NAME: DATE:
Understanding Your Target Behavior:
Is It Addictive?
DIRECTIONS: To help you decide if your target behavior is addictive, answer the following questions,
substituting your target behavior in the blanks.
Yes No 1. Do you ____________________ alone?
Yes No 2. Do you ____________________ on a regular basis?
Yes No 3. When you are stressed, do you ____________________?
Yes No 4. Do you crave ____________________ at any time of the day?
Yes No 5. Are you influenced by others to ____________________?
Yes No 6. Does your ____________________ impair your job performance or ability to engage in daily activities?
Yes No 7. Does your ____________________ cause you to use poor judgment?
Yes No 8. Do you lie to friends or family about how much or how often you ____________________?
Yes No 9. Have you tried unsuccessfully to cut down on ____________________?
EVALUATION
If you answered Yes to any of these questions, you may be addicted. If this addiction affects your
health (e.g., smoking) you should talk with a physician or other health care provider.