Risk Patterns, Why it's Important
Fill in the blank: Risk patterns encompass decisions, thoughts, or _ that heighten the likelihood of reverting to negative old habits or behaviors. These patterns often develop gradually, making them difficult to notice until they lead to significant challenges (and often at that point it’s too late!).
Hint: This word describes how you feel and think about something, which affects how you act toward it.
Attitudes
Fill in the blank: _ can include stress, environmental cues, social dynamics, or unresolved emotions. It's also known as setback factors to recovery.
Triggers
M/C: Which risk pattern is described by failing to maintain regular contact with support systems, avoiding coping skills, or letting routines slip?
A. Loss of Structure
B. Letting Up on Discipline
C. Overconfidence
D. Impulsiveness
B. Letting Up on Discipline
M/C: Having too much idle time or a disorganized schedule can increase the likelihood of returning to old risky habits. Which risk pattern does this describe?
A. Letting Up on Discipline
B. Loss of Structure
C. Impulsiveness
D. Overconfidence
B. Loss of Structure
M/C: Scenario:
Taylor has been feeling overwhelmed lately. Though they still attend support meetings, they’ve stopped sharing honestly about how they’re really feeling and instead just say “I’m fine.” They feel isolated and on edge after work each day.
Question:
Which coping strategy is best for addressing Taylor’s current challenge?
A. Stay connected by being more open with a trusted support person or group member
B. Increase journaling about daily schedule tasks
C. Distract with physical activity instead of talking
D. Practice positive self-talk about feeling fine
A. Stay connected by being more open with a trusted support person or group member ✅
Why this is best: Being honestly connected with the support network targets the isolation and suppressed emotion driving Taylor’s risk pattern — while the others can help, only opening up addresses both emotional processing and social support directly.
Vignette 1 — Social Event Stress (100 points)
Scenario:
Chris is invited to a large family reunion where people will be drinking and discussing old habits. They start feeling anxious about being around alcohol and worry they’ll be offered a drink.
Question:
Which coping strategy is best for managing this situation?
A. Avoid the event entirely and stay home alone
B. Prepare an exit plan and set clear boundaries in advance
C. Tell everyone “I won’t drink,” then hope they don’t pressure you
D. Focus on ignoring people who offer drinks
Why this is best:
B. Prepare an exit plan and set clear boundaries in advance ✅
Why this is best: Preparing an exit plan and setting clear boundaries directly addresses Triggers related to environment and perceived social expectation and empowers assertiveness.
100 Points — True / False (Foundational Insight)
T/F: Having more than one coping strategy for the same trigger increases flexibility and lowers overall risk.
Correct Answer: ✅ True
Teaching Focus: Flexibility over perfection.
T/F: Simply avoiding an event that feels risky is always the most effective coping strategy for preventing setbacks.
Correct Answer: ❌ False
Why: We want to emphasize on increasing planning, coping, and skill use over avoidance alone, which can reinforce fear and limit growth.
Fill in the blank: Self-Awareness/Mindful-Relaxation and Self-Calming/Self-Compassion Skills: :_ _ exercises to calm your nervous system
Deep breathing
Fill in the blank: Healthy Distractions: Taking a _ or stepping outside to get fresh air.
Walk
T/F Question 1: “Self‑sabotage only occurs when a person intentionally tries to undermine their own goals.”
Answer: False
Reasoning: Self-sabotage can be subconscious as well as conscious.
Fill in the blank: _ is understanding why you think, feel, or act the way you do. This is critical factor in identifying and coping with risk pattern.
Insight
M/C: External Setback Factors are identifiable external influences: Which of these is NOT considered an external setback factor?
A) People
B) Places
C) Things
D) Events
E) None of the above
E) None of the above
T/F: Spending time with people or in places tied to past substance use is harmless as long as they aren’t actively using.
False
You tell your support group you didn’t have urges this week, even though you did. Which risk pattern is this?
Dishonesty / Lying
T/F: High-risk environments are only risky if someone in them is actively using substances.
False: An old hangout may not have current use, but the environment or memories can still trigger cravings. Recognizing this helps you avoid subtle risk patterns.
