Maintenance Relapse Prevention

Maintenance and relapse prevention are the most important factors in succeeding after treatment or abstinence from any substance are achevied. Many components attribute to maintenance and unfortunately once treatment is completed and the client returns to everyday life the true challenges present themselves. Client while in treatment is very well connected with others who are battling and overcoming addiction; as well as professionals training to deal with the tools Client needs to overcome the addiction. However the opposite exist when Client returns to his surroundings. Most often the triggers that lead to relapse are nestled into the Client’s surrounding making maintenances a difficult challenge.

Relapse is defined
as the consumption of drugs after being clean for a period of time. Relapse is falling back into a pattern of behavior that is unhealthy for an individual. Being clean is the term used for abstinence from drug and alcohol. In a 12 month period relapse occurs to over 90% of clients. Same is true of 90% of alcoholics within 4 years of practicing abstinence. The number is lower within three months of clean time following treatment, some 60% relapse. It seems surprising that following treatment the rate is lower, yet the time frame of treatment and the type of treatment are not clearly defined. It takes a person an average of 6 to 7 tries at recovery before abstinence is attained.

Being mindful that the term relapse can be used in different variations depending on the type of treatment or group a client is in. If the group or treatment’s philosophy is aimed at abstinence then the tolerance for any use of substance is unacceptable. This is true of AA (Alcoholics Anonymous.) In groups where the modality is harm reduction is the one drink can be acceptable.

High Risk Situations are detrimental to a person in recovery. The text Foundation of
Addiction Counseling identifies three HRS that are frustration and Anger, social pressure and interpersonal temptation.
People, places and thing are often a great fuel for relapse. When in treatment with a professional, a client will work on identifying HRS to develop a tailored treatment plan that will prove most effective for the individual. The importance of identifying these components will give the client a greater chance of success with abstinence. When a client is armed and geared with the tools they need to battle addiction, the client is more apt to use everything they have learned to maintain sobriety. This also empowers clients to be proactive in their choices and decisions when they are facing temptation in the face. Though identifying HRS the choice still lays in the hands of the client. More than simply identifying HRS is needed for relapse prevention. Solutions and mechanisums to dealing with HRS are the key to prevailing.

When a client returns home from treatment and/or is faced with an unchanged surroundings and people who either indulged with them in the negative behaviors; relapse is more likely than not, going to occur. This is the point where the relapse preventions steps in and the various techniques of therapeutic methods used to overcome addictive behaviors are applied. Prevention, as mentioned with relapse, can be modified to different degrees for different
treatments.

Meeting the client where they are is the key to treating any disease or disorder. Tailoring treatment on individual needs will give relapse prevention a slightly different definition where each person is concerned. Again the overall goal of relapse prevention is to refrain from addictive behaviors that are unhealthy for an individual. The variation that makes the concept broad all depends on the assessment of the individual clients needs. For a person who has a social addiction to alcohol, yet never drinks alone, can refrain from having eight drinks on a night out to only having two drinks. In this case minimizing and controlling how much this individual drinks in a HRS would be considered relapse prevention. The habitual behavior of this client is to socially over indulged in drinking and by only having two drinks his patterned of behavior is drastically diminished. This will not for a person who drinks consistently regardless of what is around them or the time of day. Complete abstinence would have to be client’s only defense to battling the addiction because HRS has no boundaries and the addiction has become a crutch without boundaries.

SIDS are Seemingly Irrelevant decisions that lead to relapse yet decisions that were made without a slights thought of using fueling the decision. The individual is unaware that SIDS placed them at risk until the relapse occurs and the reflection on why they relapsed. Once the identification of SIDS is made, the individual becomes conscientious of the circumstance and can avoid a relapses of that fashion in the future. SIDS is a great example of how relapse is a learning process of addiction prevention and maintenance. Through trial and error the individual can develop a plan that will work towards long term abstinence and relapse prevention.

The relapse violation effect is controversial as I see often in this profession. Professionals and clients struggle with it alike. When a lapse occurs the guilt of the minor infringement snowballs into a full blow relapse; occurring in turn because the individual is plagued with failure and falls prey to reengaging in the behavior. The truth of the matter is the individual may have slightly dabbled causing a lapse, but could prevent the relapse by ceasing the behavior immediately upon awareness. Learning coping mechanisms are needed to control these situations when they occur. Making a slight mistake (lapse) does not need to lead to extensive violations (relapses). Again assessment of the client and their needs will be the best tool in teaching coping strategies that will prove effective when this happens.

The case study in the text book is a great example of meeting the Client where they are at in order to devolope the most effective form of treatment.
In the case study self-assessment was key with client because his level of addiction was part of his everyday life for so many years. This being the case client’s HRS monitor would be key to cliet’s treatment because he will have to strongly monitor in order to avoid relapse. The sel-mointoring chart is a great tool in working with client because it maps out clearly situation,thought, feeling and action. Detering client’s mind from taking a drink to relax. Instead client has identified health ways of dealing with situations, thoughts and feelings. Replacing negative behaviors with positive behaviors are essential in treatment. As true with children, individual like Thomas with hibutial addictions need to relearn behavior to replace the addictive behaviors. Addiction becomes aways of daliy living and becoming abstenice leave a lot of time on a persons hands. Idle time is never good for a person in recovery. Needing to fill the time once spent with attaining the substance , using it, being intoxociated and repeating the cycle; new learned behaviors and activities must replace the idel time once in recovery. As mentioned throughout this paper tecnques for lapse (single use) and relapse (out of control use) prevention are to be clearly defined in treatment. Client must understand that a lapse can be
empowering if client can immediately identify the behavior and stop it in it’s track. Lapsing becames a failure when it becomes a relapse due to client’s inability to take control of the siutaion.

Lastly support systems and life changes are needed for people in recovery. In the case study client’s family was very much affected by his addiction. Involving them in family counousling will manfest a less stressful situation for client and in turn make treatment more effective. Also the family of addicts need healing and tools to deal with the person in recovery. In Thomas case his wife was a trigger and including her in treatment will help her to learn how she can minimize the triggers in their home. The same applies to friends and the activities. The need to engage with people that do not use will create an environment of low risk for relapse. An entire life change is needed to sussuccefully maintain sobriety long term. It is true that as professionals we know all the tools to lead a addictive free life yet clients until taught have little idea how much power they can have over themselves and their addictions. It is fulfilling to see clients succeed in treatment. But even more fulfilling to see them succeed at life and living.