RufusACanal

Relapse Prevention Planning

Proper action on the part of the alcoholic and key persons in his or her life can prevent or interrupt relapse before the consequences become tragic. Planning for relapse minimizes its destructive potential. Alcoholics can utilize intervention skills at any time before drinking becomes out of control if they are prepared to recognize and understand the relapse process.

The alcoholic is ultimately responsible for all behaviour and decisions that accompany relapse. The alcoholic pays most heavily for relapse. Many alcoholics relapse because they don't understand the process and don't know what types of behaviour change are necessary to prevent it. Most relapse in alcoholism is unnecessary. It stems from lack of knowledge.

Alcoholism is a disease prone to relapse. If you had heart disease your family would know the warning signs and what to do in case of heart attacks. The same would be true if you were diabetic or epileptic. Any condition with high relapse potential should be treated with respect. The relapse pattern should be systematically explored and prevention tactics individually designed.

Proper relapse prevention plans can give you and the concerned people in your life a deep-seated sense of security. All involved can know that they are doing everything that is necessary to prevent relapse. They can develop a plan and a checklist of warning signs. As long as you follow that plan and watch for warning signs, you can be confident that recovery is following a successful course.

An essential part of the treatment process is the establishment of a relapse prevention plan. The plan should include the individuals in your life. Each person should be informed of the potential for relapse and their responsibility and appropriate action if you demonstrate early signs of relapse. The steps of relapse prevention planning are:

1. Stabilization: The first step in preventing relapse is stabilizing from the relapse that has just occurred or, if this is your first time in treatment, stabilizing your sobriety.

2. Assessment: If this is your first time in treatment, you need to assess whether you are ready for relapse prevention planning. Do you believe that you are really alcoholic and that you need to change your lifestyle? If you are not sure, you need to work on these issues before you are ready to develop a relapse prevention plan. You have to believe that you have a disease that is subject to relapse before you can do what is necessary to prevent that relapse. If you have relapsed previously, then you need to cooperate with your therapist to assess that relapse and other relapses you may have experienced to determine what contributed to the relapse process and what could have prevented it.

3. Education About the Relapse Process: You need to learn about recovery and relapse. You need to understand the sobriety-based symptoms and what it takes to manage those symptoms. You should review the 37 warning signs of relapse and learn to describe examples of the general process and specific symptoms.

4. Warning Sign Identification: Develop a list of warning signs or indications that you may be in risk of drinking. The warning list should be developed from past experiences with relapse warning signs. Try to identify at least ten specific and clear indicators that you are moving away from productive and comfortable living and beginning to set yourself up for relapse.

5. Review of Recovery Program: Recovery and relapse are opposite sides of the same coin. If you are not in the process of recovering, you are in the process of relapsing. A good recovery program is necessary to prevent relapse. Has your previous recovery program been working for you? How can it be improved? Develop a new recovery program based on what has worked for you and what has not worked for you in the past.

6. Inventory Training: Any successful recovery program involves daily inventory. AA Step 10 says, “Continued to take personal inventory and when we were wrong promptly admitted it." The alcoholic must learn to challenge himself in his day-to-day living patterns. "Am I living up to my own standards and values? Are those standards and values realistic? Am I acknowledging my alcoholism and managing its symptoms? Am I attending to my overall health needs?" For a relapse prevention plan you should design a special inventory system that monitors the warning signs of potential relapse. Develop a way to incorporate this inventory system into the fabric of day-to-day living. The key issue is this: You now know the personal warning signs. How are you going to determine if any of these symptoms have been activated in your life?

7. Interruption of the Relapse Warning Signs: It is now important to establish new responses to the identified warning signs of relapse. Determine what you are going to do about each symptom when you are able to recognize that it is working in your life. And practice each new response until it becomes a habit. The response must be available in times of stress. Only habits are dependable in times of stress. You must practice in times of low stress until the response becomes a habit.

8. Involvement of Significant Others: Make a list of all the people with whom you have daily contact. Select from that list those people that you think would be important in helping you stay sober and avoid a relapse. Determine how each person has interacted with you in the past when you have shown symptoms of relapse. Has it been helpful or harmful to your sobriety? What could they have done that would have been more helpful to your staying sober? Now determine what you would like each of these people to do the next time symptoms of relapse are recognized. Bring the key people in your life together for a meeting. Explain to them your list of personal warning signs and form a contract with each support person as to what they will do when relapse symptoms are recognized and what they will do if you begin drinking.

9. Follow-up and Reinforcement: Recovery from alcoholism is a way of life. Since relapse prevention planning is part of the recovery, it too must become a way of life. Relapse prevention must be practiced until it becomes a habit. We are all enslaved by our habits. The only freedom we can find is to choose carefully the habits to which we allow ourselves to become enslaved.

For the recovering alcoholic, it is especially true that there is freedom in structure. It is only in the habit and structure of a daily sobriety program that the alcoholic can find freedom from enslavement to alcohol.

Relapse is a process. A process is different from an event. When an event has taken place, it is unchangeable. A process can be changed or interrupted at any time. It is ongoing; it is occurring; it is not fixed in time. To see a process as an event blocks change. Death is an event; grief is a process. To experience grief as an event locks you into grief as though it were the event of death.

Relapse is not an event; it is subject to change or interruption. Relapse begins long before the first drink. There are warning signs and symptoms that pave the way. These symptoms can act as early warning signals to alcoholics and their families. By understanding the process, unnecessary pain can be avoided. Proper action by alcoholics and the key people in their lives can prevent relapse or interrupt the relapse before the consequences become tragic.

Points to Remember:

1. Most people do not make it after the first attempt at sobriety.

2. People get drunk because they fail to do what is necessary to stay sober.

3. There are a variety of behavioural setups which make a return to drinking an alternative in spite of known consequences.

4. Relapse begins long before the first drink. There are 37 warning signs of relapse.

5. Proper action by you and the key people in your life can prevent or interrupt relapse before the consequences become tragic.

6. A relapse prevention plan is an important part of treatment.


Reprinted from: St Joseph's Hospital
Box 5000-203, 1176 Nicholson Rd, Estevan, SK.S4A 2V6