Substance Abuse/Brain Injury Client Workbook

Carolyn Lemsky, Heather Chisven, Tim Godden, Denis James, Jerry Schwalb, Pamela Kaufman, and Kelly Greer, Community Head Injury Resource Services of Toronto
Substance Abuse/Brain Injury Client Workbook


This workbook was created for people who are living with the effects of a brain injury and are also having some problems due to drug or alcohol use.

The workbook was designed by a partnership of people at Community Head Injury Resource Services of Toronto (CHIRS) and the Centre for Addiction and Mental Health (CAMH).

The materials presented are based upon the programming provided at CAMH, Brentcliffe Site.

To get the most out of this workbook we strongly recommend that clients review it with a counsellor who is familiar with addictions and/or is helping people after brain injury.

Acquired Brain Injury counsellors using this workbook are encouraged to seek consultation from professionals with experience in the treatment of substance abuse.

Counsellors in addictions and substance abuse are encouraged to seek consultation from professionals with experience in the management of the effects of acquired brain injury.



How to use this workbook

Introduction to substance use and acquired brain injury

Section 1 Understanding the addiction cycle

  • Chapter 1 Getting ready for change
  • Chapter 2 My top 5 reasons for change
  • Chapter 3 The effects of drugs and alcohol
  • Chapter 4 The ABCs of substance use
  • Chapter 5 Thoughts, feelings and substance use
  • Chapter 6 First things first. Ideas to get started
  • Chapter 7 Saying no to alcohol and drugs
  • Chapter 8 Coping with cravings

Section 2 Tools to use during recovery

  • Chapter 9 Journaling
  • Chapter 10 Being in groups
  • Chapter 11 Setting realistic goals

Section 3 Understanding yourself and your relationships

  • Chapter 12 Being your own best friend
  • Chapter 13 Building self esteem
  • Chapter 14 Building healthy relationships
  • Chapter 15 Building a support network

Section 4 Coping strategies for life

  • Chapter 16 Assertiveness
  • Chapter 17 Dealing with boredom
  • Chapter 18 Coping with strong feelings
  • Chapter 19 Relaxation
  • Chapter 20 Problem-solving
  • Chapter 21 Staying healthy

Section 5 Pulling it all together

  • Chapter 22 Goal setting for recovery
  • Chapter 23 Learning from lapses

Appendix A For more information

Appendix B Forms for reproduction

How to use this workbook

This workbook was put together for three groups of people:

  • People living with the effects of brain injury who are having some problems due to drug or alcohol use
  • Counsellors in substance use
  • Counsellors in acquired brain injury (ABI)

It can be used as an aid in structuring individual counseling sessions with a client or as handouts for use in group settings. Each chapter is organized into the following sections to make the workbook easy to follow:

  • Goals
  • Information
  • Self-assessment
  • Worksheet
  • Plan

We recommend that each individual session or group work follow the structure suggested by the format of the workbook. Sessions should begin with a review of the goals, followed by the presentation of information, self assessment and personal goal-setting. In most chapters, information is brief enough that it can be reviewed with the client in a single session. However, there are some topic areas that are more complex and may take several sessions to review.

A recovery checklist is included in the Forms for reproduction section. Completing this form, or a similar plan at the end of each session, will help to keep clients focused on their particular goals. Getting in the habit of reviewing these each week will assist clients in organizing their thoughts, problem-solving, and follow-through.

A structured self-assessment is provided in most chapters. Worksheets and plans are provided to assist the client in applying the new information to their own plan of action.

The order of the chapters provides a logical sequence for the introduction of information. However, this order can be altered to fit the needs of a particular client or the structure of the program in which it is being used.

Please note that not all chapters contain all sections. Worksheets can be taken out of the workbook and used as handouts for groups.

This workbook is designed to be a resource for the following user groups:

  • Counsellors with little experience in substance use should find enough information and examples in each chapter to have meaningful conversations with their clients about substance use and its effects. However, the workbook is not intended to be a replacement for consultation with counsellors in substance abuse.
  • Counsellors with little experience in acquired brain injury should find that the structured, written presentation and concrete examples will help clients to compensate for memory impairments and other cognitive difficulties. However, consultation with an acquired brain injury professional is strongly recommended.
  • The multiple choice and checklist format of self-assessments is designed to facilitate self-assessment for persons whose cognitive difficulties make answering open-ended questions difficult.

Please click here to download the rest of the guide.

A Provider Manual can be obtained by registering at The manual is not available directly for download, but once you have registered, you will receive the pdf.

Posted on BrainLine October 16, 2009.

From the Substance Use and Brain Injury Client Workbook, written by Carolyn Lemsky, Heather Chisven, Tim Godden, Denis James, Jerry Schwalb, Pamela Kaufman, and Kelly Greer, Community Head Injury Resource Services of Toronto, 2005. Used with permission. Use of this material for profit is prohibited.

Comments (6)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I would like to have the book. I work with people who support people with brain damage (aspecially them with memory damage). More and more we see that drugs use (alcohol, soft drugs) become a bad habit, till addictions. Reading the content of the book, it seems there is a usefull way to try to treat the addiction.
I am curious about that.

I would like the book

This is a very informative book regarding brain injury and addictions. If possible, I would love to have this book, to read and also possibly provide to the clientele I work with.

Vickie Stuart
Addiction Counsellor

I have a son who has TBI and aproxia and aphasia and he smokes marijuana several times a day. He says it is the only thing that helps with his back and leg pain. Is he high risk for seizures?

Excellent resource thanks. I am a newly qualified nurse working in community addictions and found this really helpful.

Excellent information!  Very helpful -thank you!