Vignette 2 — Emotional Stress from Conflict (200 points)
Scenario: Taylor anticipates a stressful holiday where a family member tends to trigger old patterns of shame and blame.
Question:
Which strategy would most effectively help Taylor stay grounded?
A. Take short breaks to step outside and use grounding techniques such as deep breathing
B. Roughly avoid any and all interaction with everyone at the event
C. Distract themselves with their phone when triggered
D. Promise to “be strong” without a plan
A. Take short breaks to step outside and use grounding techniques such as deep breathing ✅
Why this is best:
Using self-awareness, mindful relaxation, and grounding techniques allows Taylor to stay present and avoid escalation during emotional triggers.
200 Points — Fill in the Blank (Concept Precision)
Fill in the blank:
A coping strategy is most effective when it is realistic, accessible, and __________ to the situation.
Correct Answer:
Matched / appropriate / specific
200 Points – Fill in the Blank
Fill in the blank: Coping strategies are more effective when a person identifies specific __________ rather than only noticing general discomfort.
Correct Answer: Triggers (or situations, thoughts, feelings that increase risk)
Fill in the blank: _ techniques to help you stay present (e.g., 5-4-3-2-1 technique, focusing on physical sensations like touching a textured surface)
Grounding
Fill in the blank: Healthy Distractions: Engaging in a _ or something that brings you joy (e.g., sketching, reading, journaling)
Hobby
200 points — True/False
Question 5: “Perfectionism can be a form of self‑sabotage because it may prevent a person from acting until conditions are ‘just right.’”
Answer: True
Reasoning: Waiting for ideal conditions blocks progress — a subtle, common pattern.
Fill in the blank: Another critical factor in coping and identifying risk patterns is _-_ ; which is noticing what you’re thinking, feeling, or doing in the moment. The key is to recognize risk patterns as early as possible and then make necessary adjustments before it’s too late.
Self-awareness
M/C: Internal Setback Factors are less obvious and located within the mind or body: Which of these is NOT an internal setback factor?
A) Habits / Routines
B) Thoughts
C) Situations
D) Feelings
E) Physical condition
C) Situations is an external setback factor
Fill in the blank: Holding emotions in instead of expressing them can lead to isolation, vulnerability, and risky decisions. This risk pattern is called __________. (Hint: 3 word answer)
Bottling Up Emotions
Feeling irritated or let down by life’s challenges, and letting that stress and anxiety fester instead of managing it, is called __________. (Hint: Word starts with F)
Answer: Frustration
M/C: Scenario: Jordan just stopped a part-time job and now has large blocks of unstructured time. They’re starting the day without a plan and find themselves thinking more about old behaviors they used to rely on.
Question:
Which coping strategy is the most effective next step?
A. Maintain a structured daily routine with purposeful tasks
B. Practice daily affirmations about never returning to old habits
C. Avoid thinking about past behaviors by watching TV
D. Rely on willpower to resist temptations
A. Maintain a structured daily routine with purposeful tasks ✅
Why this is best: Lack of structure is itself a risk pattern; adding purposeful routine directly counters that vulnerability rather than just thinking differently or passively distracting.
Vignette 3 — Negative Environment Exposure (300 points)
Scenario:
Jordan is visiting the house where they used to use substances with friends. Even though the people there aren’t actively using, Jordan starts feeling nostalgic and anxious.
Question:
Which coping strategy is best at this moment?
A. Engage with the environment and hope nostalgia passes
B. Step outside and reach out to a recovery buddy for encouragement
C. Tell themselves they just need to toughen up and stay longer
D. Distract with social media
B. Step outside and reach out to a recovery buddy for encouragement ✅
Why this is best: Reaching out to a support person while physically distancing from a risk environment directly addresses both environmental triggers and need for support.
Question:
Which option best represents a coping strategy rather than avoidance?
A. Canceling plans to prevent discomfort
B. Ignoring emotions and hoping they fade
C. Planning how to step away, regulate emotions, and return if needed
D. Pretending the situation does not matter
C. Planning how to step away, regulate emotions, and return if needed ✅
Why this is best: Coping involves engaging safely, not disengaging completely.
Scenario: Riley feels anxious before a work event but can’t immediately explain why. After reflection, they realize they’re worried about being judged and pressured to fit in.
