About SRP - Introduction - Part 1

Excerpted from Structured Relapse Prevention: An Outpatient Counselling Approach.

• Introduction Part 1 / Part 2 / Part 3 / Part 4
• PDF version (complete Introduction)

What Is Structured Relapse Prevention?

Structured Relapse Prevention (SRP) is an approach to outpatient counselling that uses cognitive-behavioural treatment to help clients learn the coping skills they need to deal effectively with day-to-day substance use triggers and risk situations. It was developed starting in the late 1980s at the Addiction Research Foundation, one of the founding organizations of the Centre for Addiction and Mental Health (CAMH). SRP has been used as a stand-alone, outpatient intervention of eight to 12 sessions, as an aftercare component to inpatient treatment, and as a set of tools to be used as needed when working with clients who are ambivalent about changing their substance use. SRP has also been used with individuals or groups in a variety of service contexts, including substance use treatment services, employee assistance programs, probation and parole settings, and mental health settings.

About This Manual

This manual provides all of the clinical tools you will need to implement SRP treatment with groups and individual clients. Although the manual presents a set of structured session-by-session guidelines and tools, it can be adapted to fit the needs of your own clients and groups. Some clients will benefit from the complete treatment program outlined here, while others will be best served by using selected clinical tools in a less formal way.

The structure of the manual is as follows:

Part I includes this introduction, an overview of the approach, some background material on how SRP relates to the five stages of change, and a summary of some empirical studies on its effectiveness.

Part II gives a detailed, session-by-session guide to the SRP approach. It is divided into five sections, corresponding to the phases, or “components,” of SRP counselling: Assessment, Motivational Interviewing, Individualized Treatment Planning, Initiation of Change and Maintenance of Change.

The descriptions of the SRP treatment components contain all of the clinical materials you will need, including forms for client homework assignments and questionnaires, all of which can be copied for your clinical use (or printed from the CD that accompanies this manual). In addition, Therapist Checklists are included for each of the components: brief, point-form lists of the materials you will need, the topics for discussion during the session, the related clinical tools, and the homework assigned at the end of the session. While the Therapist Checklists are meant to provide you with suggested guidelines for doing SRP, as has been mentioned, the program can be adapted in whatever ways best fit your setting and your clients’ needs.

Part III provides a series of exercises to help clients develop and improve coping skills; you are free to copy or print these, too, for clinical use. You and your client can identify the areas of coping that would be most relevant and helpful to work on in treatment, using a simple checklist provided as part of the Individualized Treatment Planning component in Part II.

Part IV contains a new feature of this edition of the manual: an adapted version of the SRP guidelines specifically for clients with concurrent mental health and substance use problems (“concurrent disorders”). This “CD-adapted” section contains general suggestions for screening and assessing clients with concurrent disorders, hints for running SRP groups with this population, revised versions of the Therapist Checklists, and adaptations of many of the clinical tools, including several of the most crucial Coping Skills Exercises.

Appendix A offers some supplementary administrative forms you may find useful (sample clinical notes and a chart audit checklist).

Appendix B reproduces three clinical articles containing background information useful for working with SRP clients:

Tupker, E. & Sagorsky, L. (2004). Motivational Interviewing. In S. Harrison & V. Carver (Eds.), Alcohol & Drug Problems: A Practical Guide for Counsellors (3rd ed.; pp. 23-44). Toronto: Centre for Addiction and Mental Health.

Herie, M. & Watkin-Merek, L. (2004). Relapse prevention. In S. Harrison & V. Carver (Eds.), Alcohol & Drug Problems: A Practical Guide for Counsellors (3rd ed.; pp. 143-168). Toronto: Centre for Addiction and Mental Health.

Martino, S., Carroll, K., Kostas, D., Perkins, J. & Rounsaville, B. (2002). Dual diagnosis motivational interviewing: A modification of motivational interviewing for substance-abusing patients with psychotic disorders. Journal of Substance Abuse Treatment, 23(4), 297-308.

At certain points in this manual, you will be advised to read one of the articles. In addition, you may want to review the articles periodically throughout your SRP work, since they include useful insights that may address some of the challenges your clients may be facing.

As you will see, there are many resources and tools in this manual! Although you may want to review the book from beginning to end the first time you use it, it is designed to be a “toolkit” of resources and client exercises. We have tried to make it as practical and user-friendly as possible, and we hope that you and your clients find it useful.

Return to the index of excerpts from Structured Relapse Prevention: An Outpatient Counselling Approach.

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