This questionnaire is designed to give us a better understanding of what strategies you are using in your treatment. Each statement describes a situation or thought that a person might try to help them not use cocaine. Please indicate how often you might make use of a particular situation or thought to help you at the present time.

 There are FIVE possible responses to each of the items in the questionnaire:

1 = NEVER
2 = SELDOM
3 = OCCASIONALLY
4 = FREQUENTLY
5 = REPEATEDLY

1.	I keep things around my home or work that remind me not to drink.
2.	I engage in some physical activity when I get the urge to drink.
3.	I do something nice for myself for making efforts to change.
4.	I can talk with at least one special person about my drinking experiences.
5.	I get upset when I think about illnesses caused by drinking.
6.	I tell myself that I can choose to change or not to change.
7.	I take some type of medication for my drinking problem.
8.	I change personal relationships which contribute to my drinking.
9.	I see signs in some public places trying to help people not to drink.
10.	I stop to think about how my drinking is hurting people around me.
11.	I consider that feeling good about myself includes changing my drinking behavior.
12.	I think about information from television and radio on how to quit drinking.
13.	Someone in my life helps me to face my drinking problem.
14.	I remove things from my home or work that remind me of drinking.
15.	I calm myself when I get the urge to drink.
16.	I reward myself when I don't give in to my urge to drink.
17.	I have someone to talk with who understands my problems with drinking.
18.	Warnings about the health hazards of drinking have an emotional effect on me.
19.	I use will power to keep from drinking.
20.	I take some type of drugs to help me not drink.
21.	I avoid people who encourage drinking.
22.	I notice that people with alcohol problems are making known their desire not to be pressed to drink.
23.	I am considering the idea that people around me would be better off without my problem drinking.
24.	I get upset with myself when I think about my problem drinking.
25.	I read newspaper stories that may help me quit drinking.
26.	Someone in my life lets me know about how my drinking is affecting me personally.
27.	I avoid situations that encourage me to drink.
28.	I try to think about other things when I begin to think about drinking.
29.	Others make life difficult for me when I drink.
30.	I have someone who listens when I want to talk about my drinking.
31.	Stories about alcohol and its effects upset me.
32.	I make myself aware that I can choose to overcome my drinking if I want to.
33.	I use tranquilizers to help me keep from drinking.
34.	I avoid people who are heavy drinkers.
35.	I find society changing in ways that make it easier for me to overcome my drinking problems.
36.	I have strong feelings about how much my drinking has hurt the people I care about.
37.	I become disappointed with myself when I depend on alcohol.
38.	I look for information related to problem drinking.
39.	I have someone who tries to share their personal experiences of alcohol with me.
40.	I use reminders to help me not to drink.
41.	I do something else instead of drinking when I nedd to deal with tension.
42.	I don't let myself have fun when I drink.
43.	I have someone whom I can count on to help me when I'm having problems with drinking.
44.	I read newspaper stories that can affect me emotionally about my drinking.
45.	I tell myself that if I try hard enough I can keep from drinking.
46.	I take antabuse to help me not drink.
47.	I leave places where people are drinking.
48.	I seek out social situations where people respect the rights of others to not drink.
49.	I stop and think that my drinking is causing problems for other people.
50.	I feel more competent when I decide not to drink.
51.	I seek out groups of people who can increase my awareness about probles of drinking.
52.	I have someoine who helps me "see through" my excuses for drinking.
53.	I stay away from places generally associated with my drinking.
54.	I find that doing things is a good substitute for drinking.
55.	I spend time with people who reward me for not drinking.
56.	Someone in my life tries to make me feel good when I don't drink.
57.	I attend meetings that help me express how emotionally destructive drinking has been in my life.
58.	I make commitments to myself not to drink.
59.	I change my diet to help me overcome drinking.
60.	I go places where drinking is not generally accepted.
61.	I see advertisements on television about how society is trying to help people not drink.
62.	I stop and think that drinking and driving causes many problems for other people.
63.	I thikn about the type of person I will be if I am in control of my drinking.
64.	I think about information that people have personally given me on the benfits of quitting drinking.
65.	My physical reactions to alcohol help me to realize that alcohol is a problem for me.

Scoring