Question: What is the main factor increasing Riley’s risk in this situation?
A. The physical location
B. Internal emotional and social pressure
C. Lack of motivation
D. Poor time management
B. Internal emotional and social pressure ✅
Why this is best: The risk comes from internal thoughts and emotions, not the environment itself.
M/C: Which of the following does NOT fall under positive thinking/self-talk to reframe negative thoughts?
A) Remind yourself that it’s okay to feel uncomfortable and that you don’t have to be perfect
B) Use affirmations to reframe negative self-talk (e.g., “I am strong, and I am in control”
C) Practice self-kindness and forgive yourself if you make a mistake
D) Positive visualization (Imagine soon you will be back home, and it will all be over)
E) Shifting the focus from yourself to how others are making things difficult for you.
F) Prayer (if applicable)
E) Shifting the focus from yourself to how others are making things difficult for you.
Healthy distractions: Having a non-alcoholic drink to hold in social settings to avoid pressure, Finding a _ corner or retreat space where you can regain focus and calm.
Quiet
300 points — Fill in the Blank
Question 3: “People engage in self‑sabotage sometimes because of internal factors such as fear of __________ or comfort in chaos.”
Answer: progress or responsibility
M/C: Prevent _ : Early identification of risk patterns helps prevent small issues from snowballing into larger problems.
A) Relapse
B) Crisis
C) Exposure
D) Escalation
D) Escalation
Internal Setback Factors are less obvious and located within the mind or body. Which of these examples is NOT an internal setback factor?
A. Anxiety
B. Negative self-talk
C. Fatigue
D. Peer pressure
D. Peer pressure
M/C: Making rash decisions without thinking through consequences is an example of which risk pattern?
A. Overconfidence
B. Fantasizing About Use
C. Impulsiveness
D. Apathy
C. Impulsiveness
M/C: Persistent conflict, insisting your way is the only way, or resisting guidance best describes which risk pattern?
A. Argumentative Behavior
B. Dishonesty
C. Apathy
D. Fantasizing About Use
A. Argumentative Behavior
M/C: Scenario: Skylar gets easily frustrated and then withdraws without processing what upset them. They find that anger builds until they have an urge to use substances again, even if just to “shut off” emotions.
Question:
Which strategy best helps intervene here?
A. Use journaling or talk with trusted others to process thoughts & emotions
B. Do extra physical activity when upset
C. Set more ambitious goals to distract from frustration
D. Use positive self-talk to minimize feelings
A. Use journaling or talk with trusted others to process thoughts & emotions ✅
Why this is best: Journaling or talking through emotions tackles the unprocessed emotional build-up, while the others may help manage emotion but don’t directly assist in working through it.
Vignette 4 — Overwhelm From High-Stimulus Event (400 points)
Scenario: Alex is at a loud party that’s too crowded and starts feeling overwhelmed, anxious, and tempted to leave abruptly.
Question:
Which coping strategy is most effective?
A. Move repeatedly between crowded areas to “get used to it”
B. Find a quiet corner or step outside to regain calm and focus
C. Push through the discomfort without addressing it
D. Wait until the feeling escalates before acting
B. Find a quiet corner or step outside to regain calm and focus ✅
Why this is best: Stepping into a calmer space helps manage sensory overload and gives room to practice grounding.
T/F: If a coping strategy works once, it will always work the same way in future situations.
Correct Answer: ❌ False
Teaching Focus: Coping requires flexibility and adjustment.
T/F: A situation is only high-risk if substances or past problem behaviors are physically present.
Correct Answer: ❌ False
Rationale: Emotional stress, certain people, memories, or expectations can raise risk even without substances present.
Fill in the blank: Support system: Reaching out to a _ from AA/NA or recovery support network for advice or encouragement.
Sponsor
Preparation and Planning: Creating an _ plan for the event (e.g., how to leave if things get too overwhelming), pre-selecting a “_” at the event who can help if things get tough, preparing yourself for certain scenarios (e.g., what to say if someone offers you a drink or a substance).
200 points for each correct answer
Exit; buddy/friend
400 points — Fill in the Blank
Question 7: “One reason people may self‑sabotage is because unresolved feelings of ____ and ______ can lead them to act against their own interests.”
