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RTC Part 1 - Questionnaire

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Family Intensive Routines Worksheet

Please watch the video and fill out the worksheet in response. (You may fill out answers as you watch if preferred)

1. In your own words, what does the phrase “what is repeated is remembered” mean?*

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2. New treatment options will never__________the__________for structure and routine.*

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3. Routines help you establish a sense of _________ and building new __________*

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4. Routines:

a. Protect you from _________ _________. Why is this important?*

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b. Help with your _________ _________ _________ . What does this mean?*

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c. Helps build a sense of __________. What belief does this create in you?*

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d. It _________ your hormones*

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e. It holds you _________ *

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f. It helps you __________. What are 5 specific needs that you need to create time for in your personal life? See Maslow’s hierarchy of needs for reference:*

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g. It helps you make time for what you __________. What are some joyful activities that you would like to make time for?*

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h. It helps you get __________ for your __________. This helps you create __________ __________ of your skills, habits, and reinforcements.*

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i. It focuses on what you can __________. How is this empowering in the mental health journey?*

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5. What do you want to change about your routines? What do you like about them?*

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Family Intensive Skills Worksheet

Please watch the video and fill out the worksheet in response. (You may fill out answers as you watch if preferred)

1. Skills are learned in: __________ settings, over __________, and in __________.*

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2. If the above is true, how can you respond to someone who is too eager to rush their treatment because they want to go back to their old routines?*

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3. Which 4 skills are typically first learned in treatment?*

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4. Which of the 13 Skills do you personally think you may be lacking? Which does your family/support system need to work on (may be the same or different).*

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5. When learning skills, people get stuck when they __________ or __________ rather than just trying them out or committing to practicing. What can you do to overcome this obstacle in your own treatment (or your own loved one’s treatment)?*

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Family Intensive Codependency and Boundaries Worksheet

Please watch the video and fill out the worksheet in response. (You may fill out answers as you watch if preferred)

**Enmeshment definition: A relationship that lacks independence of thought, values, opinions, etc. One person must always be and do the same as the other, and you lose touch with your own needs or desires. Enmeshed relationships lack boundaries and limits.

1. Codependency is a _____ addiction.*

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2. What are the 2 parties in a codependent relationship? Which do you relate with the most? (Remember, it’s not if you’re codependent, it’s just a matter of when you are codependent)*

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3. Codependency leads to enmeshment of decision making, __________ , and __________ __________.*

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4. In your own words, why can codependency interfere in someone’s healing or treatment process?*

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5. For the tips given for rescuers and the rescued - which ones stand out to you the most that you need to start implementing?*

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6. What’s the ultimate solution for codependency?*

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7. What is the definition of boundaries? List 3 examples of boundaries given in the video*

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8. How do you communicate boundaries?*

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9. What are areas in your life that you need to set boundaries, or need to improve your boundaries?*

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26732 Crown Valley Parkway
Suite 443
Mission Viejo, CA 92691
info@pacificsolstice.com
Get Help: (949) 200-7929

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RTC Part 1 - Questionnaire

Family Intensive Routines Worksheet

Family Intensive Skills Worksheet

Family Intensive Codependency and Boundaries Worksheet

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