Why You Need a Relapse Prevention Plan and Treatment Strategy
In a way, all substance use disorder (SUD) treatment programs are set with the main goal of preventing relapses in mind. Yet, there’s a specific aspect of the recovery journey dedicated to relapse prevention.
But what does a relapse prevention plan and treatment strategy look like? Is it really necessary?
In this blog post, we’ll go over what the plans entail and how they can make a world of difference in sustained recovery.
Table of Contents
- 1 Understanding Relapse
- 2 A Relapse Prevention Plan Isn’t a Way to Avoid Failure
- 3 Principles and Components of a Relapse Prevention Plan
- 4 5 Handy Tools for Supporting Relapse Prevention Plans
- 5 The Role of Aftercare in Addiction Relapse Prevention
- 6 Involving Loved Ones in the Relapse Prevention Efforts
- 7 Dealing With a Recent Relapse
- 8 Final Thoughts on Personalized Relapse Prevention Plans
- 9 Resources
On the surface level, relapse might look like a quick slip-up or a singular event, but that’s often not the case.
Relapse is actually a gradual process. It might begin weeks (or even months) before the recovering addict even takes a sip of alcohol or goes back to drug abuse habits.
Some experts break down the process into a long chain of consecutive phases. Take, for instance, Terence Gorski. He believes there are 11 phases (with 37 warning signs) to relapse.
While Gorski’s warning signs are reliable and quite helpful for clinicians, they can be a bit much for recovering addicts and their families. That’s why you’ll likely hear about the more succinct version: the three stages of relapse.
When we look at how most addicts experience relapse, we can pinpoint three main parts:
- Emotional Relapse: During this stage, the person might struggle with their recovery journey. Yet, they won’t consciously think about using—denial is a huge element here.
- Mental Relapse: The urge to use surfaces back in this phase, but a part of the individual is still fighting the chronic addiction.
- Physical Relapse: That’s when the individual finally abuses the substance again. This stage could move on to a worse state of uncontrolled use.
That said, there’s still hope, regardless of which stage the individual is in!
It’s also worth noting that the steps aren’t necessarily discrete. Some people will continue experiencing signs of emotional relapse even though they’ve moved on to the second stage.
Either way, we’ll go in-depth over the components and treatment strategies that professionals use for the relapse prevention program later in the article.
Poor self-care is often a common denominator among relapse cases. However, there’s a wide range of triggers that can push people down the spiral of emotional, mental, and physical relapse.
Here are the top triggers that addiction treatment providers need to consider while setting the prevention plan:
- Isolation (which also happens to be a warning sign of the emotional stage)
- Stress and physical exhaustion
- Depression (or other mental health issues)
- Drug-related cues (people, places, or objects that remind the person of their addictions)
- Unbalanced self-reliance
- Times of celebration
One common misconception is that relapse is a failure—it’s not.
For one, people who relapse (or have a single slip-up) can bounce back, provided they get the help they need.
But that’s not all. Let’s consider the chronic nature of addiction for a minute.
You wouldn’t really say that someone with asthma has failed just because they had an attack recently. Instead, you would likely believe they need to refer back to their physician and modify their treatment.
That’s more or less the case with addiction.
After all, the National Institute on Drug Abuse (NIDA) estimates that the relapse rates for substance abuse (40–60%) are comparable to that of hypertension and asthma (50–70%).
In some ways, relapse can be a normal part of many people’s recovery journey rather than a sign of failure. The prevention plan is only here to reduce the odds of this happening.
If the individual does spiral, the plan can help keep things confined to temporary setbacks.
For instance, it’s useful for professionals to keep an eye out for the early signs of emotional relapse (skipping meetings, bottling up emotions, poor eating/sleeping habits, etc.).
Knowing the signs and potential triggers goes a long way in keeping the severe relapses at bay!
Now, you know the scope of the prevention program, but visualizing what the plan looks like can still be challenging.
One popular model of relapse prevention therapy is the Cenaps model, with nine principles ranging from self-regulation to maintenance.
From those principles, we can extract nine recommended procedures to be incorporated into the plan.
Here are the details:
|No.||Cenaps Principle||Recommended Relapse Prevention Procedure(s)|
|1||Self-regulation||Physical, psychological, and social stabilization (via detoxification and removing crises that threaten sobriety)|
|2||Integration||Self-assessment and reconstruction of recovery/relapse history|
|3||Understanding||Relapse education programs|
|4||Self-knowledge||Warning sign identification|
|5||Coping Skills||Warning sign management|
|6||Change||Reviewing the recovery plan and going over how each warning sign is associated with a specific activity|
|7||Awareness||Inventory training (via daily sheets for planning the day and reviewing progress/problems)|
|8||Significant Others||Involving family members, sponsors, counselors, and peers|
|9||Maintenance||Plan updating (on a monthly basis for a while, then quarterly, then twice a year, and finally once a year)|
With all that in mind, we can say that self-awareness, finding coping strategies for cravings, setting a structured routine, and building a support system of trusted individuals are all vital components.