Answer: shame and guilt
M/C: Maintain _ : Addressing risk patterns reinforces commitment to long-term goals and minimizes discouragement which can deplete internal _. (Same word for both _.)
A) Discipline
B) Motivation
C) Willpower
D) Compliance
B) Motivation
M/C: Which of the following is NOT an external setback factors?
A. Financial stress
B. Conflict with others
C. Lack of transportation
D. Negative self-talk
D. Negative self-talk
Fill in the blank: You think, “I’ll never make progress anyway,” and skip your coping routine. Which risk pattern does this show? (Hint: This is a hyphenated word: _-_ )
Self-pity; this can lead to discouragement and create excuses for giving up on progress.
Fill in the blank: “Who cares?” attitude toward progress and consequences is an example of an internal risk factor called _ . (Hint: Word starts with an A)
Apathy
T/F: Reaching out to a trusted person only helps when cravings or stress are already overwhelming.
False: Checking in with your support system regularly, even when you feel fine, prevents escalation and reinforces coping skills.
Vignette 5 — Perceived Social Comparison (500 points)
Scenario: Morgan scrolls social media about a group event and starts feeling jealous, comparing their progress to others’ lives, which increases negative thoughts.
Question:
Which strategy is most helpful?
A. Keep scrolling to “see what they’re celebrating”
B. Use positive self-talk to reframe negative thoughts and reduce comparison stress
C. Assume everyone else has it easier
D. Ignore social media only during the event
B. Use positive self-talk to reframe negative thoughts and reduce comparison stress ✅
Why this is best: Reframing negative thoughts helps directly change the internal narrative around social comparison triggers
500 Points — Fill in the Blank (Early Intervention Concept)
Fill in the blank: Recognizing early warning signs such as tension, irritability, or racing thoughts allows coping strategies to be used __________ stress escalates.
Correct Answer: Before
Fill in the blank: When a situation includes several stressors at once (for example: cost, crowd size, emotional history), it’s most effective to break the situation into _ _ and plan coping responses for each.
Correct Answer: Smaller parts / specific stressors / manageable pieces
Support system: Texting or calling a recovery buddy for quick _-_ and/ or arranging a "_-_ time" with someone during or after the event to debrief. (Same hyphenated word for both answers)
Check-in
Fill in the blank: Healthy Communication: Setting clear _ with family or friends ahead of time (e.g., explaining your recovery and asking for support), Asking for _ when needed or making sure you have a moment to yourself during the event, Practicing active _ and _ during conversations to avoid feeling overwhelmed
125 points for each correct answer
Expectations; space; listening; empathy
500 points — Multiple Choice (Moderate difficulty)
Question 5:
“Which of the following is least likely to be a common form of self-sabotage?”
A. Putting off important tasks until the last minute
B. Trying to do everything perfectly before starting
C. Setting goals that are too ambitious to achieve
D. Forgetting strategies that usually help you succeed
Answer: C
Distractors: A, B, and D are common ways people undermine themselves; overly ambitious goals might be challenging but aren’t usually considered self-sabotage.
M/C: Support _ : Learning to manage risk patterns now, increases our ability to continue using coping skills effectively, which in turn builds our sense of inner strength and resolve.
A. Resilience
B. Compliance
C. Dependence
D. Avoidance
A. Resilience
T/F: Impulsivity is an external setback factor. Explain why you think your answer is right.
False: Impulsivity is an internal setback factor.
M/C: Believing you are invulnerable or that “nothing can go wrong” best describes which risk pattern?
A. Overconfidence
B. Letting Up on Discipline
C. Impulsiveness
D. Argumentative Behavior
A. Overconfidence
Romanticizing past substance use or addictive behaviors, which can trigger cravings, is called _ about use. (Hint: starts with F)
Answer: Fantasizing
Scenario: Alex loves old hobbies but has started spending extra time around people from past negative environments where use was common. They rationalize that “they don’t use anymore,” even though being around them increases cravings.
Question:
Which strategy is most appropriate now?
