Relapse Prevention: How To Create A Relapse Prevention Plan?
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A detailed relapse prevention plan is a must-have tool for all recovering addicts. It may occur on each step of recovery, and according to estimates reported by the National Institute for Drug Abuse, 40% to 60% of recovering addicts relapse. Successful relapse prevention strategies involve more than just not using any addictive substance. It entails creating a new lifestyle and sustainable drug-free behavior. A relapse prevention plan (RPP) helps the patient anticipate triggers and layout measures to counter them. It also helps the patient to gain a sense of accomplishment to keep him motivated to stay sober. A relapse prevention plan can significantly decrease the possibility of the fall if prepared well and executed with marked consistency.
Table Of Contents:
Relapse Prevention Plan (RPP) Overview
It works by:
- understanding what triggers addiction
- developing mitigating measures
- avoiding substance use as early as possible.
To achieve sustainable sobriety, a patient needs to learn new skills by engaging in substance abuse treatment programs. They should include relapse prevention activities that involve help from family, closest friends, social services, and licensed addiction therapists.
Developing A Relapse Prevention Plan (RPP)
First, recovering addicts must acknowledge that relapse is always possible. By recognizing this reality, the patient should be motivated to stay on guard and learn as much as he can about how to prevent relapse. The patient must develop a thorough understanding of three phases of relapse. This is one of the most basic relapse prevention topics. The patient should be able to identify red flags in their own behavior and emotional and mental states. If red flags can be spotted early on, the patient can roll out mitigating measures to stop progression to relapse as soon as possible.
Practical relapse prevention worksheets help a patient transition to a new life by anticipating the worst but also keeping the patient’s eyes on an optimistic future.
A well-prepared relapse prevention plans template includes the sections listed below:
Set patient recovery goals. For this relapse prevention activity to become more worthwhile, therapists recommend breaking down goals into smaller bits and pieces that can be achieved over shorter periods of time.
Ideally, the patient’s goals are geared towards holistic recovery that includes healing of the mind, body, and spirit. It may consist of:
- skills and career development
- repairing broken relationships
- pursuing hobbies that restore mental and physical health
- growing spiritually.
A relapse prevention worksheet usually follows through goal setting with a CBA of the advantages vs. disadvantages of giving up addiction.
Patients are encouraged to review this list when they need motivation or experience triggers. It can be done as follows:
- In one column, patients list down what they love about addiction, what benefits they get out of it, and what they hate about giving it up.
- In another column, patients list down what they hate about addiction and what good things they suppose will happen if they give it up.
Identifying The Triggers And Corresponding Coping Strategies
List down relapse triggers. Relapse prevention plan templates typically include this exercise to improve the patient’s awareness of what to avoid for successful relapse prevention.
Relapse prevention plan worksheets provide a checklist of common triggers that can be grouped into five categories:
Identifying the triggers is equivalent to identifying the risks. By identifying the risks, the patient can put mitigation measures in place, that’s where getting help and pursuing personal development come into play, to help counter them.
Identifying Where To Get Help
This is the part where relapse prevention techniques involving therapy, counseling, and relapse prevention group activities come in.
Items included should reflect the activities that are acceptable to the patient. Individual counseling, for example, can be gradually removed over the course of several years, depending on the patient’s progress.
On the other hand, relapse prevention for mental health challenged patients must concurrently include psychiatric interventions and addiction counseling at all times. This is based on the SAMHSA recommendations in the Treatment Improvement Protocol for substance abuse treatment.
Examples of support available for the patient are:
- Attending individual, marital, parental or family counseling
- Linking up with a case manager
- Linking up with social services
- Attending group therapy sessions, like milieu therapy,
- Learning skills in managing stress, negative emotions, and negative thoughts
- Learning skills in urge control
- Process-oriented recovery groups
Identifying Life Improvements Which The Patient Needs To Pursue
When patients have better control of their life, their chances of staying substance-free improve significantly.
Each patient will have a subjective view of relapse prevention activities to take, depending on what he feels is acceptable and helpful in his situation.
Some of the life improvements included in relapse prevention workbooks are:
- Restoring relationships or going into new
- Finding a job, pursuing a career
- Going back to school, start learning new skills to improve economic productivity
- Improving spiritual health
- Developing new hobbies and habits
- Changing the concept of fun
- Engaging in physical activities
- Taking on challenging assignments at work
- Participating in relapse prevention group activities
- Volunteering for a local charity
Identifying Actions To Take When Relapse Occurs
Since the possibility for deterioration is high, relapse prevention worksheets also include activities where the individual must lay out a plan in case the worst does happen.
Consider re-enrolling in a short-term treatment program. Relapse prevention techniques for substance abuse must be discussed with people whom an individual trusts the most to make the decision on the patient’s behalf in the event of a lapse. These trusted few would have to be committed to acting on the situation as detailed in the plan.
Relapse Prevention Plan Template
Here is a drug relapse prevention plan template a patient can use. Guide questions are provided in each section to help patients in filling out the required information.
It is essential to consider that this document should be treated as “alive,” which means it has to be revisited from time-to-time and revised when necessary.
|Components||Guide Questions||Sample Responses|
|1. Set Goals (set time-bound goals for the long-term and short-term)||What does one plan to achieve by the end of the day? Tomorrow? End of the week? End of this year?||Call spouse or a close family member to start fixing broken relationships
Get a job
Learn a new skill
Start attending a self-help group
|2. Compare the Advantages and Disadvantages of Stopping Addiction||What does one love about addiction? What benefits does one get out of it? What does one hate about giving it up?||The feeling of getting high
Intense sexual stimulation
|What does one hate about addiction?
