Relapse Prevention

“Without relapse prevention, I guess there’d be more…relapse.”  This comically simple phrase was uttered by an attendee of a process group I sat in on recently. It may seem like a funny way to put it, but the beauty of the quote lies in its simplicity. It’s quite true…

Anyone who has been involved in recovery, be it as a patient or those working in treatment for 20 years, knows of relapse prevention. Every treatment center worth their salt has process groups dedicated to the subject, and almost any employee in the recovery industry has some training in this all-important facet of treatment. Relapse Prevention is defined more clinically as a ‘cognitive-behavioral’ approach to identifying and averting dangerous situations, primarily in relation to substance abuse. Cognitive-behavioral therapy is ‘structured, short-term, present-oriented psychotherapy’, and in treatment it is often done in the group setting.

It’s important to note that ‘relapse’ doesn’t only apply to returning to drug/alcohol abuse. It involves re-entering a sphere of old behaviors that lead to bad decision making. Consequently, many relapse prevention groups focus on ‘people, places and things’ that need to be avoided in post-acute recovery. In a very simple sense, all 12-step programs are relapse prevention-based by virtue of the fact that the shared experience helps prevent a return to past behavior. As you can see, it’s a long-term life plan that really begins after initial treatment. It’s not enough to merely quit drugs or drinking, you need to guide your new life on the premise that you won’t have them to lean on when things aren’t going that well…and I have a news flash for ya: just because you’re sober, things won’t always go well.

Relapse prevention focuses on acquiring certain tools that will enable you to navigate these rough waters. One of the most important is stress management. By identifying stressful situations such as those related to crisis, work, family, school or money (there’s a big one…) one becomes more aware of when they build up, why they build up, and how they build up. Stress management always digs deeper than this, and often presents diet, rest, and time management as tools to lower stress, thereby lowering the chance of being overcome by it, with that going the possibility of returning to active substance abuse.

Other problems that often rear their ugly heads in the early stages of recovery are legal, medical and financial issues. These can cause a tremendous amount of strain, and aside from whatever consequences they may render, if they remain unchecked or ignored, stress levels skyrocket… for some, returning to active drug use is a comforting alternative. Relapse prevention tackles such issues with an eye towards a greater degree of responsibility as well as lowered anxiety.

There are many other tools that relapse prevention can provide those in recovery, and just a few of these would be identifying an over-expectation of outcomes, learning new coping skills, option reduction, and knowing your motivations. Possibly two of the most important are the identification of cravings and triggers. These are certainly not the same for everyone, and often individual therapy provides the highest level of identification of these issues. However, positive and negative results of dealings with cravings are excellent fodder for the group setting.

In the end, a well-thought-out treatment plan, including after-care (sober living transition, etc.) is essentially a relapse prevention roadmap. And like a roadmap, routes can be changed and altered, but as long as something is followed, the chances of actually reaching the destination are far better.

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