Comprehensive Relapse Prevention Assessment

Emotional Assessment

How often do you feel socially isolated?

Rarely Sometimes Often

How would you rate your sleep quality?

Sleep Well Most Nights Occasional Sleep Problems Frequent Sleep Difficulties

How often do you eat healthy food?

Regular, balanced meals Irregular but adequate meals Poor eating habits

How is your emotional control?

Good emotional control Sometimes emotional Frequently emotional

How intense are your cravings?

Minimal or no cravings Moderate cravings Strong cravings

How often do you think about past use?

Rarely think about past use Occasional thoughts Frequent thoughts

Do you have thoughts about using again?

No thoughts about using Sometimes consider using Often think about using

How often do you attend support group meetings?

Regular attendance Occasional attendance Rarely attend

Do you have a sponsor or support person?

Active sponsor relationship Limited sponsor relationship No sponsor

How would you rate your family support?

Strong family support Some family support Limited/No family support

How often do you exercise?

Regular exercise (3+ times/week) Occasional exercise (1-2 times/week) Rarely/Never exercise

How would you rate your physical health symptoms?

No significant symptoms Mild symptoms Severe symptoms

How is your energy level?

Consistent good energy Fluctuating energy levels Consistently low energy

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