Relapse prevention plan
A relapse prevention plan is an essential part of stopping people from returning to destructive behaviors. Although most used for substance abuse, it can be instituted for any damaging behavior, including gambling addiction or self-harm.
It is estimated that 40-60 percent of people relapse, exhibiting the vast need for assistance. Here is what you need to know about creating and implementing relapse prevention plans.
Key takeaways
- A relapse prevention plan extends beyond substance use. Plans can also help clients manage recurring mental health symptoms and harmful behaviors by identifying risks before they escalate. Download my free relapse plan template.
- Effective relapse prevention plans combine prevention and crisis strategies. Goals, personal triggers, healthy coping skills, support systems and crisis planning give clients both long-term tools and in-the-moment options.
- Plans should be collaborative and adaptable. Client involvement can increase investment, while regular reviews help ensure strategies continue to fit changing circumstances.
- Ongoing assessment can strengthen relapse prevention. Tools such as the AUDIT, DAST-10, PHQ-9 and GAD-7 can help therapists monitor symptoms, identify changes and adjust treatment accordingly. Other tools, such as EHRs, can help therapists securely manage and access assessments and other therapy materials.
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What is a Relapse Prevention Plan?
A relapse prevention plan is a guide to help people suffering from addiction and psychological issues maintain physical and mental health. It has five key components.
Five components of a relapse prevention plan
- Goals. What is the behavior you are trying to prevent from reoccurring? For some issues, such as substance abuse, this is straightforward. But mental health issues may be more nuanced. For example, maybe you have an anger issue, but it only occurs in very rare situations. Your goal would need to be very specific to address its particular features.
- Identifying personal triggers. People can have both environmental and emotional triggers. For example, being in a bar would be an environmental trigger for an alcoholic. In contrast, loneliness can be an emotional trigger for someone who self-harms. A plan would identify these triggers so the person could learn to cope with them or avoid them.
- Developing healthy coping strategies. It is impossible to avoid all triggers. Clients need to learn coping mechanisms to deal with them healthily. For example, what does an alcoholic do if they unexpectedly come across someone drinking alcohol? Coping strategies can include specific behaviors and cognitive approaches.
- Building a support system. It takes a village. No one person can prevent relapse without support. It is important to identify the resources available to the individual to prevent relapse. These can be friends, family, group members, or professionals.
- Crisis planning. This is where an emergency toolbox is needed. The toolbox is a set of behaviors the client can use when they feel they are close to relapsing. The aim is short-term relief as compared to a long-term solution. These may include distraction, calling a friend, performing a grounding meditation, or taking a walk.
Component | What it addresses | Example |
|---|---|---|
Goals | The behavior, symptom or pattern the client wants to prevent | Avoid alcohol use or reduce recurrence of harmful anger responses |
Triggers | Situations, emotions or conditions that increase risk | Stress, loneliness, poor sleep or high-risk environments |
Coping strategies | Healthy responses when triggers occur | Cognitive restructuring, grounding, mindfulness or exercise |
Support system | People and resources the client can turn to | Family, friends, support groups or clinicians |
Crisis plan | Immediate steps to use when relapse feels imminent | Call a support person, take a walk, use grounding or distraction |
Can you use relapse prevention for mental health?
A common misconception is that relapse prevention is only for substance abuse. Mental health issues, such as depression, anxiety, and bipolar disorder, also have triggers that can lead to episodes of each disorder.
For example, a relapse prevention plan for depression might involve identifying negative thoughts, stressful events, or bad habits (e.g., lack of sleep) that bring about depressive feelings.
Prevention might involve maintaining a healthy lifestyle and the cognitive restructuring of maladaptive thoughts. Similar to substance abuse, developing a relapse prevention plan for mental health can help clients identify situations that activate these problems and what coping measures can be used to combat them.
