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Relapse Prevention

Relapse Prevention generally refers to illness management through compliance with medication regimes. RP is a skills-based and cognitive-behavioral approach that requires patients and their clinicians to identify situations.

There’s actually some disagreement amongst the addiction treatment community as to what is considered a relapse. The recovery journeys are so intensely personal and unique, what one person considers a relapse might be considered a “slip” to others. Relapse is determined by repeat or prolonged drug use after a period of abstinence. For some, it is as much a return to a drug as it is the person’s intent.

Why Are Relapse Prevention Skills Important?

Relapse prevention skills are essential to learning to live a happy life in recovery. At any stage of recovery, there is a risk of relapsing, making relapse prevention skills highly important to know and understand.

Some of the most common triggers of relapse include:

  • Boredom
  • Stress
  • Money problems
  • Relationship issues
  • Certain sights and smells
  • Certain people or places
  • Falling into old habits
  • Anger
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Most alcohol and drug treatment centers educate clients on relapse prevention techniques and help clients learn them in order to maintain recovery and achieve short- and long-term goals. There are a vast array of relapse prevention tools one can implement into their daily routine to help prevent relapse.

Relapse Prevention Strategies Include:

  • Building awareness around the potential negative consequences of encountering high-risk situations and thoughts that associate substance use with good outcomes (i.e., it challenges positive expectancies surrounding substance use)
  • Helping the patient to develop and expand their repertoire of coping skills that address specific high-risk situations for relapse (often called “triggers”), whether those situations lead to drug use-related thoughts, feelings, or bodily sensations
    • Skills range from techniques to communicate with others when in a risky situation (e.g., how to confidently and comfortably say “no” to a drink if it is offered, called “assertive drink and drug refusal”), to “urge surfing,” a technique. To help individuals cope with the intense longings to consume the substance that occurs during cravings
  • Planning for “emergencies.” That is, unexpected situations where the patient finds themselves suddenly struggling to abstain from drinking or using other drugs
  • Assessing and reinforcing the patient’s confidence in his/her ability to abstain from substance use, even in the face of challenging situations (e.g., self-efficacy)
  • Finding alternative ways of thinking about positive thoughts related to substance use, and negative thoughts related to abstinence, sometimes called “cognitive restructuring.” This activity includes discussing the thinking “traps” (sometimes called cognitive distortions, or unhelpful thinking styles) that can develop after years of drinking and using other drugs.
The clinician will use a range of strategies to facilitate these activities. For example, many of the cognitive-behavioral approaches – role-playing is common. This means in RP, the clinician and patient may act out an upcoming or common “real-life” situation to help with skill practice and application.

The patient should also expect to do work honing and practicing these skills outside of the session. This is sometimes referred to as “homework,” “practice,” or simply “outside activities.” These outside activities could include, thought journaling that asks patients to draw their awareness to and work to change ways of thinking about their substance use.

Any number of strategies to address potentially high-risk situations (e.g., exercise to cope with anxious feelings that may trigger thoughts about drinking, drink refusal skills at a social gathering, or calling someone from their support network).

Typically it is a three-part process, including:

  • Emotional relapse
  • Mental relapse
  • Physical relapse

With a relapse prevention plan, it is possible to acknowledge and act upon certain feelings and events, in turn avoiding a physical relapse.

In short, A relapse prevention plan helps you recognize your own personal behaviors that may point to relapse in the future.

Importance on how to create a Relapse Prevention Plan

  • Assess Your History with Drugs and Alcohol
  • Determine Any Signs That Could Lead to Relapse
  • Establish an Action Plan

Inclusions of Relapse Prevention Plan

  • Triggers
  • How to Manage Cravings
  • Preventative Tools
  • Support Groups and Programs
  •  Lifestyle Changes

Gorski-Cenaps Relapse Prevention Model

Terry Gorski is an internationally recognized expert within the field of substance abuse, mental health, violence, and crime.

Within his model he states the following nine steps to be imperative in developing a CENAPS model of relapse prevention [1] or a Gorski relapse prevention plan: 

  • Self-regulation: Physical, psychological, and social stabilization
  • Integration: Completing a self-assessment
  • Understanding: Educating yourself on relapse signs and prevention methods
  • Self-knowledge: Identifying warning signs for when you are likely to relapse
  • Coping skills: Managing these warning signs effectively
  • Change: Reviewing the recovery plan
  • Awareness: this is through practice and consistency
  • Support: The involvement of significant others
  • Maintenance: A comprehensive follow-up plan

Marlatt’s Model of RP

Dr. Gordon Alan Marlatt, a University of Washington Psychology professor, founded this relapse model centered around high-risk situations.

The Marlatt Model [2] illustrates how both tonic (stable) and phasic (short-lived) influences interact with each other in order to evaluate the likeliness of relapse.

Call We Level Up now at (954) 475 6031 to know and learn more about relapse prevention and other aspects of treatment. Together with the people you love most, you can build a better future. Call today and start bringing healing and a big smile back into your home for all members of your family.

Sources:

[1] CENAPS model of relapse prevention – https://www.ncbi.nlm.nih.gov/pubmed/2197389

[2] Marlatt Model – https://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf