Can I leave early?
This simple grounding technique has you breathe in for four seconds, hold for four, and out for four.
What is box breathing.
In the movie Cast Away, Wilson the volleyball symbolizes the human need for this protective recovery factor.
What is connection or social support
Provides more support than standard outpatient care while allowing individuals to remain in the community
Offers consistent structure during high risk periods
Creates accountability through frequent contact
Allows access to multiple clinicians and peer perspectives
True or False: Addiction is only caused by poor choices, not genetics or environment.
What is False?
This therapy style focuses on mindfulness, emotion regulation, and distress tolerance.
What is DBT (Dialectical Behavior Therapy)?
A common process of intentionally exchanging symbolic, information-encoded soundwaves between two brains without using machines.
What is talking with someone in-person?
The term for an irrational fear of happiness
Cherophobia
True or False: Chronic stress can change brain chemistry.
What is True?
Replacing unhealthy routines with stable and predictable ones strengthens what important factor in recovery.
What is structure
Quote: “My pop was real big. He did like he pleased. That's why everybody worked on him. The last time I seen my father, he was blind and diseased from drinking. And every time he put the bottle to his mouth, he didn't suck out of it, it sucked out of him until he shrunk so wrinkled and yellow even the dogs didn't know him”
What is One Flew Over the Cuckoos Nest? (Spoken by “Chief”)
Name two Clinical Benefits of IOP
Treats substance use and mental health conditions at the same time
Helps identify relapse warning signs early
Focuses on skill development, not just discussion
Provides real time peer feedback and support
True or False: There is an age limit to Neuroplasticity
FALSE
Examples:
This structured plan lists triggers, coping skills, early warning signs, and what to do if cravings become intense.
What is a relapse prevention plan.
Name up to 3 types of gaslighting
What is projection, sabotage, denial, put-downs, threats, distraction, ignoring/avoidance, minimization/trivializaion
These are common Cognitive Distortions (name at least 4)
1. All-or-Nothing Thinking (Black-and-White Thinking)
Seeing situations in extremes with no middle ground.
Example: “If I’m not perfect, I’m a failure.”
2. Overgeneralization
Drawing broad, negative conclusions based on a single event.
Example: “I messed up once, so I’ll always mess up.”
3. Mental Filtering
Focusing only on the negative details and ignoring positives.
4. Discounting the Positive
Rejecting or minimizing good things as if they don’t count.
Example: “They said I did well, but they were just being nice.”
5. Catastrophizing
Expecting the worst case scenario or blowing problems out of proportion.
6. Mind Reading
Assuming you know what others are thinking without evidence.
7. Fortune Telling
Predicting the future negatively and treating it as fact.
Example: “I know the interview will go horribly.”
8. Emotional Reasoning
Believing something is true simply because it feels true.
Example: “I feel worthless, so I must be worthless.”
9. Should Statements
Rigid rules about how you or others must act.
Example: “I should never feel anxious.”
10. Labeling
Using global, negative labels for yourself or others.
Example: “I’m a loser,” “They’re useless.”
11. Personalization
Taking responsibility for things outside your control or blaming yourself excessively.
12. Blaming
Assigning responsibility to others for your feelings or circumstances.
13. Control Fallacies
Believing you are either completely responsible for everything or powerless over your life.
14. Magnification and Minimization
Exaggerating the negatives or shrinking the positives.
15. Comparison (or “Fairness” Distortion)
Chronic, unhelpful comparing of oneself to others or believing life should always feel fair.
What substance is often considered to be have caused the most harm in society?
What is alcohol?
Your old using buddies, the corner store, or that song that used to play at every bad decision moment are examples of these.
What are external triggers.
In the film "Basketball Diaries", Leonardo DiCaprio's character goes through a painful heroin withdrawal.
In "The Last Samurai", Tom Cruise's character goes through a painful alcohol withdrawal.
While both are dangerous, which one is more lethal without proper medical care?
Alcohol.