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Therapy techniques used in relapse prevention
Motivational interviewing
Motivational interviewing (MI) was created to motivate people to alter their substance abuse behavior. It uses client-centered therapy techniques to empower the client to overcome resistance to change. It is often used as an adjunct to other types of therapy to reduce ambivalence to treatment.
HALT (Hungry, Angry, Lonely, Tired)
The hungry, angry, lonely, tired acronym represents risk factors that are associated with relapse. The therapist must help the client learn to recognize when they are experiencing these sensations and take the appropriate steps to ensure problems do not escalate. Behavioral self-control strategies, such as avoiding high-risk environments and sticking to healthy daily routines, will make it easier to prevent HALT.
Trigger identification and coping
Identifying triggers is a cognitive-behavioral therapy (CBT) technique used to treat several issues, including anger and substance abuse. Although there are a variety of ways to implement this technique, it generally follows the same blueprint: The individual notes the situation and their accompanying cognitive, emotional, and physical reaction. They then develop coping measures to deal with the trigger and observe how it changes the outcome.
Mindfulness and stress management
Anxiety and stress are major precursors for substance abuse and other mental health conditions. And nothing busts stress better than relaxation and mindfulness meditation. Ideally, clients will develop and maintain a daily meditation practice. However, several mindfulness exercises, including grounding and body scans, are excellent ways of dealing with stress that arises in the moment.
Self-care
It may not get as much publicity as some other techniques, but one of the core areas of relapse prevention is self-care. These are the behaviors the individual exhibits over the long term to maintain a healthy physical and psychological state. Exercise, sleep, and healthy eating are the pillars of self-care.
Free Resources for Therapists
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Therapist tips for creating relapse prevention plans
These suggestions will help therapists create effective relapse prevention plans:
Use a collaborative client-centered approach
Therapists must remember that this is the client’s plan. Although they may have ideas for what should be included, individual input is paramount. A client who feels heard and involved will feel more motivated and invested in following through with treatment. This means allowing the client to develop their goals and find coping mechanisms that work best for them.
Update regularly
People and circumstances change. What may have worked at one time may no longer be effective. Or something happens that demands new coping skills. As a rule, it is a good idea to review and update plans every six months or when major life changes occur.
Consistent monitoring
Therapists can’t accurately create or update a relapse prevention plan if they aren’t fully aware of their client’s status. But some clients are less than forthcoming, and it can be difficult to determine how they are actually doing.
Fortunately, objective screening measures can help therapists determine their client’s functioning. Therapists can administer these measures at intake and then periodically during treatment to precisely understand their client’s current psychological state.
Some of the most popular screening resources for substance abuse and mental health relapse include:
- Alcohol Use Disorders Identification Test (AUDIT): A comprehensive 10-question World Health Organization tool for assessing alcohol consumption, dependence, and related problems.
- Drug Abuse Screening Test (DAST-10): A 10-item self-report questionnaire used by healthcare professionals to screen for the severity of drug abuse, excluding alcohol and tobacco, over the past 12 months.
- The Patient Health Questionnaire-9 (PHQ-9): A nine-item self-report measure whose items mirror the criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- The Generalized Anxiety Disorder Scale (GAD-7): A seven-item questionnaire widely used to measure the frequency and severity of anxiety over two weeks.
Making assessment even easier, some of the best electronic health records (EHRs) have these screening measures built into their platforms. Clients can take them online, and the software will score them and track progress over time.
Incorporate relapse prevention into other documentation
Although a relapse prevention plan is a separate document, it is highly related to progress notes and the overall treatment plan. Therapists must keep in mind the relapse prevention plan when creating individual notes or treatment goals.
Thankfully, modern practice management platforms make this simple. They may include AI therapy notes software that does much of the work for you. It will automatically summarize the main points of therapy sessions and create a progress note that can incorporate the goals of the relapse prevention plan.
