Case Scenarios
An individual in recovery suddenly stops participating in group, starts sleeping more, and says, "I'm just tired." What are three things you would want to assess before deciding what is happening?
Depression, relapse risk, physical health, grief, conflict, anxiety, suicidal thoughts, or recent stressors.
If someone believes, "I will never be good enough," how might that belief affect recovery?
They may avoid relationships, reject help, expect failure, give up easily, or feel undeserving of success.
An individual in recovery says every boss they ever had was unfair. What pattern would you explore?
Authority issues, accountability, communication, expectations, workplace behavior, or repeated conflict patterns.
Why can becoming sober make someone feel lost?
Addiction may have become part of their identity, routine, relationships, coping, and sense of belonging.
An individual in recovery says, "I don't miss using. I just miss who I was when I was using." What might this reveal?
A struggle with identity, belonging, confidence, connection, freedom, or grief over losing an old lifestyle.
An individual in recovery says they have forgiven everyone who hurt them, but becomes angry every time childhood is mentioned. What does this tell you and what would you explore?
Their emotions may not match their words. Explore unresolved trauma, grief, shame, anger, or avoidance of painful emotions.
An individual in recovery believes, "People always leave." Name three behaviors that could keep this belief going.
Pushing people away, avoiding vulnerability, testing relationships, controlling behavior, not trusting others, or leaving first.
An individual in recovery has had five serious relationships and describes every partner as "crazy." What questions would you ask?
What role did they play? What happened before each relationship ended? What patterns repeat? What feedback have others given?
An individual in recovery says, "I don't know who I am anymore." Why can this be progress?
They are beginning to create a new identity instead of returning to old behaviors.
An individual in recovery says, "I know I need to change, but I don't know why I keep doing the same things." What is the difference between knowing and changing?
Knowing is understanding. Change requires willingness, emotional acceptance, effort, and practicing new behaviors.
An individual in recovery follows every rule, never gets into trouble, and says all the right things. However, they never share anything personal. Why could this still be concerning?
They may be complying without truly engaging and may be avoiding vulnerability, shame, rejection, or emotional discomfort.
Why is changing behavior often easier than changing a core belief?
Behaviors can change quickly, but beliefs are built over years and become connected to identity and how someone views themselves.
Why is looking for patterns more useful than focusing only on one event?
Patterns reveal deeper beliefs, coping skills, behaviors, and relationship styles.
An individual in recovery has always been "the strong one." How could this become a barrier?
They may avoid asking for help, hide emotions, reject support, or believe vulnerability is weakness.
An individual in recovery pushes away a healthy relationship and says, "I knew they would leave eventually, so I saved myself the pain." What pattern might be happening?
Self-protection through self-sabotage caused by fear of rejection, abandonment, or vulnerability.
An individual in recovery says, "Everyone has always betrayed me." What additional information would you need before accepting this as fact?
Relationship history, patterns, personal responsibility, childhood experiences, communication style, expectations, and evidence of repeated betrayal.
An individual in recovery says, "I've always been the screw-up in my family." How could this belief affect their choices?
They may sabotage success, avoid responsibility, expect rejection, or continue acting according to that identity.
An individual in recovery changes jobs, homes, and relationships often. What are three possible explanations besides poor decision-making?
Trauma responses, fear of commitment, impulsivity, unstable circumstances, mental health concerns, or difficulty tolerating discomfort.
Why can letting go of an unhealthy identity feel like grief?
Even unhealthy identities provide familiarity, purpose, and belonging. Losing them creates uncertainty and sadness.
An individual in recovery says, "My childhood wasn't that bad. Other people had it worse." Why is comparing trauma harmful?
Pain is not measured by comparison. Explore how experiences affected development, coping, beliefs, relationships, and emotional regulation.
An individual in recovery has relapsed four times. Every relapse happened after getting a job, rebuilding relationships, and becoming more stable. What questions would you ask?
Explore fear of success, self-sabotage, guilt, identity changes, discomfort with stability, overconfidence, and loss of structure.
What is more difficult to change: a habit, an emotion, or a core belief? Defend your answer.
Core beliefs are often hardest because they influence emotions, decisions, behaviors, and identity.
An individual in recovery has the same major problems with work, family, finances, and relationships for ten years. When should we ask, "What is the pattern?"
When the same outcome continues despite different situations, suggesting deeper beliefs or behaviors are driving the cycle.
An individual in recovery says, "If I'm not the addict anymore, then who am I?" Why is this important?
Long-term recovery requires building an identity based on values, purpose, relationships, and healthy choices.
An individual in recovery moves from blaming everyone else to saying, "Everything bad that happened was my fault." What distinction must they learn?
The difference between accountability and shame. Accountability creates change; shame creates hopelessness and increases relapse risk.