A. Engage in hobbies or creative activities instead of spending time in that environment
B. Practice positive affirmations that old friends won’t trigger cravings
C. Set goals to reduce time with old friends gradually
D. Increase structured routine elsewhere only
A. Engage in hobbies or creative activities instead of spending time in that environment ✅
Why this is best: Replacing a high-risk association with a positive hobby addresses both avoidance of the trigger and productive engagement — whereas the other choices indirectly help but don’t actively eliminate the risk situation.
Vignette 6 — Perceived Expectations (600 points)
Scenario:
Pat feels pressure at a work party to “fit in” by participating in group activities that were once part of old habits.
Question:
Which coping strategy is the most proactive and grounded?
A. Quietly avoid every activity and sit alone
B. Plan in advance how to refuse assertively and suggest alternative activities
C. Try to say yes to everything to avoid letting others down
D. Focus on getting through it without preparation
Why this is best: Planning assertive responses and alternative engagements respects social connection while actively managing triggers
600 Points — Multiple Choice (Beliefs That Support Coping)
Question:
Which belief most strongly supports effective coping?
A. “If I try hard enough, I won’t need strategies.”
B. “Coping skills are only for crises.”
C. “Planning ahead gives me more choices when stress increases.”
D. “Strong emotions mean I’ve already failed.”
C. “Planning ahead gives me more choices when stress increases.” ✅
Why this is best: This belief promotes proactive coping and self-efficacy.
Question (Multiple Choice – Very Hard):
Scenario:
Jordan is at a family gathering where past arguments often happen. They feel irritation rising and notice urges to leave suddenly.
Question:
Which response is the most effective coping strategy?
A. Leave immediately without saying anything
B. Take a brief break and use calming techniques to lower emotional intensity
C. Confront the family member directly
D. Ignore the feelings and stay as long as possible
Why this is best:
Managing emotions first reduces impulsive decisions and keeps options open.
B. Take a brief break and use calming techniques to lower emotional intensity ✅
Why this is best: Managing emotions first reduces impulsive decisions and keeps options open.
Support System: Having a “safe word” with a _ person in case you need immediate support (Hint: This is an adjective; a word that describes a noun).
Trusted
Fill in the blank: SEE IT THROUGH TO THE END- When thinking about using do not neglect to consider how you feel at the end, when whatever it is that you have used is all gone. Think about the disappointment you will feel. Think about how you will wish you had done something else instead of using. Think about all of the lies and/or excuses you will have to make to cover up. Think about the trust you’ve worked so hard to regain and how hard you have worked staying clean up to this point.
Remember: _ thinking; Take time to remember the hangovers, feeling sick, wasted $, arguing with family, etc. Always remember that giving in to the craving now will only make it harder in the long run. Sometimes giving in can be like knocking down a house of cards that you painstakingly took the time to build, card by card. You may have previously experienced that awful “morning after” feeling that comes when you wake up the next day after a bad night. If you can just learn to remember that feeling and become determined not to feel that way again you can achieve a lot when it comes to increasing your motivation not to give in to your cravings.
Consequential
600 points — Multiple Choice (Hard / Critical Thinking)
Question 6 (Revised):
“Which of the following approaches is least likely to help someone break patterns of self-sabotage?”
A. Keeping track of recurring behaviors and reflecting on them
B. Relying solely on willpower without adjusting routines or environment
C. Seeking guidance or support from trusted friends or mentors
D. Experimenting with small, manageable changes to habits
Answer: B
Reasoning: Relying only on willpower is often ineffective because self-sabotage is driven by unconscious patterns and emotional triggers. Awareness, support, and incremental habit changes are more effective.
M/C: Risk patterns are closely tied to external or internal factors that provoke _ or urges (also known as _).
A. Thoughts / Consequences
B. Stress / Symptoms
C. Cravings / Triggers
D. Behaviors / Habits
C. Cravings / Triggers
T/F: Psychological condition is an external setback factor.
