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Taking the Escalator 

Substance Use Therapy Tools

Harm Reduction

12 Step Alternatives      Addiction and Substance Use Resource

      Non 12 Step Motivational Harm Reduction Tools for Substance Use & Mental Health

Group Activities by Topic

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Email: [email protected]

NEW: Ideas, News and Suggestions for Counselors:

LOOKING for a brief (5-15 minute) Icebreaker, group close out idea or brief discussion module? - Check out the:

 Taking the Escalator FORUM page

FACEBOOK USERS - New group for collaborating with colleagues

Join Co-Occurring Disorders Tools for Clinicians and Case Managers

Share information, tools, feedback, with peers in this challenging field

Dr. Erin Zerbo is one of the most engaging, knowledgeable and interesting addiction specialists around today - As a doctor of addiction psychiatry she has studied the brain in-depth and can explain neurobiology and addiction behavior from such a compassionate and empathetic yet scientific perspective. 

She does speak at a rapid pace as she has so much to share. However if you tune in, focus and listen you will definitely learn something as she is an excellent researcher and teacher on substance use disorders and related topics 

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Thanks to all who have sent positive and encouraging messages. A common question sent in is: "Can I use these materials?" - The answer is YES - Everything on the Taking the Escalator is free for clinicians, case managers and others working in substance use and mental health treatment and prevention settings. 

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Unless otherwise specified, all materials on this page are Taking the Escalator originals. At the end of each subheading section are some additional resources from around the web for Taking the Escalator users to look through and download. These materials are open source for public use

Materials that are from outside sources are marked with a square bullet point as done for this line. It is our policy not to violate other source's copyrights, so if you notice a potential conflict, please email us at [email protected]

Materials marked "CCI" are from a large collection which comes generously from the Centre for Clinical Interventions (CCI) in Western Australia, who has allowed these mental health worksheets and activities to be uploaded and shared for counselors by Taking the Escalator. 

To view the CCI website directly go to -

Alphabetical Listings by Topic:

< To search by word anywhere on this page press: CTRL F >

Accountability and Responsibility

6 Shoulds and Should Nots for Responsibility

Accountability and You - Are You Meeting the Challenge?

Accountability Self-Examination Worksheet

Responsibility Road - Looking at the critical concept of increasing responsibility

The Responsibility Riddle

Addiction and the Brain

This is Your Brain on Drugs...(Fried Egg Not Included)

VIDEO - The Brain and Addiction Behavior with Dr. Erin Zerbo, MD

Adolescent/Young Adult Specific

Adolescent Activities List - A guide with recommendations from this website for clinicians working with adolescents

ADOLESCENTS: RISK FACTORS - Exploring risk factors for substance use issues with young people

Adolescent Substance Use - A basic educational outline for those working with adolescents and parents

Adolescent Substance Use Group (Multiple Choice) - This is a kahoot activity for adolescent substance use groups

Drug Dealing

Identifying Teen Risk and Protective Factors for Substance Use (PDF Presentation Slides) - Powerpoint version

VIDEO LINK - Teen Risk and Protective Factors for Substance Use (Corresponds with above)

Three Paths: A Discussion of Marijuana

Anger Management

Anger Discussion Sentence Completion - Simple questions for opening up discussion on anger

Anger Management: Digging Deeper and Using Basic AM Skills

Anger Memories: Family

Anger Styles

Basic Anger Management

Owning and Discharging Anger

Owning Anger Using "I" Statements

Ways People Express Anger



Anxiety and Panic

The Great Lie of Anxiety

READ - Coping with an Overactive Mind - (Inspirational reading submitted by Nicole Tierney)

Assessment and Screening Tools

Click to view the Taking the Escalator Assessment and Screening Tools

Assessing Your Change Initiative - Getting started learning about insight, internal motivation and external motivation

VIDEO LINK - "Understanding Insight and Motivation for Positive Change" - (Corresponds with Assessing Change Initiative)

Attention, Concentration and ADHD

Attention and Concentration



Anger Attitude Check

Confident or Cocky - It Matters

Garbages and Gardens (Attitude Made Simple)

Keeping it Positive: "I Love it When a Plan Comes Together"


Professing the Positive

Shift to a Positive Focus

Surviving Challenges by Adjusting Your Attitude

CBT Specific

Cognitive Behavioral Therapy Overview

REBT - Overview of Rational Emotive Behavioral Therapy skills for group

Change Planning/Recovery Planning

READ: 5 and 5 for Change

Change Analysis - Examining the actual, the real and the ideal

Change Management Planning

Flipping the Script on Addiction

A Journey Through Change - Looking at change from various perspectives

Outside In - Building yourself up on the inside by developing a solid plan

READ: Planning for Inspiration

Return to Normalcy

Stay Inspired by Planning for Change (Activity)

