Self-assessments are helpful in supporting and motivating change. Completing these activities will help you better understand your values, vulnerability factors, what kind of support you need and who may be able to best help you. Everyone who participates in the CRAFT Connect programs is encouraged to complete these self-assessment activities:
What are My Values? Worksheet
Who Are My Family/CSOs? Worksheet
Social Support Worksheet ((Sarason, S. et al, 1983)
Vulnerability Surveys
“My Recovery Story, So Far” Worksheet
What are My Values? Worksheet
Generally, people like to live a life with meaning and purpose. When these goals are met we are able to develop a harmony with our inner self and the outside world. This is a lifelong journey that evolves based on unique circumstances, individual experiences and global events. Explore your values by answering these questions. Then look for differences between what you believe in and hope for and your behavior. Consider how your actions may go against your values.
What gives my life meaning?_____________________________________________________________________________________________________________________________
What gives me hope?_____________________________________________________________________________________________________________________________
How do I get through tough times? Where do I find comfort?_____________________________________________________________________________________________________________________________
Am I tolerant of other people’s views about life issues?_____________________________________________________________________________________________________________________________
Do I make attempts to expand my awareness of different ethnic, racial and religious groups?_____________________________________________________________________________________________________________________________
Do I make time for relaxation in my day?_____________________________________________________________________________________________________________________________
Do my values guide my decisions and actions?_____________________________________________________________________________________________________________________________
Summarize what you learned from the worksheet.
_____________________________________________________________________________________________________________________________
Who Are My Family/CSOs? Worksheet
Think about all of the people in your life you feel a particularly strong connection with. People who support you “when you are feeling down and help you get your feet back on the ground”. These could be people you spend holidays or birthdays with. Whose praise or encouragement makes you feel good. Who regularly text, phone, or email you. People you “appreciate being around”. Your family/Concerned Significant Others (CSOs) could include immediate and extended family united by birth, marriage or adoption including parents, partners, grandparents, spouses, children, siblings, cousins, aunts and uncles as well as friends, sober peers, co-workers, members of the community, etc. It’s doesn’t matter if you live with or nearby by them.
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: _____________________________________________________________________________________
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: _____________________________________________________________________________________
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: _____________________________________________________________________________________
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: _____________________________________________________________________________________
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: ______________________________________________________________________________
Name: _____________________________Relationship to me: ___________________________
Identify why you feel close to them: _____________________________________________________________________________________
What do these relationships have in common? Think about one-word qualities.
__________________________________________________________________________________________________________________
Social Support Worksheet
If you had difficulty identifying who your Concerned Significant Others (CSOs) are then answering these two-step questions may help.
Step 1: For the A part, list all the people you know who you can count on for help or support in the manner described. Write the person’s initials, first name and last name, and their relationship to you, see Example. Do not list more than one person next to each of the numbers beneath the question.
Example, A part. Who do you know that you can trust with sensitive personal information?
No one 1.) T.N. (brother) 2.) L.M. (friend) 3.) R. S. (friend) 4.) D. N. (father)
5.) W. T. (employer) 6.) 7.) 8.) 9.)
Step 2: For the B part, circle how satisfied you are with the overall support you have. If you have no support for a question, circle the words “No one,” but still rate your level of satisfaction. Do not list more than nine people per question. Please answer all the questions the best you can.
Example, B part. How satisfied are you with the support you have in area Example(a)?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
1 A. Who can you really count on to be dependable when you need help?
No one 1.) 2.) 3.) 4.)
5.) 6.) 7.) 8.) 9.)
1 B. How satisfied are you with the support you have in area 1 A?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
2 A. Who can you really count on to help you feel more relaxed when you are under pressure or tense?
No one 1.) 2.) 3.) 4.)
5.) 6.) 7.) 8.) 9.)
2 B. How satisfied are you with the support you have in area 2 A?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
3 A. Who accepts you totally, including both your worst and best points?
No one 1.) 2.) 3.) 4.)
5.) 6.) 7.) 8.) 9.)
3 B. How satisfied are you with the support you have in area 3 A?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
4. A. Who can you really count on to care about you, regardless of what is happening to you?
No one 1.) 2.) 3.) 4.)
5.) 6.) 7.) 8.) 9.)
4. B. How satisfied are you with the support you have in area 4 A?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
5 A. Who can you really count on to help you feel better when you are feeling down-in-the-dumps?
No one 1.) 2.) 3.) 4.)
5.) 6.) 7.) 8.) 9.)
5 B. How satisfied are you with the support you have in area 5 A?
6–very 5-fairly 4-a little 3-a little 2-fairly 1-very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
Vulnerabilities Surveys
Your quality of life has suffered from the stress of a substance use or mental health disorder and made you more vulnerable or capable of being emotionally wounded. Select from the drop-down menus of the five online surveys he answers that apply to your situation over the last 30 days. Survey results are confidential. Entering your name, email address and hitting “Send” downloads the completed survey and sends it to you within the hour. the hour.
Focuses on the consequences this struggle has had on you, your family/CSOs.
Measures the level of satisfaction with your current family/CSOs system and communication within that system.
A diagnostic self-report scale for screening, diagnosis and severity of anxiety disorder.
A diagnostic self-report scale for screening, diagnosis and severity of depressive disorder.
Intended to estimate your current happiness with 10 areas of your life.
“My Recovery Story, So Far” Worksheet
1. Identify your underlying positive feelings about your family and Concerned Significant Others (CSOs). _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. Describe the major problem areas – physical, emotional, social, spiritual, intellectual, occupational, financial – you have experienced as a result of a substance use/mental health disorder. Challenges that diminished the overall quality of your life. _____________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________
3. Express the frustrations, painful thoughts and feelings you have about these struggles – shame, guilt, anger, fear, anxiety, loss, grief, isolation, etc.? _____________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________
4. What have you done to try and change or stop unwanted behaviors? Has it been effective? _____________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________
5. Which problem areas would you like to work on as part of your recovery? _____________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________