Diaphragmatic breathing worksheet
Mindfulness-based interventions, such as mindfulness and addiction worksheets, can be an effective approach to treating substance use disorders and relapse prevention.
This article provides an overview of mindfulness in recovery worksheets and mindfulness-based strategies to use with clients.
We’ve also included free, downloadable mindfulness and addiction worksheets that you can save to your electronic health record (EHR) and use in your practice.
What is mindfulness?
Mindfulness is an ancient practice with roots in Buddhist and other spiritual traditions, involving being present in the moment and aware of your internal states and surroundings. It fosters acceptance and nonjudgment to increase awareness and decrease overwhelm.
In the 1970s, Jon Kabat-Zinn introduced mindfulness into Western psychology and medicine, and developed an eight-week program called mindfulness-based stress reduction (MBSR). This program involves meditation training, including simple stretches and postures.
Initially created as a stress management program, MBSR evolved to treat several physical and mental health conditions, including:
Depression
Post-traumatic stress disorder
Chronic pain
Diabetes
High blood pressure
Immune disorders
Anxiety
Skin diseases
Mindfulness in addiction recovery
There is a well-known link between stress and addiction. People experiencing stress may turn to substances to cope, and repeated use may lead to the development of a substance use disorder.
Even if a person is in recovery from substance use, ongoing stress is a risk factor for returning to use (relapse).
However, research shows that incorporating stress-management techniques, like those in the mindfulness and addiction worksheets, can help individuals in recovery develop healthier coping strategies to maintain their recovery.
Many recovery programs now incorporate a range of mindfulness-related activities, including meditation, into their treatment. Some recovery groups, such as Recovery Dharma and Refuge Recovery, also use mindfulness techniques found in the mindfulness in recovery worksheets.
There are also recovery-specific mindfulness programs, including:
MBSR for addiction recovery: MBSR that has been adapted to help individuals observe urges rather than act on them, increase distress tolerance skills, and help them connect to the present moment by observing the body and emotions without judgment.
Mindfulness-based cognitive behavioral therapy (MBCT): A mindfulness-based stress reduction program combined with cognitive behavioral therapy (CBT) that teaches nonjudgmental awareness, how to recognize unhelpful thought patterns, and how to respond to distress with acceptance.
Mindfulness-oriented recovery enhancement (MORE): This approach also incorporates MBSR by addressing the roots of addiction (like stress, emotional pain), and the deficiency in natural reward processing, shifting the participant's attention away from substances and toward more naturally rewarding and meaningful experiences.
Mindfulness-based relapse prevention (MBRP): This program combines elements of mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy to enhance awareness of triggers, improve distress tolerance, foster emotional and bodily awareness, and develop relapse prevention strategies to reduce the risk of relapse. MBRP is effective for individuals with co-occurring disorders, like anxiety and depression, and substance use disorders.
Research shows that these mindfulness-based interventions have been successful for the treatment of substance use disorders by:
Reducing cravings
Improving positive affect
Strengthening emotional regulation skills
Potentially rewiring neural pathways linked to reward and stress
Increasing executive functioning
Enhancing autonomic regulation
Increasing self-compassion
Mindfulness and addiction recovery exercises
Mindfulness-based addiction recovery activities that can also be found in the mindfulness in recovery worksheets include:
Thought labeling
This mindfulness activity involves observing thoughts during meditation by naming them with non-judgmental phrases, such as “worrying,” “planning,” or “craving,” without acting on them.
Urge surfing
One of the techniques in the mindfulness and addiction worksheets is the urge surfing exercise.
This technique is helpful when experiencing a craving and involves observing the craving by visualizing it as a wave, rising, cresting, and falling, without acting on it.
Three-minute mindful breathing
This three-step technique included in the mindfulness in recovery worksheet helps to create a brief reset to destress. It involves:
Becoming aware of what is happening right now
Focusing your attention on the breath
Expanding your awareness to the whole body and environment
Body scan meditation
The body scan activity fosters interoceptive awareness, reduces stress, and helps individuals connect with their body by slowly paying attention to different parts of the body and noticing sensations without judgment.
Savoring practice
This exercise retrains the brain to find enjoyment in everyday, non-addictive sources of pleasure, such as savoring a cup of tea, by using your senses to absorb the experience fully.
Chocolate exercise
In this mindfulness activity, you hold a piece of chocolate close to your nose and lips, using your senses to observe the sensations while resisting the urge to eat the chocolate.
The idea is to break down the elements of craving into sensory, cognitive, and emotional components, recognizing how emotions and the mind can drive behavior, but mindfulness can help resist urges.
How to use the mindfulness in recovery worksheets
You can download and use the mindfulness and addiction worksheets in several ways:
Use it in session as a psychoeducational prompt about mindfulness and addiction recovery.
Give the mindfulness in recovery worksheets to the client to remind them of what you discussed during therapy.
Create a substance use disorder folder with other screening and information worksheets, such as our substance use assessment form and relapse prevention worksheets.
Ask the client to reflect on the activity worksheet between sessions, practice a mindfulness skill, and report their progress at their next therapy appointment.
Combine mindfulness and addiction worksheets with other worksheets, such as DBT emotional regulation worksheets, RAIN mindfulness exercise, distress tolerance worksheets, and a mindfulness fact sheet, to use in group or individual settings.
Sources
American Psychological Association. (2024). Mindfulness meditation: A research-proven way to reduce stress.
Garland, E. L., & Howard, M. O. (2018). Mindfulness-based treatment of addiction: Current state of the field and envisioning the next wave of research. Addiction Science & Clinical Practice.
Marcus, M. T., & Zgierska, A. (2009). Mindfulness-based therapies for substance use disorders: Part 1. Substance abuse.
National Institute of Health. (2021). Mindfulness for your health. The benefits of living moment by moment.
Niazi, A. K., & Niazi, S. K. (2011). Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. North American Journal of Medical Sciences.
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