Checking In

Check In - A basic tool for checking in where you are today

Check In Cheat Sheet - A comprehensive list of information and ideas for the check in process in therapy

Group Goal

Progress Report - Basic progress report worksheet for getting relevant discussion started

Systems Check - A comprehensive review of where you are in the change process

Children (Activities for Children 12 and Under)

Closing Group - Ideas, Activities and Worksheets for the End of the Session

Discussion Outline for Speakers or Video

End of the Day Review

Goodbye Group - An outline for group when someone is leaving, graduating or moving on

Group Close-Out Ideas

Life Story Outline

Motivational Minute

Text Yourself Before You Wreck Yourself - (Group close-out homework and follow-up activity)

Topics for Art or Journaling

Weekend Relapse Prevention Plan

Cohesion Building for Groups

3A's - Appeciation, Assessment & Advice

Adjective Anecdotes

Brief Group Module and Icebreaker Collection 1 - Multiple shorter activities to choose from in this collection

Brief Group Module and Icebreaker Collection 2 - More shorter activities like in collection 1 above

Brief Group Module and Icebreaker Collection 3 - Even more  

Caption This

Care or Don't Care Icebreaker - Another basic tool for starting group discussion

Choose or Lose Icebreaker - Some basic multiple choice questions for opening up discussion

Cohesion Cards

Declare-Disclose-Display - A variety of ways to get the group talking and interacting

Deep and Personal - Some in depth personal questions for opening people up

Describe - Draw - Describe - Get group sharing thoughts and feelings with art

Escalator Jeopardy - A comprehensive educational review - (Also see "Life Jeopardy" under the Coping Skills heading)

Fill in the Blanks Discussion Generator

Fun Facts

Grab Bag - A great list of interesting, questions and other situations to get people talking

Grading the Group - Interactive group report card

Group Awards

Group Glue - This one has a little bit of education because it explains the power and value of group cohesion

Group Profile

Group Member Fill In the Blank - A great exercise to have fun and make group interactive

The Honesty Game

Hello Neighbor

Icebreakers for Break Time - Short but interesting group assignments for breaks in between groups

Image Narrations

The League of Just Us - A basic fun activity focused on superheros

Making the Most out of Substance Use Treatment - This is unique because it is an interactive Kahoot activity

Majority - Interactive exercise, better for an established group than a new one

One Thing

Pointless Pursuits - (Warning: only try this if you and the group members have established a degree of comfort with one another)

Positive Vibes

The Randomizer

Remember When...

Slips of Paper - A quick and easy icebreaker that gets a group talking with no prep time

Social Media Icebreaker - Exercise for self expression based on social media

Teaching an Old Dog New Tricks

Telehealth Specific Group Cohesion Building Activities - Ideas specifically for virtual video groups

Topic Turnaround

Unique - Discussing what you would and wouldn't do

Do not forget to check the Taking the Escalator FORUM page for more icebreakers and brief group therapy modules


Breaking the Cycle of Broken Promises


Communication and Social Skills

Assertive Communication

Learning to Say "No" Effectively

Sophisticated Debates

Win, Lose or Indifferent: Positive Qualities for Positive Gains


Complacency - (Submitted by Laura Laura Hennessy, LCSW. LCADC)

Co-Occurring Disorders/Coexisting Mental Health Issues

COD - Co Occurring Disorders - An older outline about COD's and addiction

Coexisting Mental Heath Issues - A checklist for starting to look at mental health


Control Loss

READ: To Control or Not to Control...Is that the Question?

Powerlessness and Willpower - Looking beyond powerlessness to examine where we can build willpower

Power and Control - (Submitted by Caitlin Kennedy, LCSW, LCADC)

Working Out Self Control Muscles

Coping Skills - General

READ - Accept - Cope - Adapt, Part One

Accept-Cope-Adapt - An approach for dealing with life struggles

Coping Circle

Coping Tool Box: Warmup Exercise

"Life" Jeopardy

Pet Appreciation - Discussing how animals can help us cope

Skill Building


Use Your Brain and Not Your Pain - Another simple but effective strategy for coping with challenging emotions

COVID-19 Specific

Additional COVID-SPECIFIC resources from the web listed below:


Coping with Cravings - An essential list of tools for understanding and managing cravings and urges

