Relapse prevention plan

A relapse prevention plan is created to stop someone from going back to harmful behaviors. It is usually thought of regarding substance abuse but can be used for any addictive or maladaptive behavior, such as gambling or self-harm. The importance of a relapse prevention plan cannot be understated. It is estimated that 40-60 percent of people relapse. Without a solid plan, it could be much higher. Here is everything you need to know about relapse prevention plans.

Why is preventing relapse important?

A crucial aspect of a relapse prevention plan is to understand why it is so important not to relapse. You want the client to remember the negative consequences of their behavior and all the individuals who they hurt. This helps motivate them to not repeat past harmful acts.  Additionally, it is critical to recognize the positive effects of resisting harmful behavior.

Ideally, you want the client to express gratitude for the people in their life who have stood by them and appreciate the good in their lives. A productive exercise is to have them answer the question: “Isn’t your life better now?”

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Stages of relapse

By examining the stages of relapse we can illustrate the relevance of a relapse prevention plan.

Emotional relapse: The first stage of relapse is emotional relapse. The desire to return to negative behaviors may not even be conscious at this stage, but the individual is starting to have thoughts and behaviors that lead them down a path toward relapse. A slippery slope, so to speak. For example, a person may stop treatment so they don’t have to deal with difficult emotions or they may begin to exhibit a lack of self-care. A relapse prevention plan helps the individual establish a healthy lifestyle and personal connections that attempt to keep emotional relapse at bay.

Mental relapse: In the mental relapse stage, the individual has not yet gone back to their harmful behavior but they are contemplating it. Think of it as an internal struggle between using and sobriety. The person may be fighting urges, start to be more secretive, and put themselves into risky situations. A relapse prevention plan will help a client understand the triggers and mental states that make a mental relapse more likely.

Physical relapse: Physical relapse is when the individual returns to the harmful behavior they were trying to prevent. The emergency toolbox that is developed as part of a relapse prevention plan is the resource used to prevent a physical relapse right before it occurs. Even if someone does relapse, they can turn to their support network and review their goals to help them get back on the path toward sobriety.

The emergency tool box

As we mentioned, relapse is a common occurrence. And urges to perform harmful behavior are quite frequent, especially at first. So, what is a person to do if they feel on the verge of relapsing? Turn to their emergency toolbox. The toolbox is a set of behaviors for the client to do when they feel like they are close to relapsing. Keep in mind, these are not long-term preventative behaviors. Instead, they are actions to perform in the moment to stop someone from doing something they will regret.

Some toolbox measures may include:

• Distraction
• Calling a friend
• Taking a walk 

Helping your client develop their toolbox is one of the most important parts of relapse prevention.

Support and connection

Speaking of friends, nothing is more important than getting support from others. Many experts believe that addiction is more about needing connection than the rush you get from performing a particular behavior. That connection can come from many sources, including friends, family, therapeutic groups, and professionals. The therapist will assist the client in establishing their support network which may also involve helping the client remove unhealthy relationships from their lives.

What should be in a relapse prevention plan?

• Goals: Goals are integral to a relapse prevention plan. You have to know what you are trying to accomplish. The therapist helps the client create personal goals by assessing their needs and grounding them in reality. Goals help to inspire the client and stay focused on what they want to achieve.

• Triggers: You can’t avoid relapse if you don’t understand your triggers. Triggers can be anything that makes it more likely that the person will perform the harmful behavior again. Therapists help their clients recognize their triggers and avoid situations in which they could arise. For example, an alcoholic probably wants to avoid going to bars and a drug addict shouldn't hang out with the people with whom he used to do drugs (unless they are also sober).

• Mental State: Similar to triggers, certain emotions, and mental states are more likely to lead to relapse. For instance, feeling depressed increases the chances of self-harm, and being bored increases the desire to drink. The therapist needs to work with the client to figure out which mental states might lead to relapse.

• Prevention: Just as a person needs an emergency toolbox, they also need to add healthy behaviors that will help them avoid relapse in the long term. These may include starting an exercise program or making friends by joining a new activity. The therapist will encourage the client to adopt self-care and a healthy lifestyle to keep them on a positive path. Prevention is really about avoiding an emotional relapse before it starts.