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What I Want From Treatment
DO YOU WANT THIS FROM TREATMENT
1. I want to receive detoxification, to ease my withdrawal from alcohol or other
2. I want to find out for sure whether I have a problem with alcohol or other drugs.
3. I want help to stop drinking alcohol completely.
5. I want help to stop using drugs (other than alcohol).
7. I want to decrease my use of tobacco.
10. I want to take Antabuse (a medication to help me stop drinking).
11. I want to take Trexan (a medication to help me stop using alcohol or heroin).
13. I want to learn more about alcohol/drug problems.
14. I want to learn some skills to keep from returning to alcohol or other drugs.
15. I would like to learn more about 12-Step programs like Alcoholics Anonymous
16. I would like to talk about some personal problems.
1. I need to fulfill a requirement of the courts.
17. I would like help with problems in my marriage or close relationship.
18. I want help with some health problems.
19. I want help to decrease my stress and tension.
20. I would like to improve my health by learning more about nutrition and exercise.
21. I want help with depression or moodiness.
23. I want to work on my spiritual growth.
24. I want to learn how to solve problems in my life.
25. I want help with angry feelings and how I express them.
26. I want to have healthier relationships.
27. I would like to discuss sexual problems.
28. I want to learn how to express my feelings in a more healthy way.
29. I want to learn how to relax better.
31. I want help with feelings of loneliness.
32. I want to discuss having been physically abused.
33. I want help to prevent violence at home.
34. I want to discuss having been sexually abused.
35. I want to work on having better self-esteem.
What I Want From Treatment
38. I want advice about financial problems.
39. I would like help in finding a place to live.
41. Someone close to me has died or left, and I would like to talk about it.
42. I have thoughts about suicide, and I would like to discuss this.
43. I want help with personal fears and anxieties.
45. I feel very confused and would like help with this.
46. I would like information about or testing for HIV/AIDS.
48. I want to learn to have fun without drugs or alcohol.
49. I want someone to tell me what to do.
50. I want help in setting goals and priorities in my life.
51. I would like to learn how to manage my time better.
52. I want help to receive SSI/disability payments.
53. I want to find enjoyable ways to spend my free time.
54. I want help in getting my child(ren) back.
56. I need help in getting motivated to change.
57. I would like to see a female counselor.
58. I would like to see a male counselor.
59. I would like to see the counselor I had before.
60. I would like to see a doctor or nurse about medical problems.
62. I would like my spouse or partner to be in treatment with me.
63. I would like to have private, individual counseling.
64. I would like to be in a group with people who are dealing with problems similar to 0
65. I need someone to care for my children while I am in treatment.
67. I believe I will need to be in treatment for a long time.
From: Appendix B—Screening and Assessment Instruments Enhancing Motivation for Change in Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 35. Center for Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. Copyright Notice NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
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