Questions to Ask Clients in Recovery
Questions for counselors, case managers, peer support workers and sponsors meeting with someone in recovery from substance use. They cover the shape of an ordinary week, cravings and near misses, sleep, money, household, and what the person wants you to do when things get worse. They are conversation questions, not a screening instrument, and they do not replace your own training, supervision or the treating team.
20 questions, each with the reason to ask it · includes a conversation guide
The questions
Open any question to see why it works.
- 1
How are you doing today, separate from how recovery is going?
Clients learn quickly how to file a report on their recovery. Asking about the day itself often surfaces the sick parent, the unpaid bill or the argument that is actually driving the week, none of which appear in an answer about substance use.
- 2
What does a normal weekday look like right now, hour by hour?
Structure is the most fragile thing early on, and a schedule with an unfilled stretch in it is a more concrete piece of information than a self-rated craving score. Listen for where the hours are empty and who, if anyone, is around then.
- 3
Are you counting days, or have you stopped?
Whether someone counts tells you which framework they are working inside, and it matters if they lapse. For a person who counts, a slip can feel like being returned to zero, which is its own risk. For a person who has stopped counting, ask what replaced it as the marker of progress.
- 4
Who knows, and who does not?
This maps the settings where the person has to manage a story rather than just be there. Work, extended family and old friend groups are usually on different sides of that line, and the effort of maintaining it is a cost that rarely gets named as one.
- 5
What is going better than it was three months ago?
This gets asked far less than what is going badly, and the answer gives both of you something concrete to return to on a bad week. If nothing comes to mind at all, note it rather than filling the gap yourself, because a flat answer here often precedes a difficult stretch.
- 6
What does a craving actually feel like for you, and where do you notice it first?
Descriptions vary more than people expect: irritation, boredom, a jaw or stomach sensation, or a particular thought that arrives fully formed. Naming the earliest signal moves the point of intervention back from the decision to the hour before it.
- 7
When did you last come close, and what happened instead?
Asking about a near miss rather than a failure gets a straighter answer. The second half matters more: what people actually did in the moment is often not what is written on their plan, and the real thing is worth keeping.
- 8
Which people, places or times of day are you avoiding, and what has that cost you?
Avoidance works, and it also shrinks a life. Asking about the cost tells you whether the current arrangement is sustainable or quietly resented, and resentment about a restriction tends to show up later as a decision to test it.
- 9
What do you say when someone offers you a drink?
Ask for the actual sentence they have used, not the strategy. If there is no sentence, you have found something worth rehearsing out loud in the room. Answers along the lines of I just say no tend to collapse at a wedding or a work dinner.
- 10
How are you sleeping?
Disturbed sleep is one of the most commonly reported problems in early recovery, and it degrades mood, judgment and appetite together. Ask what they are taking to sleep, including over the counter products, and note it for the prescriber rather than commenting on it.
- 11
What are you taking right now, prescribed or not, and who is prescribing it?
Ask this flatly and without a reaction, and include supplements, over the counter medicines and anything borrowed from someone else. The reaction on your face determines whether you get the whole list this time or a partial one for the next year.
- 12
What is money like at the moment?
Financial strain and sudden unstructured cash are different risks and both are real. It is also worth knowing whether someone else controls the account, since that arrangement often carries a level of surveillance and resentment that has not been discussed.
- 13
Is anyone in your household still using?
This is the environmental factor with the most weight and the least room to change, and clients often do not volunteer it because they know how it sounds. The answer moves the conversation from what would be ideal to what is actually available.
- 14
Have you had any thoughts of hurting yourself?
Ask it plainly, in ordinary words, without softening it into a euphemism. Vague phrasing invites a vague answer. If the answer is yes, follow your setting's protocol rather than continuing down this list.
- 15
What do you do now for enjoyment?
An empty answer here is worth taking seriously. Boredom and flatness are among the things people most often describe when they explain how a return to use began, and this is a question you can work on with the client directly rather than referring it onward.
- 16
What has treatment gotten wrong for you before?
Most clients withhold this because past criticism has been received as resistance. Inviting it tells you which approaches to skip and which words to avoid, and it is one of the few questions that visibly changes the balance of the room.
- 17
If you did use again, who would you tell and how soon?
Some clients hear this as permission, so say plainly why you are asking: a plan that only works for someone who never lapses is missing at the moment it is needed. The answer also shows you who the person trusts when they are ashamed, which is different from who they trust generally.
- 18
What do you want people to say, and not say, when they see you doing well?
Praise about sobriety can land as pressure or as a reminder that everyone is watching. Getting the preferred wording means you can pass it on to family members who ask you what to say, which they often do.
- 19
If you started struggling and did not tell me, what would you want me to do?
This gets you two things: permission to check in a specific way, and the person's own account of what they look like when they are sliding. Ask what other people have noticed first in the past, since it is rarely the thing they notice themselves.
- 20
What have I not asked about that I should have?
Close with it every time and leave the pause long. This is where the housing problem, the court date or the relationship that nobody has mentioned tends to arrive, usually in the last two minutes of the session.
Asking well in recovery work
Practical guidance for the conversation itself.
How the asking goes
How the asking goes
- Ask one question and then stop talking. Silence after a question about use is uncomfortable for the worker before it is uncomfortable for the client.
- Use the client's own words for substances, quantities and time. Translating what they said into clinical language signals that you are writing a note rather than listening.
- Ask about behavior and specifics rather than categories. When did you last, and how much, and who was there gets a straighter answer than are you managing.
- Do not stack questions. Two joined together invite the client to answer the easier one.
- Keep your face and voice the same for every answer. The list of what a client tells you next month is set by how you reacted this month.
Order and timing
Order and timing
- Open with the ordinary week before anything about use. It is easier to answer and it produces most of the useful detail anyway.
- Leave household, money and safety questions until the person has had a chance to settle, unless something in the room says otherwise.
- Ask about a lapse plan while things are going well. It is a very different conversation to start after a lapse has already happened.
- Do not attempt the whole list in one session. Four or five questions answered properly are worth more than twenty answered briefly.
- Return to the same two or three questions across sessions so you can hear change rather than guess at it.
What this list is not
What this list is not
- It is not a screening or assessment tool, and none of these questions produce a score or a diagnosis.
- Prescribing, withdrawal management and any change to medication belong with the prescriber and the treating team.
- If safety comes up, follow the protocol of your setting rather than continuing the conversation on your own judgment.
- Documentation, consent and what you may share with family are governed by your service's rules and by the client's own consent, and both should be clear to the client before you ask anything personal.
- Bring what you are unsure about to supervision. The questions that unsettle you are usually the ones worth talking through with a colleague.