Cravings Plan

Cross Addiction

Cross Addiction - Education and exercise on substituting addictive behaviors

Decision Making and Ethics

Decision-Making and Ethics - Examining what is behind making the right choices

Ethical Decision-Making 2 - Using insight and ethics to make tough choices

The Five Basic Elements of Effective Decision Making

Making the Right Choice - Another look at making decisions starting from good solutions

Red Flags for Decision Making – Warning Signs for Productive Living

When All Else Fails: The Costanza Principle - (Literally only use when all else fails)

Defense Mechanisms

Shielding - Looking at how we may try to protect ourselves from in comfortable realities

Group Roles - Outline of different ways individuals may protect themselves in group settings


Coping with Depression

Depression and Alcohol Quiz - A very basic quiz focused on opening up a basic discussion on this topic

Developmental Disabilities

  • Tips4Inclusion - Tim Rohrer is a young man who grew up with disabilities who now shares his own tools and resources

Disease Concept of Addiction

Defining Addiction

The Disease Concept of Addiction - Review of "symptoms" of addiction

Distress Tolerance

Eating Disorders and Body Dysmorphia


Empathy Moments

READ: Empathy without Agreement

"I Feel Like No One Understands"

Excuse Making

READ: Circumventing Excuses

Or READ - The Subterfuge Exclusion - (Similiar to Circumventing Excuses in different format)

Families, Support and External Motivation

Addiction and Choice - More Food for Thought

Do You Have to Want to Change? - Podcast

CRAFT (Community Reinforcement and Family Training) - "10 Basic Messages for Families" Slides - Robert Meyers PhD

External Motivation - Looking at what pushes us to change and ways to increase support

Family Match Game - An icebreaker discussion for multii-family therapy group

Family Timeline

Good Choices for Good Living - For Families

POWERPOINT SLIDES - Good Choices for Good Living - For Families

Healthy Families - Looking at positive family qualities

Helpers - Identifying who is out there to help you with the change process


The Pendulum - Examining Common Family Issues - Examining some common family challenges

READ: Push Your Best Foot Forward

Stages of Change -A Guide for Families of Individuals with Substance Use Issues

Support Report - Assessing and maximizing exisiting potential support system

Support Zones & Interpersonal Boundaries - Stepping outside of your comfort zone to build support

Strategy List for Families Dealing with a Loved One's Substance Use Issue

VIDEO - Click here to see the above outline "Strategy List for Families..." via Facebook Live video

You Cant Nag Someone Sober


Are You Letting Fear Hold You Back?

CONFIDENCE BUILDING - (Overcoming Fear of Failure)

Courage and Discouragement

Overcoming Fear of Change

Overcoming Fear of the Unknown

Feelings, Thoughts and Emotions (General)

Change the Channel: The TV Mind Analogy

Dealing with Feelings - Coping with feelings from three viewpoints

READ: Emotional Self-Prevention - Looking at sensitive areas

"The Feeling"

Feeling Under the Weather - A brief true-false list to open an honest discussion about feelings

Five Key Aspects of Appropriately Managing Feelings

Happiness Factor - (Submitted by Lesley SanFilippo, LCSW)

The IDEA Technique - A tool for coping with challenging thoughts and feelings

Meta-emotions - Feelings about feelings

READ: Please Dont Feed the Monster - An illustration about negative thoughts and feelings

Thinking About Thinking - Looking at the link between thinking, feeling and behaving

Thinking, Feeling and Coping in Challenging Scenarios

Thinking Styles - Tool for self-analyzing how we think

Thoughts and Feelings - Gaining an improved understanding how our thoughts and feelings affect us


READ: Nicole Tierney on Forgiveness

Part 1 : Forgive, Live and Love

Part 2: Divisions of Forgiveness

Part 3: Some Thoughts to Help Cope

Forgiveness and Self Care - Contributed by Jamie Lewitt MSW Intern


Give the Gift of Kindness and Hope

Giving Activities - There is more happiness in giving than receiving

Goal Setting

Four Year Prediction Time Capsule - An interactive exercise on long term goal setting

Giving Yourself the Best Chance to Succeed

Goal Setting - Using goals to build motivation

Goal Setting Collective: Looking Forward to the Year Ahead

Goal Setting Go Fish

Good Choices for Good Living

PCRP - Person Centered Recovery Plan - (Submitted by Katie Tracy, LCSW)


Gratitude Grab Bag

The Gratitude Grid

Overreaction: Putting Things in Perspective with Gratitude

Grief and Loss

Coping with Death and Dying - A simple outline for discussing coping with a recent loss without abusing substances

