Relapse prevention therapy is treatment designed to identify the reasons, behaviors, and outcomes of relapse in a person during the aftercare stage of addiction treatment. Being able to understand and prepare for relapse is imperative to addiction recovery. Relapse prevention therapy armors newly sober individuals with the self-confidence and knowledge they need to live out their normal lives without fear of relapse.

We at the Discovery Institute want you to know that it is not too late. We are always here for you, and want you to be as educated as possible. Below, we will be discussing relapse prevention therapy. This kind of treatment is especially important because recovery is never a “one and done” ordeal. Recovery is a lifelong journey that we want to be a part of with you.

The Dangers of Relapse

Many people who are in recovery and some professionals in the industry look at relapse as an unavoidable part of addiction recovery. The rate of relapse is high, so being prepared and informed about relapse is of growing importance. Many overdose deaths happen right after relapse.

Tolerance is when an addict can use a high dose of a drug or alcohol because their body has grown accustomed to it. After detoxification and elimination of the drug circulation throughout the body, tolerance decreases. When a relapsing addict takes the amount of drug or alcohol they were used to before sobriety, their bodies no longer are able to handle it. High overdose rates occurring post-relapse give an addict a responsibility to know what to do in relapse situations.

Identifying Commonalities in Relapse

Since relapse rates are so high, there have been studies on the process of relapse. Behaviors seen before relapse are usually similar. Because of these similarities, they are also avoidable through relapse prevention therapy. Three situations most commonly seen directly before relapse are social pressure, self-conflict, and a decreased emotional state.

Effective coping responses and behaviors are a necessary defense against these high-risk relapse situations. Relapse prevention therapy gives individuals the tools they need in order to cope with these high-risk situations. We will now discuss the four stages of relapse. It is important to know if a relapse is coming so that you can identify it and consciously avoid it.

Stage 1: Emotional Relapse

The first stage of relapse is the emotional stage. Some refer to this as the internal stage of relapse. Characterized in this stage are events, whether external or internal, that will affect the person’s life. One aspect of this is change. When a person’s life has a drastic change (break-up, loss of a loved one, getting fired, etc.,) they may feel internal pressure and stress. Stress is another large part of the internal stage.

Also, what begins to happen internally is the individual will realize they crave the substance. Relapse prevention therapy must take into account the idea of denial. Denial is a common defense mechanism for addicts. Usually, when an individual begins recovery, they must learn to accept that they have lost control of their lives. Denial can often be a large inhibitor in place of acceptance. However, when stage 1 of relapse occurs, denial often reactivates.

Lastly, one of the most detrimental aspects of stage 1 is P.A.W, or Post-Acute Withdrawal. Post-acute withdrawal is when the individual begins to feel withdrawal effects even when they have not taken the substance in a long time.

Stage 2: Mental Relapse

In the second step of relapse, an individual’s behavior will change. A social breakdown may occur and the person will experience a loss of structure in his or her life. This is where the internal problems from step 1 begin to manifest outwardly. 

During the mental stage of relapse, individuals tend to begin thinking about their previous substance abuse. They may start to dwell on the times when they used to drink or use drugs. Individuals may begin to consider or even follow through with spending time with people who used to abuse substances with them. 

While thinking about their past lives, individuals in mental relapse may not consider the negative effects of their substance use. Instead, they may romanticize and fantasize about alcohol or drug abuse. They might simply think about the “positive” effects of substance use (i.e. euphoria, etc.) But, the unhealthy and harmful results of substance abuse may not come up in their minds.

First, a change in behavior is characteristic of stage 2. A normally calm and reserved person will appear more stressed. Another common sign is a studious individual will begin to skip classes, or a good worker will begin to miss many days on the job. Then, there is a social breakdown, in which the person may isolate themselves from their group of friends, or their behavior change becomes so detrimental that they are no longer able to participate in group activities. 

Next, there is a loss of structure. The normal routine that kept a person safe will begin to break down. This leads into step 3.

Stage 3: Loss of Control

When a person is in this stage, they lose control of their life through a loss of judgment. They experience a behavioral loss of control. A loss of judgment is when the individual begins to consider actions that are clearly detrimental to themselves or others. A behavioral loss of control is doing those things that were thought of in loss of judgment: acting irrationally without considering the consequences.

Finally, individuals in this stage of relapse may think there are no options for them. Maybe they begin to feel that their only social outlets are through parties with alcohol or drugs. This leads the individual to feel as though they have nowhere to go but relapse.

Stage 4: Physical Relapse

At the final stage is when the physical use of drugs or alcohol actually occurs. Individuals commonly think fo this stage as the definition of relapse. But, as we have discussed, relapse occurs in stages. This final stage is the only one that involves the physical use of alcohol or drugs. But, relapse prevention therapy works to help people identify the signs and stages leading to this phase. 

If you are experiencing any of these stages or you are worried you may be on track: stop and reach out to us. Below we will be discussing a few practical ways to engage in relapse prevention therapy.

Relapse Prevention Therapy

There are a number of different approaches to relapse prevention therapy. The three most commonly utilized are:

  • Coping Skills- sessions that identify high-risk situations and how to cope with them without relapse.
  • Clinical Therapy- sessions that focus on understanding the process and consequences of relapse.
  • Lifestyle Change- sessions that encourage treatment prior to relapse and a moderated lifestyle.

Coping Skills

A huge part of relapse prevention therapy is coping skills. In these times of relapse prevention therapy, it is helpful to identify your triggers. These are the thoughts, feelings, places, people, or memories that all play a part in triggering a relapse.

Part of relapse prevention therapy is identifying these triggers and asking the individual how to cope. The practice of managing triggers is an integral part of relapse prevention therapy. This is because when we are triggered, we are not ourselves. Oftentimes we cognitively know we should not relapse, but our mind is working against us. This is why it is so important to identify these scenarios and put up safeguards to prevent them.

Clinical Therapy

Therapy is one of the best ways to improve relapse prevention. It is also an incredible way to encourage growth as a person. Even if you do not struggle with addiction, consider seeing a licensed professional. Therapy is all about exposing the underlying motivations for our actions. Sometimes, events that occurred in the past affect an individual’s present-day behaviors. Part of relapse prevention therapy is identifying those emotions or thought processes that inhibit our growth. Good clinical practice helps us to identify what we need out of life to grow.

Lifestyle Change

Finally, lifestyle change involves changing one’s habits, work environments, or other surroundings so that you can prevent relapse. This could involve changing your hobbies from things that lead us to boredom or isolation, to healthy beneficial activities. For some people, lifestyle change may include relocation. It might be necessary to move to a new neighborhood, city, or even state in order to continue recovery from addiction.

For others, the biggest lifestyle change might be a change in friends. Perhaps, individuals in recovery may need to develop a new friend group full of individuals who support them and hold them accountable. It may be hard to get rid of toxic people because they were at one point your friends. However, regardless of how they are toxic, you need the influence of people who build you up, as opposed to tearing you down.

Seeking Relapse Prevention Therapy

At the Discovery Institute of New Jersey, we offer relapse prevention programs for all of our clients. We understand the need for knowledge and preparation of relapse. Whether you are seeking a detox program for the first time or you have relapsed, we can help! Our relapse prevention therapy programs can aid in your recovery journey. If you have any questions about our relapse prevention therapy or any of our other programs, our team is here to help. Just call us today for more information about our services and resources.

References:

https://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf

http://dhhr.wv.gov/bhhf/Documents/MAT%202017/M114%20Relapse%20Prevention%20Plan.pdf 

Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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