False: It's an internal setback factor
Practical application: You stop smoking but start overeating or gambling instead. What is this risk pattern? (Hint: 2 words)
Negative Substitution
M/C: Combination of answers: You skip your routine, feel frustrated, and spend time with old friends tied to past use. Identify the risk patterns:
A. Loss of Structure, Frustration, Negative Associations
B. Overconfidence, Impulsiveness, Dishonesty
C. Letting Up on Discipline, Self-Pity, Argumentative Behavior
D. Apathy, Fantasizing About Use, Negative Substitution
A. Loss of Structure, Frustration, Negative Associations
M/C: Scenario:
Morgan feels strong cravings during moments of stress. Even though they have some coping plans, they haven’t practiced them when not in crisis, so when cravings hit, they often default to old reactions.
Question:
Which is the strongest strategy to build real resilience over time?
A. Develop and practice coping skills for cravings and stressors in low-stress moments
B. Keep an emergency coping list for crisis only
C. Wait until a craving occurs before trying a new strategy
D. Use structured routine only
A. Develop and practice coping skills for cravings and stressors in low-stress moments ✅
Why this is best: Practicing coping skills when not in crisis builds skill familiarity so strategies actually work during high-risk moments — a principle supported in relapse prevention frameworks.
Vignette 7 — Financial or Logistical Pressure (700 points)
Scenario:
Jamie is stressed about covering travel costs for a group reunion, feels overwhelmed, and worries this may trigger cravings and resentment.
Question (Hard): Which strategy is best for minimizing risk and emotional pressure?
A. Cancel travel, assume things won’t help anyway
B. Identify specific stressors (cost, crowd, pressure) and plan coping steps like budgeting, grounding, and support check-ins ahead of time
C. Ignore the financial worry until it goes away
D. Rely solely on positive thinking about the trip
B. Identify specific stressors (cost, crowd, pressure) and plan coping steps like budgeting, grounding, and support check-ins ahead of time ✅
Why this is best: Breaking down multiple stressors, acknowledging them, and planning targeted coping steps (budgeting plan, self-care, support check-ins) directly addresses environmental triggers and emotional activation in a comprehensive way.
700 Points — Multiple Choice (Advanced Self-Awareness)
Question:
Which action best reflects self-monitoring, an important coping skill?
A. Avoiding reflection to stay positive
B. Checking in regularly with thoughts, emotions, and stress levels
C. Waiting for others to point out warning signs
D. Responding only when emotions feel overwhelming
B. Checking in regularly with thoughts, emotions, and stress levels ✅
Why this is best: Self-monitoring allows earlier intervention and better outcomes.
Scenario:
Alex feels confident about attending a social event and doesn’t plan ahead. Midway through the event, unexpected emotions surface and cravings increase.
Question:
What would have been the most protective step to take before the event?
A. Trust confidence and past success
B. Identify possible triggers, plan an exit, and arrange support if needed
C. Avoid all social events indefinitely
D. Wait to figure things out if cravings appear
B. Identify possible triggers, plan an exit, and arrange support if needed ✅
Why this is best: Confidence alone doesn’t replace preparation; planning ahead reduces risk when emotions change unexpectedly.
Fill in the blank: Assertive Responses: (233 points for each correct answer)
Practicing how to say “_” firmly if offered substances (e.g., “I’m in recovery, and I choose not to drink” or “I don’t use that anymore, but thank you”)
Politely _ yourself from conversations that feel uncomfortable or triggering
Setting clear _ on what you’re willing to talk about or engage in during the event
No, Remove, Boundaries
Fill in the blank: Reverse Tomorrow Trap – Remember when you were using, and you kept that up by promising yourself “I’ll quit tomorrow” day after day? Well, in this case, now that you are not using, just do the opposite by telling yourself that you will wait until tomorrow to use instead of using and giving in right now today. (The idea of course is to wake up tomorrow and do the same thing by continuously pushing off the idea of giving in to your cravings, very similar to the “_ _ at a Time” concept that is so effective in the 12 Step model (Alcoholics Anonymous)
One day
700 points — Multiple Choice (Hardest / Critical Thinking)
Question 7:
“Which scenario is the best example of subtle self-sabotage?”
A. Intentionally doing something harmful to fail
B. Forgetting to practice helpful routines or habits
C. Deliberately cheating despite not wanting to
D. Giving away money right before paying bills
Answer: B
Reasoning: Subtle self-sabotage is often unconscious, like forgetting helpful routines, while the others are obvious or intentional.