RELAPSE PREVENTION PLANNING – PRINCIPLES AND PROCEDURES

Terence T. Gorski

Understanding the framework and basic principles that underlie the relapse prevention planning process is essential for successful outcomes and lifelong recovery. Accompanying each principle is a brief procedure or clinical technique that can be used to operationalize that principle with patients and clients.

The first principle of self-regulation states that the risk of relapse will decrease as the patient’s and client’s capacity to self-regulate thinking, feelings, memory, judgment, and behavior increases. This principle is operationalized with a procedure for physical, psychological, and social stabilization

The second principle of integration states that the risk of relapse will decrease as the patient’s and client’s level of conscious understanding of the events that led up to past relapse episodes increases. This principle is operationalized in the technique of self-assessment in which the patient’s and clients consciously examine recent problems caused by the relapse, their life history, alcohol and drug use history, and their overall recovery and relapse history.

The third principle of understanding states that the risk of relapse will decrease as the understanding of the thoughts, feelings, actions and situations that lead to relapse increases. This principle is operationalized by a relapse education procedure which teaches the patients and clients about the addictive disease process, the developmental model of recovery, common stuck points and complicating factors, and relapse prevention planning.

The fourth principle of self-knowledge states that the risk of relapse will decrease as the patient’s and client’s ability to identify future high risk situations that can trigger relapse warning signs increases. This principle is operationalized with a procedure called relapse warning sign identification in which the patient’s and clients identify the sequence of problems that have led from stable recovery to chemical use in the past, generalizes those steps to future circumstances that could cause relapse, and creates a personal list of relapse warning signs.

The fifth principle of coping skills states that the risk of relapse will decrease as the patient’s and client’s knowledge and skill at using effective coping strategies for specific warnings signs increases. This principle is operationalized with a procedure called warning sign management in which the patient’s and clients identify critical warning signs, examines how they coped with these warning signs in the past and develops new coping strategies for the future. The coping process focuses on the development of specific cognitive, affective, behavioral, and relationship skills for dealing with the critical warning signs.

The sixth principle of change states that the risk of relapse will decrease as the relationship between recovery program recommendations and identified relapse warning signs increase. This principle is operationalized in a procedure for reviewing the recovery plan in which the patient’s and clients develop a written recovery plan and then takes each warning sign on their final warning sign list and identifies the components of the recovery plan that will help them cope with each warning sign. The recovery plan is modified to accommodate any warning signs that were not addressed in the original plan.

The seventh principle of awareness states that the risk of relapse will decrease as the use of daily inventory techniques designed to check for compliance with recovery program recommendations and the presence of relapse warning signs increase. This principle is operationalized by a procedure called inventory training. Here the patient’s and clients are taught specific techniques for planning each day and reviewing progress and problems at the end of the day. They are also taught how to use others to review their inventory.

The eighth principle of support states that the risk of relapse will decrease as responsible involvement of significant others in the relapse prevention planning process increases. This principle is operationalized by a procedure called the involvement of significant others. The patient’s and clients list the people who should be involved and evaluate their appropriateness. Appropriate persons are invited to a meeting that discusses the patient’s and client’s warning signs and the past experiences and reactions of other people to those warning signs. A new communication contract is set up that will allow open communication about future warning signs should they occur. A relapse early intervention plan is also developed.

The ninth and final principle is maintenance which states the risk of relapse will decrease when relapse prevention plans are revised on a regular basis. This principle is operationalized with a comprehensive follow-up plan which calls for the regular review and revision of the relapse prevention plan as the patient’s and clients move ahead through new stages of recovery or new stages of life development.

To learn effective relapse prevention strategies and techniques attend the Relapse Prevention Therapy Certification School, June  8-12, 2020. Over the past 40 years, research has clearly shown that relapse is a process that begins long before recovering people start using alcohol or other drugs. Alcohol and drug use do not mark the beginning of the relapse process—it is the final stage. Alcohol and drug use is just the final step in an ongoing relapse process. The relapse process begins as recovering people begin using thoughts, feelings, and behaviors that create so much pain and problems that self-medication with alcohol and other drugs seems like a good choice.

Best Wishes In Your Ongoing Recovery,

Terence T. Gorski

Behaviorial Health, Addiction, and Recovery books, pamphlets, DVD’s, digital downloads and resources authored by Terry Gorski are available at www.gorskibooks.com and training is available through www.cenaps.com.

Terence T. Gorski is an internationally recognized expert on relapse prevention, substance abuse, mental health, violence, and crime. He is a prolific author and has published numerous books and articles.