Foundations of Addictions Counseling 3e Capuzzi amp Stauffer Copyright 2016 2012 2008 by Pearson Education Inc All Rights Reserved Relapse Return of disease after full or partial recovery ID: 556977
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Relapse Prevention for Addictive Behaviors
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Relapse: Return of disease after full or partial recovery
Rates of relapse
Difficult to determine
90% of alcoholics return to drinking within 4-year period
40-60% relapse for drug addiction
Relapse defined differently by different treatment approachesSlide3
Relapse vs. Lapse
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Lapse
Modest breach of agreed goals
Can be a learning experience
Relapse
A more serious violation of treatment goals, learning is not evident
Relapse Prevention
A range of therapeutic methods applied to a range of behaviorsSlide4
Relapse Prevention (RP) Model
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Relapse is complex and multidimensional
Counselor must understand factors leading to abstinence or relapse
Intrapersonal
Self-efficacy
Outcome expectancies
Craving
Level of motivation
Coping ability
Emotional states
Interpersonal
Social supportSlide5
Preventing Lapses or Relapses
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Lapses or relapses more likely immediately after treatment
Plan for common issues
1. High risk situations
2. Seemingly irrelevant decisions
3. Abstinence violation effectSlide6
High Risk Situations (HRS)
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Identify client’s particular HRS
Frequent HRSs
Frustration and anger
Emotional “highs”
Interpersonal conflict
Easily used to blame others
Social pressures
Subtle and pervasive in Western society
Once identified they can be easily managedSlide7
Specific Coping Strategies for High Risk Situations
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
Plan ahead
Must be considered, planned, and implemented
Begins with brainstorming
Which strategies to use
Multiple methods of stress relief
Rehearse alternative responses to drinking
Identify strengths and resourcesSlide8
Seemingly Irrelevant Decisions
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Also known as “Setups”
Decisions that may seem irrelevant at the time but often lead to relapse
Thought processes/thinking errors and psychological traps
Multimodal treatment and 12-step attendance offers the best chance for long term recovery and abstinence
Help to catch thinking errors
Others experience same “traps”Slide9
The Abstinence Violation Effect (AVE)
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
Psychological Trap
Temptation to break rules once set
Minor violations seem to justify major ones (already failed)
Coping strategies can prevent the progression
Does AA’s message of powerlessness make relapse after a single drink an inevitability? Self-fulfilling prophecy?Slide10
Lifestyle Change
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Restoring balance to life – work/leisure
Balancing “shoulds” and “wants”Slide11
Developing a Management Plan
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Stabilization plan
Assessment
Relapse education
Identify warming signs
Identify problem solving strategies
Recovery planning
Inventory training
Family involvement
Follow upSlide12
Case Study of Relapse Prevention
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Thomas, 27-year old male
Married, father of 2-year old daughter
Employed as salesman
Cannot keep a job
Frequent angry outbursts
Anxiety attacks
Considering suicide
Long time drinker/case of beer dailySlide13
Case Study:Recovery
Phase Begins
Foundations
of Addictions Counseling, 3eCapuzzi
& StaufferCopyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
Anti-depressant and anti-anxiety medications
Withdrawal and stabilization
Identify HRS’s and self-monitor
Develop coping strategies
Education about lapse and relapses
Therapeutic contract/time out for relapse
Reminder cardsSlide14
Case Study: Support
Systems
Foundations
of Addictions Counseling, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
Involvement of family
Marital relationship
System of non-using friends
Social modeling
Disengaging from using friendsSlide15
Case Study: Other
Lifestyle Changes
Foundations
of Addictions Counseling, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
Change unhealthy environments
Body awareness techniques
Confront relapse possibilities
Job/major stressor
Financial StrainsSlide16
Final Points to Remember
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.All Rights Reserved
Pacing is important
Don’t overwhelm client with too many interventions at once
Set realistic goals
Go slow
Balance “shoulds” with pleasureSlide17
Useful Web Sites
Foundations
of Addictions Counseling
, 3eCapuzzi & Stauffer
Copyright © 2016, 2012, 2008 by Pearson Education, Inc.
All Rights Reserved
About.com: Alcoholism & Substance Abuse
www.alcoholism.about.com/od/relapse/Relapse_Prevention.htm
Information for Individuals and Families
www.addictionsandrecovery.com