewhere, go to the mall, play a sport, or meet up for coffee.
Journal about someone you care about. Describe your relationship, their best qualities, and what you’d say if you saw them?
Distract by changing your environment:
If you’re in an emotionally charged or overwhelming situation, it’s OK to leave. A change of space can help reset your emotions.
Distract your thoughts with focus:
Engage your brain in something mentally challenging—switch to a work task you’ve been avoiding or problem-solve something that requires full attention.
How to use the list of coping skills for addiction PDF
You can download and use the list of coping skills for addiction PDF in several ways.
For example, you can print or screen share the worksheet and use it as a session psychoeducational prompt.
Give the coping skills in recovery worksheets to clients to remind them of what you discussed during therapy.Or, ask the client to reflect on the coping skills between sessions, try one new skill over the next week, and report their progress at their next therapy appointment.
Lastly, you may use the list of coping skills for addiction PDF as part of supervision or case consultations.
Sources
Kelly, J. F., Bergman, B. G., Hoeppner, B. B., Vilsaint, C. L., & White, W. L. (2017). Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug and Alcohol Dependence.
National Institute on Drug Abuse. (2020). Drugs, Brains, and Behavior: The Science of Addiction. Treatment and Recovery.
Recovery Research Institute. (n.d.). 1 in 10 Americans report having resolved a significant substance use problem.
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