Serious alcohol and benzodiazepine withdrawal can be lethal without medical intervention.
Heroin withdrawal can also be extremely dangerous and should also be done under medical supervision, it can cause erratic and increased-risk-taking behaviors that could be lethal, but the physiological dangers of heroin / opiate withdrawal itself are LESS lethal than Alcohol and Benzos.
Name 2 Psychological Benefits of attending IOP
Reduces isolation
Normalizes struggle and setbacks
Improves emotional regulation
Encourages insight through shared experience
Your brain keeps memories from that time you said that awkward joke ten years ago but forgets why you walked into the kitchen.
True
True or false. Relapse is a sign that the person has failed recovery.
What is false.
Finish this phrase: “Recovery is not about perfection, it’s about ___.”
What is progress?
True or False: We will still be having IOP group next Friday, 12/26/2025, the day after Christmas
TRUE :)
This common chemical can commonly be found under a kitchen sink next to the dishwashing detergent and other cleaning supplies. It is also served as a popular beverage in most fancy restaurants.
What is alcohol
This thinking error convinces you that everyone is judging you, which is impressive since most people barely notice their own behavior.
What is mind reading.
In the film "Training Day", What drug is laced in the marijuana that Denzel Washington gives to his rookie partner Ethan Hawk?
PCP.
Name two benefits of attending IOP Even With Low Motivation
Skills are learned even when motivation is low
Participation reduces risk of legal or system related consequences
Documentation protects progress and compliance
Improves stress tolerance and communication skills
Increases stability even before full sobriety is achieved
Expands future options instead of limiting them
True or False: It is possible that some part of your brain could be in the Precontemplation Stage of Change RIGHT NOW, and you wouldn't even know it.
What is True
Alcohol primarily enhances this inhibitory neurotransmitter, which is why it slows reflexes and thinking.
What is GABA
This has been ranked as the substance that has caused the most damage to the public
What is alcohol
This unhealthy boundary type that is too open and relaxed, at times allowing toxic influences to easily infiltrate and disrupt a person's well-being and potential lead to relapse or other unhealthy behaviors
What is a porous boundary?
Cognitive behavioral therapy identifies "thought traps" such as catastrophizing, mind reading, or emotional reasoning. These are collectively called what.
What are cognitive distortions.
This effect happens when a person slips and then thinks "Well I already messed up so I may as well go all in," which is the recovery version of dropping your phone and then running it over with your car.
What is the abstinence violation effect.
The green character in the film "Inside Out" symbolizes "Disgust". How can the emotion of disgust be used to help you in your recovery?
OPEN ENDED. What is reframing / What is repelling yourself emotionally from negative influences
Name at least 2 PRACTICAL benefits of IOP
Helps meet court or probation requirements so that you can move beyond these things.
Documentation of positive social engagement and compliance.
Builds routine and purpose, especially helpful in the first few years of re-establishing sobriety.
Successful program completion is like gaining state approved, legally official "recovery status", something positive, on paper, that you can point to as a positive, official separation from negative past incidents and previous unhealthy behaviors. Becomes more credible the more time that accrues post-graduation without additional incident. (If you relapse and go back to a program, that's OK this still applies! It's all the same argument that still holds when you apply it to the last completed program and the time you accrue after the last completion.)
Program completion can be used as a professional explanation during an interview with HR, who now also feels less liable upon hiring you knowing "the state has approved your recovery". Provides employment opportunity in all kinds of ways down the road.
True or False: You can only be in one Stage of Change at a time
False.
This type of support person helps you stay accountable and provides encouragement as you work toward your goals.
What is a mentor or sponsor.
HALT stands for these four body-mind states that can masquerade as cravings.
What are Hungry, Angry, Lonely, Tired?
This brain chemical is the “that felt good, do it again” messenger that gets over-recruited in addiction.
What is dopamine?
Who is the best IOP counselor
All of them are equally helpful because access to multiple and diverse clinical perspectives provides a healthy and balanced program. (See Clinical Benefits)