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Relapse Prevention Therapy and Strategies

Millions of people go through addiction recovery every year. For some, the recovery process is a new thing, and for others this is their second, third, even fourth time trying. Unfortunately, it’s well-documented that relapse rates are surprisingly high, and many individuals who have successfully been through recovery, might relapse within the first few months. Statistics show that about two-thirds of people attempting recovery for the first time will relapse. 

Those who have a long history of addiction are well-aware that recovery is hard, but maintaining that newfound sobriety is even harder. Relapsing usually happens when rehab ends and the patient goes back into society, facing real-life problems and dealing with everyday tasks. However, one of the things that can greatly decrease a recovering individual’s chances of relapse is Relapse Prevention Therapy.


Relapse History

Studies show that roughly one-third of all patients achieve permanent abstinence, another third have brief relapse episodes, and one-third have chronic relapses that might lead to eventual death. Chemically dependent individuals can be categorized in these three categories:

  1. Transition patients – these individuals fail to accept they are battling with addiction. This is due to their mistaken beliefs and inability to accurately perceive reality.
  2. Unstabilized relapse-prone patients – treatment failed to provide these individuals with the necessary skills needed to prevent the addiction progression. Consequently, they failed to stick to a recovery program that requires treatment, abstinence, and lifestyle change.
  3. Stabilized relapse-prone patients – these individuals are well-aware of the fact they’re chemically dependent, need to stay sober, and maintain an ongoing recovery program. They attend AA, NA, and 12-step meetings. Unfortunately, these patients can also develop symptoms of dysfunction and eventually relapse.


Triggers and Warning Signs

The most common high-risk situations involve negative emotional states, pressure from others to use, relationship conflicts, and poorly established coping skills to handle these high-risk situations. There are three states of relapse: emotional, mental, and physical.

In addition, patients who are experiencing emotional relapse don’t think about using, but their emotions are preparing them for a possible relapse. The warning signs are: anger, isolation, mood swings, anxiety, intolerance, trouble sleeping, and trouble eating.

Patients who are struggling with mental relapse are in war with themselves. There’s one part of them that want to go back to using, and a part that hesitates. The warning signs are lying, fantasizing about using, planning your relapse, and thinking about people you used with.

Furthermore, patients who fail to control their emotional stresses and mental urges will eventually fall victims to a physical relapse. Next thing they know, they’re driving to meet their dealer or are headed to the liquor store. Stopping the relapse at this point is undoubtedly hard.


Short History of Relapse Prevention Therapy

Relapse Prevention Therapy was originally designed 40 years ago by G. Alan Marlatt, together with his coworker Judith Gordon, to treat alcohol abuse and addiction. Their cognitive-behavioral model inspired Terence Gorski, an expert on addressing alcohol and drug use, to design his own version of relapse prevention therapy, known as the CENAPS® Model of Relapse Prevention Therapy (CMRPT). Marlatt and Gordon’s treatment approach was later adapted to treat cocaine users.


Relapse Prevention Therapy

Relapse Prevention Therapy is a systematic method of teaching recovering patients to recognize and manage relapse warning signs. The five primary goals of Relapse Prevention Therapy are to:

-construct a list of relapse warning signs;

-assess the global lifestyle patterns contributing to relapse;

-develop warning sign management strategies;

-develop a structured sign management strategies for the warning signs;

-create a relapse early intervention plan that will provide the client with step-by-step instructions to interrupt alcohol and other drug use;

Counselors often use the basic principles of the CENAPS Model of Relapse Prevention Therapy. Each of these principles forms the basis of specific relapse prevention therapy procedures:

Step 1: Stabilization

In order for the relapse-prone patient to stabilize socially, physically, and psychologically, an initial treatment plan is established. This process includes detoxification, solving the crises that are a menace to sobriety, learning skills to manage post-acute withdrawal, but also establishing proper diet, exercise, stress management, and self-help groups.

Step 2: Self-Assessment

This step involves identifying patterns that caused past relapses. The detailed reconstruction of life history, alcohol and drug history, and recovery and relapse history, can lead to identifying critical issues that trigger the patient’s relapse. The life history includes examining the patient’s childhood, high school years, college, intimate relationships, and friendships. Furthermore, the alcohol and drug history explores how often was the patient using, what did he/she want to accomplish, and what were the consequences of using. Finally, the recovery and relapse history examines each period of abstinence and chemical use in order to find out what exactly happened during each period.

Step 3: Relapse Education

During this step, patients learn about the relapse process and how to manage it. This is usually done with the help of relapse education sessions and reading assignments. Additionally, patients learn about complication factors in relapse, warning signs identification, relapse warning signs management strategies, and effective recovery planning.

Step 4: Warning Sign Identification

This step educates patients on how to recognize the problems that led from a stable recovery to relapsing. Patients use this knowledge to prevent any future relapses. They make a list of initial warning signs, analyze the warning signs, and make a final warning sign list. Moreover, there are two different types of warning signs: those related to a core psychological issue, and those related to a core addictive issue.

Step 5: Warning Sign Management

During this stage, patients learn how to manage and cope with their warning signs of relapse. Warning sign management is oriented towards three different levels, including:

  • situational-behavioral level (patients here learn how to avoid situations that trigger warning signs);
  • cognitive-effective level (teaches patients how to challenge their irrational thoughts);
  • core issue level (patients learn how to identify the core addictive and psychological issues that create the warning signs);

Step 6: Recovery Planning

This step involves the development of a schedule of recovery activities that will aid patients recognize and cope with warning signs.

Step 7: Inventory Training

Furthermore, inventory training teaches patients how to complete daily inventories. There are two types of inventories, daily and evening. A daily recovery plan sheet is used to plan the day, and an evening inventory sheet is used to review progress and problems that occurred during that day.

Step 8: Involvement of Others

Since patients can’t recover on their own, they need people are willing to help them and guide them through the process. Patients get help from family members, 12-step program sponsors, counselors, and peers. This support is essential in drug relapse prevention and can help patients in many ways including: creating a stress-free environment, providing happiness and overall well-being, and offering a healthy outlet to talk about their feelings openly.

Step 9: Relapse Prevention Plan Updating

Finally, the patient’s relapse prevention plan needs updating on a monthly basis for the first 3 months. Then, quarterly for the remainder of the first year, and twice a year for the next 2 years. When the patients manage to maintain at least 3 years of uninterrupted sobriety, the relapse prevention plan should be updated on a yearly basis.

For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.

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