Home
About Us
Services
Foster Blog
Contact
Humberger Toggle Menu
Contact
Addiction Recovery Assessment
Name
*
Email Address
*
Phone
We will really appreciate if you can kindly drop your number so that we reach you faster. Thank you for understanding
How would you like us to deliver your results? (You can choose options you are cool with)
Call
Text
Whatsapp
Email
We recommend Call (Direct/via whatsapp) so that your assigned psychotherapist can directly brief you on your results and offer personalized recommendations based on your submission. You would be sent a reminder text/email when your results are ready (usually within 60 minutes), then schedule an available time for your assigned psychotherapist call. We will not charge you for this call. Thank you very much.
Cravings and Urges
How often do you experience cravings or urges related to your addiction?
Never
Rarely
Sometimes
Frequently
Always
What triggers these cravings or urges? (Select all that apply)
Stress or anxiety
Social situations
Negative emotions (e.g., sadness, anger)
Physical pain or discomfort
Boredom
Others
How intense are your cravings when they occur?
Very Mild
Mild
Moderate
Strong
Overwhelming
Emotional Triggers
What emotions do you often experience before feeling the need to engage in your addiction? (Select all that apply)
Sadness
Anger
Fear
Loneliness
Boredom
Guilt/Shame
Others
When facing emotional triggers, how do you usually cope with them?
Talk to someone
Engage in healthy distractions
Try to resist but eventually give in
Immediately give in to the addiction
Others
Anxiety and Stress
How often do you feel anxious or stressed as part of your recovery process?
Never
Rarely
Sometimes
Frequently
Always
When you're anxious, how likely are you to turn to addictive behaviors as a coping mechanism?
Not likely at all
Slightly likely
Moderately likely
Very likely
Almost always
What other coping mechanisms have you tried for managing anxiety and stress?* (Select all that apply)
Meditation or mindfulness
Physical exercise
Talking to a therapist
Journaling or reflecting
Avoiding triggers
Others
Support and Resources
Do you have a support system (e.g., friends, family, sponsor) to help during cravings or emotional difficulties?
Yes, and they are very supportive
Yes, but they are not very helpful
No, but I would like one
No, and I don’t feel I need one
Have you attended any addiction recovery meetings or therapy sessions?
Yes, regularly
Yes, occasionally
No, but I plan to
No, and I don't plan to
What resources have been most helpful for you in your recovery? (Select all that apply)
Therapy/counseling
Support groups
Books or online resources
Family and friends
Journaling
Other
Motivation and Progress
How motivated do you feel to continue on your path to recovery?
Extremely motivated
Very motivated
Somewhat motivated
Not motivated
How do you track your progress in recovery? (Select all that apply)
Keeping a journal
Regular check-ins with a therapist
Milestones or sobriety anniversaries
Support group feedback
I don't track my progress
Other
Submit
Let's Talk
Copyright 2024 – Highfoster
×
Call us on Whatsapp
