Substance use recovery / SUR-A11-3
Refusal with an Exit — Clinician dialogue
Guide a collaborative conversation about refusal with an exit while checking fit and participant choice.
15 minutes · Clinician script · Mental health professionals
Fictional example: Jordan is invited to an event where returning to use feels more likely.
Use within your training and assessment of readiness. A refusal works best when it includes a realistic way to leave or get support.
Invite and obtain permission
Offer: "Would it be useful to explore refusal with an exit using an ordinary or fictional example? We can adapt it, observe, or stop." Ask what the person wants from the conversation.
Elicit before teaching
Ask: "How does this show up, if at all, in your own words?" Offer this idea tentatively: A refusal works best when it includes a realistic way to leave or get support. Ask what fits and what does not.
Guide the task
Rehearse a brief decline, an exit line, and an alternative plan for a low-stakes invitation. Ask for permission before giving an example. Use this fictional illustration if useful: Jordan is invited to an event where returning to use feels more likely.
Reflect and check accuracy
Reflect only what was offered: "I heard you describe ___. What did I miss?" Ask: What makes leaving feasible rather than just a sentence on paper? Avoid assigning motives or interpreting silence as agreement.
Respond to a mismatch
If the person rejects the frame, say: "Thank you for correcting it. What would be more useful?" Return to their language or choose a different approach.
Close with agency
Ask which observation, question, or support request the person wants to keep. Confirm a manageable ending and appropriate follow-up; do not turn a tentative possibility into a homework obligation.
Prompts for this resource
- Readiness, permission, cultural context, and access needs to check:
- What makes leaving feasible rather than just a sentence on paper?
- What would tell me to adapt, stop, or seek supervision?
Conceptual background
Substance Use Disorders — National Institutes of Health
Background on the approach only. Original exercises and wording are by More Than Therapy with AI assistance; the source does not validate or endorse these materials.