Substance use outcomes
A meta-analysis of 10 randomized trials found a significant effect favouring ACT on substance use outcomes against active treatments.
Lee et al., 2015
For therapists in residential, PHP and IOP programs
Free ACT worksheets for substance use treatment.
Five worksheets to use in group or as treatment plan assignments, written by Michael Chester, MA, LPC, who spent 8+ years in substance use treatment across OP, IOP, PHP and RTC.
The worksheets
Five worksheets, in order.
Each one works as a group topic or a treatment plan assignment. Plain language, written for clients.
1. Who I Want to Be in My RecoveryValues: the direction behind the work
2. Burning the BoatsActing on clarity while we have it
3. Your Choice PointThe moment between what shows up and what you do next
4. From Pushed to PulledBuilding a life worth moving towards
5. My First Week HomeWhere the pull gets tested — built alongside a continuing care plan
The push fades
Consequences fade. Values don't.
The Big Book says it plainly: after even a short time, the memory of how bad it was begins to fade. Willpower can't bring it back when a client needs it most. These worksheets build a different kind of motivation while there is still a clinician in the room: a pull towards who they want to be, which gets stronger with use.
How it works
- 1
Work them, don't hand them out
Run one as a group topic, or add it to a treatment plan and review it together. The questions land differently when someone is listening.
- 2
Send one step home
Pick one small action for the week and ask about it next time. Worksheet 1 ends with exactly that.
- 3
Finish before they go
Do My First Week Home in the last week or two before discharge or step-down, alongside their continuing care plan.
The research behind it
Built on an approach with decades of research.
The worksheets and the course are built on Acceptance and Commitment Therapy (ACT). These are the findings most relevant to substance use care.
Inside residential care
In a randomized trial inside a 28-day residential program, a brief ACT group targeting shame improved continuing-treatment attendance and reduced use at follow-up.
Luoma et al., 2012
Outside the therapy room
Meta-analyses of self-help and internet-based ACT found significant effects on depression, anxiety and psychological flexibility, with outcomes improving as guidance increases. That is why the course pairs every session with a guide and a live community.
French et al., 2017; Han & Kim, 2022
These findings are about ACT, not about this course or these worksheets specifically. Mindset Evolution has not been studied in a clinical trial, and it makes no promise about any client’s outcome. See how we explain the research to clients on the early recovery page.
References
- Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders. Drug and Alcohol Dependence, 155, 1–7. doi.org/10.1016/j.drugalcdep.2015.08.004
- Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., & Fletcher, L. (2012). Slow and steady wins the race: A randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology, 80(1), 43–53. doi.org/10.1037/a0026070
- French, K., Golijani-Moghaddam, N., & Schröder, T. (2017). What is the evidence for the efficacy of self-help acceptance and commitment therapy? A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 6(4), 360–374. doi.org/10.1016/j.jcbs.2017.08.002
- Han, A., & Kim, T. H. (2022). Efficacy of internet-based acceptance and commitment therapy for depressive symptoms, anxiety, stress, psychological distress, and quality of life: Systematic review and meta-analysis. Journal of Medical Internet Research, 24(12), e39727. doi.org/10.2196/39727
If a client wants more
Setting a client up for Mindset Evolution.
A 10-session online course and community built on the same ACT ideas as the worksheets. One video session a week, about an hour plus a practice action. Members post a weekly commitment, and Michael reads and responds.
Meant to be used alongside a client's aftercare plan, or after they complete it. It is not a replacement for one.
A good fit when a client
- is approaching discharge or stepping down to a lower level of care
- is stable enough to work on their own once they leave
- got something out of the worksheets and wants more
- wants to participate in a supportive community
- does better with a weekly structure and people who notice
Not the right fit when a client
- is in acute crisis or has active safety concerns
- has untreated psychosis
- is looking for treatment or a level of care
- would be using it instead of an aftercare plan
Set it up together, before they leave
A link handed over on the way out is easy to lose in the first week home. Signing up together in session, while they are still in your program, helps them follow through.
- 1
Share the early recovery page
Send or show them joinmindsetevolution.com/recovery. They can watch the first video and see what the ten sessions cover.
- 2
Sign up together in session
In their last week or two, open the join page with them. Tap Start free trial and choose Standard ($49/month). Premium is only for people who have finished all 10 sessions. The 7 free days start the day they sign up.
- 3
Plan Session 1 before they go
It opens as soon as they join. Pick a day and time in their first week home and add it to their My First Week Home plan.
$49/month for the first three months (the course), then $19/month for as long as they stay. Founding rates are locked in: neither price goes up. Cancel anytime from Skool.
Also free
A 45-minute session for your clinical team.
Michael will walk your clinicians through the ACT ideas behind the worksheets and how to run each one in group or session. Virtual, at a time that suits your schedule. No cost, and no commitment beyond the hour.
To be clear about what this is
A resource, not an arrangement.
- It is free, in both directions. Nothing is paid to you for using the worksheets or mentioning the course, and nothing is asked of you. No referral agreement, no fee, and no expectation that you send anyone anywhere.
- The course does not replace your work. Mindset Evolution is a separate, paid personal growth course. It is not therapy, not treatment and not aftercare. It is meant to be used alongside a client's aftercare plan or after they complete it, and it does not replace any part of your programming or their aftercare plan.
- Nothing comes back to you. The course does not report on a client to you or anyone else. If they want to, they can bring their Session Guides or weekly commitment into session.
- No client information is involved. Nothing on this page collects, requests or stores anything about the people you serve.
Who wrote them
Michael Chester, MA, LPC
Licensed Professional Counselor in South Carolina and founder of Everest Therapy Solutions in Mount Pleasant. He has spent 8+ years in substance use treatment settings across OP, IOP, PHP and RTC, and wrote these worksheets for the part of the work that starts once the clinical piece is in place.
Questions about using them with your clients are welcome.
admin@everesttherapysolutions.com
843-256-3322 (call or text)
An important note. Mindset Evolution is a personal growth course built on research-based psychological strategies. It is not therapy, not treatment, and not a substitute for professional support. It is not suitable for people in acute crisis, with active safety concerns, or with untreated psychosis.
If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) in the U.S., or contact your local emergency number. If you're looking for a therapist, Everest Therapy Solutions can help you find the right support.