Session Nine: Relapse Prevention

Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

Session Goals

Orient participants to addiction and mental health problems as chronic relapsing conditions.
Discuss some of the common features of relapse as a process.
Explore the ways that relapses can be used as learning experiences that enhance the prospect of long-term recovery.
Discuss practical issues that participants face and how relapse prevention approaches can (and perhaps already have) helped them deal with the relapsing nature of co-occurring addiction and mental health problems.

Content Outline

Relapse prevention: substance use.
Relapse prevention: mental health.

Activities

Activity 9-1: Identifying Risk Factors
Activity 9-2: Relapse Prevention Plan
Activity 9-3: Caregiver Relapse Prevention Plan

Leaders’ Notes

Relapse and relapse prevention are areas that we have learned a lot about in the past two decades. Now, what starts out being something that people are apprehensive about can sometimes be an important, constructive part of the process of change and recovery. One of the goals of this session is to help participants see these processes through a new lens, one that helps them see a relapse as something that can often be prevented or if it happens, can be minimized. Often family members can see things shaping up and can help their relatives either avoid a relapse or to deal with it effectively.

When we framed the discussion in this way, we found that family members took a more constructive view of relapse. Since we knew we would be using the metaphor of a journey to talk about recovery in the next session, we introduced the idea that on every long journey there will be periods of bad weather. By being prepared, by trying to move around—or if need be to work through—bad weather, the journey could still continue. One of the best tools in this process is to get participants to talk about the experiences they have already had with relapse:

were there events that indicated a relapse was coming?
do they have a better sense of what was helpful in averting, or minimizing, a relapse and what wasn't helpful at all?

Their past experiences can be the starting point for putting relapse and relapse prevention in a new perspective. Participants will have different “takes” on this. Some may be bruised and apprehensive about it happening again. Others might have stories about how they helped to make relapses better (or worse), or how awareness and good communication in the family might actually have prevented a relapse.

Ask the group to identify things they can do to keep things on course, and ways that if they are not careful they could make things worse. For example, sometimes people admit they saw warning signs, but let things go. Or, they reacted too impulsively, perhaps out of fear or frustration, only to find that they had escalated things in the wrong way.

Relapse prevention plans

Writing a relapse prevention plan (see Session 9 - Activity 9-2) helps family members think about more effective ways of responding to signs of a possible relapse. Suggest that, if possible, they work on this project with their relative.

As we discussed in Session 5, many family members have trouble justifying taking time to care for themselves. We suggest reinforcing the importance of self-care by asking them to create a plan that addresses the steps that they would take to prevent a “relapse” in their own physical, emotional, social and spiritual health.

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