Grief and Loss Cycle (Submitted by Caitlin Kennedy, LCSW, LCADC)

Guilt and Shame

Guilt and Shame - Understanding and learning to cope with these challenging feelings

Understanding and Coping with Guilt and Shame - Similar to the other but in a different format

Insight Building - Basic, (Early Stage)

Be Your Best Self

Counting the Cost of THC (This has nothing to do with marijuana)

How High was I..How Low did I Go? Assessing highs and lows of getting high

Insight: Keeping the Window Open

The Irony of Addiction

Labels - For lower insight levels, comparing what is using, abusing and addiction

The Last 3

The Numbers Game

Past, Present and Future

Point of View Adjustment - Looking at other viewpoints to gain awareness

Remembering Me A.D. (After Death)

Self-Ratings Scale (The Lanni Scale)

Taking a Trip to the Other Side - Again exploring insight and motivation building from new perspectives

Using Fables to Overcome Foibles

What is Self-Honesty and Why is it So Important?

Why Didn't I Listen?

Insight Building - Advanced

Addiction and Mental Health Pictured

An Interview with Your Past and Future Self

Find Yourself

The Insight Game - Who knows the group?

Keeping it Real

Making Healthy Self -Investments

Overcoming Ignorance and Indifference for Positive Growth


Pick a Card - A variety of questions for insightful discussion

Simile Self Identification

Simple Insight Inventory - Strengthening existing insight to build motivation

Simple Insight Inventory II - (External/Support) - Working on external motivators and supports

READ - Topping Out...Worse than Hitting Bottom?

Truth Mining

READ - Unfollowing the Nonsense - A brief discussion on how media can influence perception

Why am I Here? - Getting honest about the real reasons for coming to treatment

Wisdom, Intelligence and Changing Your Paradigm


READ - Integrity - (Reflective reading submitted by Charles Radiola, MA, LCADC)

Self Awareness: (See Insight)

Self Care and Wellness

Body Talk

Boredom Buster

Rethinking Boredom

Self-Care Review

Self Esteem

Insecurity - Everyone has them, is the group ready to share them?

Maintaining a Balanced Ego - Looking at a balanced view of self

Self Esteem II - More self esteem, continued...

Self Esteem Boost: Building Self Esteem and Increasing a Sense of Self Worth

Self Value - (Submitted by Lesley Sanfilippo, LCSW)

Self Esteem and Affirmation Development - (Submitted by Caitlin Kennedy, LCSW, LCADC)

Self Awareness - (Submitted by Caitlin Kennedy, LCSW, LCADC)

The Truth about Self Esteem - An in depth look at Self Esteem from a realistic perspective

Setbacks and Relapse

Associations - Honestly considering how your choice of associations affect you

READ: Beyond People, Places and Things

The "Cushion" Background Information

The "Cushion" Concept for Managing Setbacks

Crushing Compromise

Deflating the Cushion from the Inside

External and Internal Setback Factors

FOMO - How to Identify, Prevent and Overcome the “Fear of Missing Out”

Getting Over the Hump - An activity for those who have been at this a long time

Holiday Survival Plan - Planning ahead to get through any holiday without setbacks or relapse -

READ: IF - Intensity and Frequency

Managing Setbacks: Group Introduction

Plan to Avoid Relapse - (Submitted by Caitlin Kennedy, LCSW, LCADC)

Principle Zero

The Setback-Motivation Guide

Setback Prevention Skills for Success

Stability and Setback Prevention Checklist

Starting Over

The Struggle is Real

Timeline Analysis

Triggered: A Discussion on Coping with Mental Health and Substance Use 

UNG- Unnecessary Grief - Thinking and planning ahead to avoid trouble later

Weekend Plan - A basic planning tool for surviving weekends


Smoking Cessation Specific Worksheets:

Cravings and Smoking: Basic Principles

Cravings and Smoking: Skills List

Nicotine Replacement Therapy Options

Smoking Quit Plan

Smoking Relapse Warning Signs

Smoking Triggers Worksheet

Spirituality (Moved to "Meaning and Purpose")


The River of Choices: Coping with Stigma

Podcast - Overcoming Stigma with Empathy

Stimulant Use Disorders

Stress Management

Coping with Stress - A comprehensive list of effective coping skills

Killer Bs – The Effects of Stress and the Body, Brain and Behavior

Stress Management

Stress Planning


Stories of Recovery

Melissa Mackolin on her Journey to Recovery - Podcast

Nicole Tierney: A Story of Recovery and Hope


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