Co-Occurring Disorders Decisional Balance Sheet

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DECISIONAL BALANCE SHEET
Patient name________________________
Date completed ____________
What are the benefits/pros of alcohol /
What are the costs/cons of alcohol /
drug use?
drug use?
Importance Rating Scale
On a scale of 1 to 10, with 1 being not important and 10 being very
important, how important is it to you to stop drinking/drugging?
____
Why not a____? (choose a rating 2 numbers lower and record patient’s
response)_____________________________________________________
__________________________________________________________
Connections: Co-Occurring Disorders

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