At ReCreate Life Counseling, we advise clients in relapse prevention treatments to incorporate elements of accountability, mindfulness, and coping skills into their plans.
We’ll cover how the treating professional can involve family members and friends later, though!
Since each case is different, the prevention plan can change from one person to another.
However, there are a few common therapy and treatment modalities that can help keep the relapse incidences away.
Here’s a rundown of the top supporting programs and intervention strategies:
The 12-step program can help recovering addicts find coping skills and build a support network. Plus, it’s a great way to find a sponsor who will help them when the cravings kick in.
Note that the success rate estimates change among programs. However, it’s safe to assume that, for many people, 12-step meetings can help with relapse prevention efforts.
Hopefully, this process will help the individual develop healthier thought patterns that will help prevent relapses.
Another form of psychotherapy that could be part of the prevention plan is DBT.
Unlike CBT, DBT focuses on validating and accepting the person’s current situation, which boosts their distress tolerance and emotional regulation. It also helps with other aspects like mindfulness and building interpersonal relationships.
How effective is it? Well, one study found that a year of DBT reduces psychiatric hospitalization days by a whopping 77%.
Keep in mind that you can do CBT or DBT through teletherapy as part of the relapse prevention plan.
One of the relapse prevention tools we use at ReCreate Life Counseling is meditation.
We believe that long-term success rates are higher when holistic therapies (yoga, guided meditation, and art expression) are used alongside traditional therapies (group therapy and one-on-one counseling).
After all, stress is a common relapse trigger—the more you work to control it, the better!
In some cases, we also recommend journaling and taking up hobbies for stress relief.
MATs are often a good fit for people with a high relapse risk, like opioid addicts.
In a MAT program, the patient stops their substance abuse and starts taking a prescribed medication like methadone and buprenorphine instead. The administration is done under supervision, of course.
Overall, the prescription should help reduce the cravings. As the patient makes progress in the recovery plan, they’re tapered off the MAT intake.
However, there are risks and eligibility barriers to consider. Get in touch with us today to know if MAT programs are the right choice.
Even after the 90-day period is over, there will always be risk to some extent. That’s where aftercare comes in.
A well-rounded aftercare plan can help the recovering addict resist cravings and stay on track. Doing so is relatively easy in the inpatient treatment center since the environment is controlled. However, once the patient is out, things get tricky.
Ideally, the healthcare professionals will prepare the patient to transition smoothly into the aftercare plan from the residential program.
Depending on the case, the ongoing support can include a mix of the following approaches:
- Support groups
- One-on-one therapy sessions
- Regular check-ins
- Vocational help
- Sober living (great for providing structure, supervision, and support)
It’s worth noting that the duration of the aftercare plan changes on a case-by-case basis, especially when it comes to sober living.
Unlike halfway houses, most sober living houses are voluntary and don’t come with strict stay limitations. Individuals are welcome to stay for one or even two years until they feel ready to live independently.
If all goes according to the aftercare plan, integration into normal life should be safer and easier.
So far, we’ve seen that the average relapse prevention program is multifaceted and requires a substantial blend of planning and willpower.
Thankfully, patients don’t have to take that road alone. We’re not just talking about the team of experts at ReCreate Life Counseling Services—family and friends are more than welcome to help.
In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) encourages getting family members involved in the relapse prevention plan.
After all, loved ones can pick up on the early warning signs that the individual himself might miss. Plus, there’s no denying that families can bring along to the table either by offering their services (driving the recovering addict to and from meetings) or offering emotional support.
However, there’s still a need for boundaries. Otherwise, the family’s involvement will lean more towards controlling (and sometimes outright judgemental) behavior rather than a supportive model.
That’s why the treatment providers should lay down a plan that explains the family’s roles and valid intervention options in cases of relapse or other emergencies.
Some patients never relapse, but as we covered earlier, relapses are normal for other recovering addicts.
To respond to a relapse, we’d recommend:
- Getting Immediate Help: Talk to your sponsor or doctor. Dial up a helpline if you need to.
- Jumping Back on Track: Depending on whether it’s a case of lapse (a single slip-up) or a full-on relapse, you might need to go through more treatment programs. Be patient!
- Learning From the Relapse: Ask yourself what triggered the incident. Did you prepare for it earlier? If not, then it might be time to revisit the initial prevention plan and tweak it.
The most important part here is to never lose hope!
If you know that someone else has relapsed, make sure they’re safe and seek medical support to reduce the risk of overdose.
Relapses can be devastating, soul-crushing experiences for both the recovering addicts and their loved ones. They’re not uncommon, and yet they’re never a reason to give up on treatment plans altogether.
With some planning and self-reflection, patients can help draft their own aftercare and relapse prevention programs and procedures. As it happens, the plans are better when they’re tailored to each individual’s needs and unique situation.
If you want to learn more about personalized treatments and relapse prevention, don’t hesitate to call our team at (888) 685-3082.