7/28/2019 CBT Handouts [Landscape]

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Client’s Name _________________________________________ Date ________________________ 

Activity Schedule

Monday Tuesday Wednesday Thursday Friday Saturday Sunday6am

7am

8am

9am

10am

11am

12pm

1pm

2pm

3pm

4pm

5pm

6pm

7pm

8pm

9pm

10pm

11pm

12pm

7/28/2019 CBT Handouts [Landscape]

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Client’s Name _________________________________________ Date ________________________ 

Functional Analysis Worksheet

Trigger

What sets me up to use?

Thoughts, and Feelings

What was I thinking?What was I feeling?

Behavior

What did I do then?

Positive Consequences

What positive thinghappened?

Negative Consequences

What negative thinghappened?

 

7/28/2019 CBT Handouts [Landscape]

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Client’s Name _________________________________________ Date ________________________ 

Coping With Cravings and Urges

Reminders:

Urges are common and normal. They are not a sign of failure. Instead, try to learn from them about what your craving triggers are.

Urges are like ocean waves. They get stronger only to a point, then they start to go away.

If you don't use, your urges will weaken and eventually go away. Urges only get stronger if you give in to them.

You can try to avoid urges by avoiding or eliminating the cues that trigger them.

• You can cope with urges by -

• Distracting yourself for a few minutes.

• Talking about the urge with someone supportive.

• "Urge surfing" or riding out the urge.

• Recalling the negative consequences of using.

•Talking yourself through the urge.

 Each day this week, fill out a daily record of craving and what you did to cope with craving.

• Example:

Date/Time Situation, thoughts, and feelings

Intensityof 

Craving(1-100)

Length

of Craving

How I Coped

Friday, 3 pm Fight with boss, frustrated, angry 7520

minutesCalled home, talked to Mary

Friday, 7 pm Watching TV, bored, trouble staying awake 6025

minutesRode it out and went to bed early

Saturday, 9 pm Wanted to go out and get a drink 8045

minutesPlayed basketball instead

7/28/2019 CBT Handouts [Landscape]

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Client’s Name _________________________________________ Date ________________________ 

Daily Record of Craving

Date/Time Situation, thoughts, and feelings

Intensityof 

Craving(1-100)

Lengthof 

Craving

How I Coped

 

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Client’s Name _________________________________________ Date ________________________ 

Dysfunctional Thought Record

Date Situations

Briefly DescribeEmotions

Rate each emotion

(0-100%)

Automatic Thoughts

Record thoughts, then rate

the degree your belief ineach thought (0-100%)

Rational Response

Rate your belief in

each thought (0-100%)

Outcome

Re-rate

eachemotion