The importance of relapse prevention plans
Relapse prevention plans are a vital component when treating substance abuse and a variety of mental health problems. Not only do they present a guideline for long-term prevention, but they also provide concrete skills to perform in crisis situations. By utilizing a collaborative approach and proven techniques, therapists can create a comprehensive and effective plan to prevent relapse.
How EHRs can help with documentation
Modern EHR/practice management platforms (such as TheraPlatform) can streamline documentation by providing HIPAA‑compliant, integrated systems for note entry, storage, scheduling, and billing.
They allow therapists to:
- Use and customize templates (e.g., SOAP, DAP, and others) or build their own to streamline note writing and ensure consistency.
- Link notes to treatment plans, goals, and session history so client progress is easily tracked over time.
- Utilize e-fax and secure document sharing via client portal to safely exchange information with clients or other providers while maintaining confidentiality.
- Leverage dictation and telehealth transcription, which can automatically convert sessions into therapy or assessment notes, saving time and reducing manual entry.
- Take advantage of AI features that streamline documentation by automatically populating intake form data into assessment templates and generating complete therapy and assessment notes from the information you provide, all with a single click.
Watch this video to learn how to save time on therapy notes
Meanwhile, AI‑assisted note tools are emerging which can further help clinicians by:
- Automatically transcribing session audio (if permitted) and highlighting key moments (e.g. emotional shifts, major themes).
- Suggesting draft notes or filling in objective or assessment sections based on observed data, freeing up clinicians’ time.
- Supporting consistency and reducing missing components in notes, which helps from clinical, legal, and insurance perspectives.
Together, structured SOAP‑type notes, good EHR platforms, and smart AI support tools can support more efficient workflows, consistent documentation, and accountability.
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- Billing & payments
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Resources for mental health therapists
Theraplatform is an all-in-one EHR, practice management and teletherapy solution with AI-powered notes and Wiley Treatment Planners that allow you to focus more on patient care. With a 30-day free trial, you have the opportunity to experience Theraplatform for yourself with no credit card required. Cancel anytime. They also support different industries including mental and behavioral health therapists in group practices and solo practices.
More resources
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- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
- Insurance billing 101
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References
B.C. Government. Patient Health Questionnaire (PHQ-9). https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/depression_patient_health_questionnaire.pdf
Boudin, M. (2025). Choosing therapy. Addiction triggers worksheet. https://www.choosingtherapy.com/therapy-worksheets/addiction-triggers-worksheet
Melemis S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale journal of biology and medicine, 88(3), 325–332. https://pmc.ncbi.nlm.nih.gov/articles/PMC4553654
Skinner, H. A. (1982). Drug Abuse Screening Test (DAST) [Database record]. APA PsycTests. https://doi.org/10.1037/t03979-000
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1037/t02591-000
TheraPlatform. Grounding techniques for coping with anxiety. https://www.theraplatform.com/blog/489/grounding-techniques-for-coping-with-anxiety
TheraPlatform. Motivational interviewing for substance abuse. https://www.theraplatform.com/blog/339/motivational-interviewing-for-substance-abuse
World Health Organization. (2001). AUDIT: The alcohol use disorders identification test: Guidelines for use in primary health care (2nd ed.) https://iris.who.int/handle/10665/67205
Young, D. (2022, December 11). The Guardian. Why do so many drug and alcohol addicts relapse? The answers are complex. https://www.theguardian.com/commentisfree/2022/dec/11/connection-and-support-are-key-for-serial-relapsers-to-break-the-addiction-cycle
FAQs about relapse prevention plans
What should be included in a relapse prevention plan?
A plan typically includes specific goals, personal triggers, coping strategies, a support system and a crisis plan.
Can relapse prevention plans be used for mental health conditions?
Yes. They can help clients recognize and respond to triggers associated with conditions such as depression, anxiety and bipolar disorder, as well as harmful behaviors.
How often should a relapse prevention plan be updated?
The blog recommends reviewing the plan about every six months and whenever major life changes, new triggers or changing needs make an update necessary.
