Stages of Change
Thoughts, Feelings, Actions
Triggers & Cravings
Distress Tolerance & Coping
Random
100

Someone says, “I don’t have a problem. Everyone drinks like this.”

What is Precontemplation?

100

“I can’t handle discomfort without using.”

What is a cognitive distortion (all-or-nothing thinking)?

100

Anything that increases the urge to use substances.

What are triggers?

100

Skills used to get through intense emotions without using.

What are coping or distress tolerance skills?

100

You see me once in June, twice in November, and not at all in May. What am I?

What is the letter “e”?

200

Client actively attending treatment and practicing skills.

What is Action?

200

“Everyone will judge me if I relapse.”

What is mind-reading?

200

Avoiding triggers without coping skills increases this risk.

What is relapse?

200

Using temperature change or exercise during cravings targets this system.

What is the nervous system?

200

This TV show features a fictional paper company called Dunder Mifflin.

What is The Office?

300

Client has been sober and working to prevent relapse long-term.

What is Maintenance?

300

Which part of the CBT triangle is usually easiest to change first?

What are actions?

300

Cravings usually peak and fall within this amount of time.

What is 20–30 minutes?

300

Accepting reality without approving of it.

What is radical acceptance?

300

These sea creatures have three hearts and blue blood.

What are octopuses?

400

Client admits substance use is causing problems but isn’t ready to stop.

What is Contemplation?

400

Replacing “I can’t do this” with “This is uncomfortable but temporary” changes this corner.

What are thoughts?

400

This technique involves riding out urges without acting on them.

What is urge surfing?

400

Using ice or cold water during a craving is an example of this skill.

What is a TIPP skill (temperature)?

400

This river is the longest in the world.

What is the Nile River?

500

Client is making a plan to cut down or enter treatment.

What is Preparation?

500

CBT stands for this

Cognitive Behavioral Therapy

500

Cravings often intensify when this basic need is unmet.

What is sleep?

500

This long-term skill helps reduce reliance on crisis coping.

What is emotional regulation?

500

This evidence-based therapy teaches clients to identify and change thoughts that lead to substance use.

What is Cognitive Behavioral Therapy (CBT)?

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