What good things will happen if one gives it up?
|It leads to losing a job, family and forced to stop schooling
One will be healthier, soberer, stay employed, happier with a family around
|3. Identify The Triggers And Corresponding Coping Strategies||What triggers the cravings?||Physical
Seeing drugs on tv
Emotional and Psychosocial
Seeing old friends who use drugs
Places where one used to get high
Parties where people drink and smoke
|What can one do to avoid triggers?||Move to a different town
Find a new job or attend a different school
Find new clean and sober friends
Learn a new hobby or skill
|What can one do to manage triggers better?||Learn skills to better manage stress, conflict, failure, depression, etc.
Attend self-help groups
Never miss counseling
Never miss group therapy
|4. Identify Where To Get Help||What relapse prevention facilities or resources are available?||Individual counseling
Process-oriented recovery groups
Marital, parental and family counseling
|5. Identify Life Improvements||What does one want to do to achieve the goals set?||Fix broken relationships
Find a new job or attend a different school
Find new friends who do not use alcohol or drugs
Learn a new hobby or skill
|6. Identify Actions To Take When Relapse Occurs||Does one have family and close friends to assist? Has one assigned someone with the responsibility to make decisions on your behalf in case one falls?||Yes/No|
Relapse Prevention Models
A relapse prevention model is a simplistic way of explaining what motivates a person to stay sober and what factors may contribute to a relapse. By gaining a better understanding of what drives it, mitigating measures may be put in place to increase the patient’s chances of full recovery.
Three relapse prevention models are described below:
Marlatt Relapse Prevention Model
This model is based on three significant thrusts that helped shape drug relapse prevention practices today:
- A patient must believe in their personal capacity to stay sober.
- A patient must value the tangible and intangible benefits of giving up addiction.
- A patient must gain the power to control their triggers, both internal and external, to catalyze positive behavior change.
A substance abuse worksheet will typically include activities centered on improving the patient’s self-efficacy to continue abstinence and stay goal-driven, both of which can decrease the probability of lapse according to this paradigm.
Gorski Relapse Prevention Model
Identifying triggers, applying measures to mitigate triggers, planning for recovery, daily scheduling, and family involvement all critical components of relapse prevention approaches to treatment that are anchored on the Gorski relapse prevention model.
There are nine basic principles in the Gorsky relapse prevention model:
- Self-regulation. This involves completing treatment and detaching oneself from drug use and triggers.
- Principle of Integration. Resolving past issues driving addiction.
- Principle of Understanding. The patient and his loved ones are well-informed about the real and continuing possibility of relapse, stages, and triggers.
- Self-knowledge. This involves identifying triggers, including drivers of past lapses and root causes of addiction, such as family problems and a history of substance abuse.
- Coping Skills. The Gorski relapse prevention model emphasizes on improving individual efficacy to prevent and respond to triggers.
- Recovery Planning. Addiction recovery worksheets help the patient come up with a relapse prevention plan.
- Inventory Training. This involves daily scheduling to avoid triggers.
- Involvement of significant others. A patient requires an active personal support group to deal with the challenges of recovery and the high likelihood of relapse.
- Maintenance and follow up. Gorski stresses that for addiction relapse prevention to become effective. It involves finding the right balance of programs and activities that increases a patient’s chances of full recovery.
Melemis Relapse Prevention Plan
This plan proposes five rules for a patient to live by – five relapse prevention tips, which should significantly decrease the likelihood of relapse.
The five rules are:
- Rule 1: Change a life. Personal substance abuse relapse prevention plan must not only include drastic changes to avoid triggers but also to incorporate in their lives new routines, hobbies, interests, people, and environments that make it easier for them to stay free of addiction.
- Rule 2: Be completely honest. Melemis writes, “Addiction requires lying.” The proponent recommends setting up recovery circles that involve a patient’s support group and where all members are completely honest with each other.
- Rule 3: Ask for help. Participation in self-help groups gives patients a better perception that they are not alone going through the tough challenges associated with recovery. The participation also shows them that others can do it, and reminds about the consequences.
- Rule 4: Practice self-care. Patients must find healthier alternatives to have fun and relax.
- Rule 5: Don’t bend the rules. The patient must learn to abide by the rules at all times and not make excuses to justify non-adherence.
Prevent Relapse Successfully
Improving the patient’s self-efficacy to resist addiction triggers and to create a new life free from substance dependence is possible. The reality, however, remains: the possibility of relapse is high.
- National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
- Steven M. Melemis “Relapse Prevention and the Five Rules of Recovery” Yale J Biol Med. 2015 Sep; 88(3): 325–332. Published online 2015 Sep 3. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
- Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Treatment Improvement Protocol (TIP) Series, No. 47. Center for Substance Abuse Treatment.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. Link: https://www.ncbi.nlm.nih.gov/books/NBK64094/
- Terence T. Gorski. The Cenaps Model of Relapse Prevention: Basic Principles and Procedures. Journal of Psychoactive Drugs Volume 22, 1990 – Issue 2: Understanding and Preventing Relapse Link: https://doi.org/10.1080/02791072.1990.10472538
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