How to Create a Relapse Prevention Action Plan
One of the core goals of behavioral therapy in a drug rehabilitation program is preventing relapse. When the risk of relapse is reduced, a person is better able to focus on their family, work, school, friends, and overall health.
Creating a relapse prevention action plan during rehabilitation helps to decrease the likelihood of relapse after treatment.
What Is a Relapse in Addiction?
Relapse has long had moral implications during addiction treatment. But, it is important to know that if you or a loved one relapse, it is not a moral failing or a sign of poor willpower. Relapse, in terms of addiction as well as other chronic illnesses, means a return of symptoms associated with the underlying disease. Since addiction is a chronic disease like diabetes, hypertension, and asthma, relapsing back into compulsive behaviors simply means that you should return to treatment.
The National Institute on Drug Abuse (NIDA) reports that rates of relapse among several chronic illnesses are similar to relapse rates for addiction.
- Addiction relapse: 40 to 60 percent
- Hypertension (high blood pressure) relapse: 50 to 70 percent
- Type 1 diabetes relapse: 30 to 50 percent
- Asthma relapse: 50 to 70 percent
When someone with asthma gets treatment, their doctor will work with them on a long-term treatment plan that includes medication and lifestyle changes. This plan will work for a certain amount of time and then symptoms may return. When symptoms of the underlying condition return, people with asthma do not blame themselves for a lack of willpower; they go back to the doctor to change their treatment plan.
This approach works well for addiction treatment as well. When medications are available, they are prescribed. Behavioral therapy through outpatient or inpatient rehabilitation helps to change compulsive behaviors. If a relapse occurs, the person should return to an addiction specialist to adjust their treatment plan.
Part of rehabilitation involves therapists helping their clients learn how to write a relapse prevention action plan. While relapse is part of the underlying disease of addiction, you can learn to recognize behaviors that may lead to relapse, employ daily approaches to manage stress, attend support groups, and take other steps that help you prevent relapse. This can all help you to recognize when you should return to addiction treatment before a relapse takes hold.
How Relapse Prevention Plans Can Help
The American Society of Addiction Medicine (ASAM) lists six dimensions of multidimensional assessment for addiction treatment and recovery. One of these dimensions explores the individual’s unique relationship with attempts to quit and subsequent relapse in the past. Knowing if someone has been through treatment before and had a relapse, or has tried more than once to quit on their own and were not able to stop abusing substances, can help clinicians determine the next steps in treatment, including how to prevent relapse later.
The concept of relapse prevention is part of the approach of cognitive-behavioral therapy to understand the causes of behaviors and make positive changes to those behaviors. Over the past several decades, relapse prevention has become an umbrella term for most types of therapy that focus on developing better coping mechanisms to avoid compulsive behaviors.
A plan to prevent relapse focuses on understanding a potentially high-risk situation and applying an effective coping response. This leads to a sense of increased self-efficacy and decreases the probability of relapse. For example, after completing an alcohol rehabilitation program, you may find yourself at a holiday party where people are drinking. Learning how to say “no” if offered a drink can empower you to avoid alcohol in this situation, which reduces your risk of relapse. Several studies have shown that this approach to preventing relapse is very effective for most people.
What to Include in an Action Plan
A relapse prevention plan may include the following sections:
I plan to prevent relapse through the following strategies:
- Attend support group meetings.
- Contact a sponsor or therapist when intense cravings occur.
- Find an important hobby or volunteer position to fill up my time and give me a sense of fulfillment.
These people may be a spouse, best friend, sponsor, therapist, or spiritual leader.
In one column, list the things the drug did for you, like making you feel good. In a second column, list all the negative things the drug caused, like legal or financial problems, damage to your health, and harm to your personal relationships.
Work with a counselor in a group or individual therapy and discuss what a relapse might look like. Write down what environmental triggers, emotions, and obsessive thoughts may indicate an oncoming relapse.
These may include exercise or hobbies that can make you feel better instead of abusing substances. For example, taking a walk, camping, working on a painting, or writing in a journal may all be methods to improve your mood when you are stressed.
If you have lost a job due to substance abuse and your financial situation causes you stress, write that down. Write down options to address this stress. For example, talking to your spouse about finances and how you can help keep them stable while you look for work. List steps you are taking to overcome this stress, like looking for jobs every day and applying for positions you are qualified for.
Include a statement like, “If I develop a strong urge to abuse my substance of choice or any other substance, I will contact these people.” Your support team is so important, you list them twice in your action plan. This is a clear plan of action to take when relapse is on the horizon.
The above items are examples of things to include in your relapse prevention plan, and they may work for you. When it’s time to write your plan, speak with your therapist or support group to identify the specifics for your personal plan. There may be personal touches you can add, like a commitment to a certain amount of daily exercise, meal planning lists, or a therapy calendar, among other options. Aim to create the most supportive plan for you, so you are ready if any of your triggers pop up.
There are several elements to addiction treatment that each play an integral role. But, it may often be difficult to navigate them all.