FRESH Start Relapse Prevention/Safety Plan
Name: ______Date: ______
Completed with: ______
Things that will help me maintain my sobriety: (for example: AA or NA meetings, exercising, see my therapist regularly, talk to a positive friend, doing something I feel good at or enjoy,etc.) ______
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People, places and things that I need to avoid in order to support my sobriety: (for example: friends who drink or use, bars, certain activities that you would do while using, situations at work that will be stressful, etc..______
How I would know I am close to relapse: (for example: I am more depressed, irritable, thinking about alcohol and/or drugs a lot, putting myself in risky situations, etc.) ______
Supports that will help with these warning signs: (for example, church, conversations with certain people who can understand, AA or NA, hobbies that keep my mind off of drinking/drugs, [Kim] [Wanda], DCF, etc.)______
If a relapse happens, steps I will take to get back into sobriety: (for example, go to AA and talk about it, talk to [Kim] [Wanda] at FRESH Start, tell the DCF worker, get into counseling or tell counselor, etc.)
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If a relapse happens, what I will do to make sure that my children are safe: ______
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Signature Date