Reducing the risk of relapse

Relapse prevention counselling can arm us against being caught out by high-risk situations, says
Terence Gorski.
 Relapse prevention is a critical component to recovery planning; it is the process of preparing for, mitigating, responding to, and recovering from a potential or actual relapse. It is a dynamic process, identifying, mapping, and managing personal reactions to high-risk situations. Relapse Prevention Counselling (RPC) provides the tools and recommended actions to assist our clients in increasing their chances to recover and prevent relapse. RPC presents seven powerful clinical processes that quickly identify and mange high-risk situations that cause relapse: special emphasis is placed on the management of  

o     irrational thoughts, o     unmanageable feelings, o     selfdestructive urges, and o     self-defeating behaviours. Making the commitmentWhen embarking on recovery, we ask our clients to make an honest commitment to stop using alcohol or other drugs. By reviewing the problems that motivated them to enter treatment, we show them the relationship between their current problems and their alcohol and drug use. Because we are well aware of the power of addiction to entice even the most stalwart back to use, we ask our clients to set up a monitoring and accounting system to back up their commitment. We also ask that they enter into a written ‘abstinence and treatment contract’ that spells out the commitments they are making about their recovery and relapse prevention. When they sign the agreement, they are putting their personal integrity on the line. 

Stopping relapse quicklyOne of the goals of RPC is to prepare the client to stop using alcohol and other drugs quickly if they do start using. The chances that they will recognise their relapse and take steps to stop using are dramatically increased if they have a prepared written plan for what to do. Identifying high-risk situationsWe do not get into high-risk situations by accident, but rather set ourselves up to get drawn into them. Once in the situation we do not know what to do; we make excuses as to why or how we ended up in the situation. Planning is an essential part of preparing to prevent relapse, and identifying high-risk situations is the first planning activity.  

Identifying high-risk situations can be difficult. They are personal to each of us and not all high-risk situations will elicit the same response. We may not appreciate the effect certain situations will have on our recovery and just how vulnerable we are. But through preparation and a proactive approach, we can recognise potential high-risk situations and be proactive in preparing our defence with various intervention options. Mapping and managing situationsWe need to thoroughly understand our high-risk situations. 

The greater the level of detail in mapping, or recording such situations, the more prepared we will be if we find ourselves confronted by them. To manage high-risk situations, we must know what they are and how we get into them. We can recognise them by reviewing a list of common high-risk situations, identifying those that apply to us, and assigning a title and personal description that make them easy to remember and recognise when they happen. The next step is to map the situation, by describing exactly what we do and how other people react to what we do that makes us want to use alcohol or other drugs despite the commitment not to. Remember, the more detail you can record in the mapping process, the better prepared you will be in the actual situation. 

Try to see what you are doing and saying in the correct sequence and think about each consecutive action. The closer the map is to reality, the better prepared you will be if the situation should occur. Managing personal reactionsHigh-risk situations can activate deeply entrenched habits of thinking, feeling, acting and relating to others that make us want to use alcohol or other drugs. To manage these situations effectively, we must learn to understand and control the way we react. 

Our chances of managing high-risk situations without using alcohol or drugs increase as we get better at recognising and managing our thoughts, feelings, urges, actions and social reactions that make us want to use. Developing a recovery planWe must have a recovery plan that helps us to avoid relapse. People who successfully recover tend to do certain basic things. You may not do all of the things that someone else does, but once you understand yourself and your recovery needs you will be able to build an effective personal programme for yourself. Your programme should include a regular schedule of activities, designed to match your unique profile of recovery needs and unique high-risk situations. 

The challenge of recovery is never really over. It seems that once we start a recovery process we are either growing or we’re stalled, or regressing. There is no standing still: We either commit ourselves each day to improve and refine our recovery skills, or we become complacent and slowly move toward relapse. We must make a conscious choice each day about which path to follow. Choose recovery and you will move from a place of pain and fear, to a place of power and serenity. From; 26 March 2007, Drink and Drugs News.  

Relapse prevention is part of the BriefTSF manuals at BriefTSF.com

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