About SRP - Introduction - Part 2
Excerpted from Structured Relapse Prevention: An Outpatient Counselling Approach.
Who Are SRP Clients?
SRP counselling is designed for people who have a moderate to severe substance use problem and are willing to work, on an
outpatient basis, with a counsellor toward changing their use of alcohol or other drugs.
SRP clients are men and women of various ages and backgrounds. They have different problems and needs, and they begin treatment
at different stages of readiness.
A few sample profiles of clients who have been through SRP at CAMH are presented below.
Client Profile: John
“John,” a 28-year-old business manager, started SRP counselling to address his alcohol and cocaine use. John was encouraged
to seek treatment by his family physician, who was concerned when John presented in his office with complaints of lack of
energy and depressed mood. John found that his cocaine use was always triggered after a drinking occasion. He also noticed
that his substance use was having a negative effect on his relationship and his productivity at work. When he first started
attending Motivational Interviewing sessions before his SRP group began, John said that he wanted to quit using cocaine, but
just to cut down on his drinking. John’s counsellor worked with John’s stated goals, and helped him to weigh the costs and
benefits of quitting cocaine use and cutting down alcohol consumption. As John began attending the Initiation phase sessions
of SRP, he began to notice that even small amounts of alcohol placed him at high risk of cocaine use. Midway through his SRP
treatment sessions, he changed his goal to abstinence from all substances. John told his counsellor that it had been important
to him to come to this decision on his own.
Client Profile: Kumar
“Kumar,” age 35, was mandated to treatment as a condition of bail after he was arrested and charged with assault. One evening,
after being out with friends at a bar, he had come home and gotten into an argument with his partner. He became aggressive
and pushed her against a wall. She called emergency services, and Kumar was arrested and charged. In the beginning Kumar was
resistant to the idea of coming in for treatment, and he repeatedly stated, “But I’m not an alcoholic!” Kumar typically drank
eight beers on Friday nights after work, and three or four beers on two other days during the week. After a few group SRP
sessions, he began to identify some of the negative consequences of his drinking. Kumar decided that cutting down on his drinking
would be his best option. Although his counsellor expressed some concerns about his goal given his aggressive behaviour and
involvement with the legal system, the counsellor and Kumar agreed to look at a harm reduction plan for reduced drinking.
Kumar’s goal was to not drink at the bar alone or with friends, but to have one or two drinks on a Saturday, and only if it
did not interfere with his being able to participate in family activities. At the end of treatment Kumar reported being able
to keep to his goal, and had begun attending anger management counselling.
Client Profile: Dianna
“Dianna,” a 25-year-old self-employed personal shopper and SRP client, was encouraged by concerned family members to seek
treatment for her heavy use of alcohol. She reported drinking five to eight glasses of wine, five days per week. She said
that her drinking often led to blackouts and high-risk sexual behaviour. Also, Dianna had sustained a life-threatening injury
as a result of falling while intoxicated, which had left her with permanent health consequences. Dianna promised her family
that she would be abstinent from alcohol for a period of six months. During her 11 weeks in SRP treatment, Dianna began seeing
many benefits to not drinking, including a new relationship with a partner who did not use substances. However, even after
three months of abstinence, Dianna was expressing ambivalence about abstinence as a long-term goal. She and her counsellor
agreed to follow up her SRP treatment with biweekly sessions to address her ambivalence, and to continue to work on relapse
prevention.
“John,” “Kumar” and “Dianna” are just three out of hundreds of clients at CAMH who have benefited from SRP. With the help
of their therapists and SRP program aids, these clients identified their problems and triggers to use; they set clear goals,
learned new coping strategies and changed their substance use behaviour.
Return to the index of excerpts from Structured Relapse Prevention: An Outpatient Counselling Approach.
Centre for Addiction
