Relapse Prevention Assignment
Relapse prevention and management is the main goal when trying to reduce or eliminate drug use – the path through the stages of change is not smooth for a young person, or for anyone. However there are number of relapse-prevention and management strategies that can be used.Relapse Prevention Assignment Paper
The term relapse is well established and is used in this module. However, the word ‘lapse is often used. Relapse implies a total reversion to heavy drug use and a sense of failure. Lapse has less negative connotations, and emphasizes the everyday nature of slipping-up when trying to change behaviour. Lapses can be minor and temporary. Relapse management is the term used for working with a young person to prevent or reduce the impact of a ‘lapse before heavy drug use becomes re-established.
Even when a young person is extremely motivated to change their lifestyle and drug use, it is probable that they will encounter situations that encourage drug use. This may be due to the way they are feeling (low mood, anxiety, craving for the drug) and/or circumstances that are conducive to drug use (e.g. friends pressurizing them into using, stress in relationships or at work).
What approaches do you take when working with a young person who is trying to change, but lapses?
Relapse (lapse) prevention and management
Motivational interviews and relapse drills
Relapse (lapse) prevention and management
There are some essential ingredients of relapse (lapse) prevention and management. These include the following:
Acknowledging that a lapse is a normal experience and should not be viewed negatively. Peers/friends are not likely to have any difficulty with this concept, but family members and workers often equate a lapse with the ‘beginning of the end’. Both the young person and their families should be helped to adopt an attitude that lapses provide opportunities for learning how to avoid further lapses.Relapse Prevention Assignment Paper
Strengthening the motivation to change throughout the change process. Discuss with the young person (at a time that feels right for them) the need to revisit the pros and cons for maintaining change.
Identifying high-risk situations (that include factors both internal and external to the young person). High risk factors for young people will not uncommonly include their friends and families under certain circumstances. It will help enormously if others can be aware which of their behaviors help protect against relapse and which serve as triggers. For example, a common trigger is monitoring the young person’s every movement, so that they feel they are not trusted or sufficiently independent. This is a sure recipe for resentment and secretiveness, which is associated with relapse. Top of page
Developing coping strategies and skills to avoid high-risk situations and to deal with them when they are unavoidable. One of the foremost strategies to cope with high-risk situations is to turn to prearranged supportive people such as friends and family members. Help the young person discover and participate in non-drug related alternative behaviors with friends and family to combat a possible lapse.Relapse Prevention Assignment Paper
Developing coping strategies and skills to deal with lapses. Again, if the worker, friends and family do not overreact, they can be invaluable in helping to terminate a lapse.
Recognizing and implementing changes to the young person’s environment and lifestyle to minimize the frequency of high-risk situations and to strengthen their commitment to change.
Positive self-talk: the young person can be helped to develop a phrase or two to repeat to themselves when tempted to use (or go beyond their limit). This phrase should be positive in tone so that it also helps to build their self-esteem (e.g. ‘I’ve gone without before, so I can do it again’.). It would be useful for a friend or family member to help the young person develop their phrases, and could share in this process by occasionally repeating it aloud to the young person when they indicate they are feeling vulnerable.
Problem-solving skills (see Topic 7). Enlisting family and friends in problem-solving will greatly increase the range of solutions to choose from.
Relaxation skills. Change is stressful! Being able to relax will help to maintain change and face challenges. Craving for a drug is a very stressful experience. One of the ways of countering cravings is by relaxing and thereby reducing arousal levels. Some friends/peers, family members and situations will be an aid to relaxation, others definitely will not! There is no one way of achieving relaxation. Relaxation can also follow arousal associated with exciting risk-taking activities.Relapse Prevention Assignment Paper
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Anger and depression management. Negative mood is associated with relapse, so mood needs to be monitored and dealt with before it builds up to a crisis. Anyone close to the young person (including the worker) can often detect the early stages of trouble brewing. They can also be the targets of anger, and so conflict resolution skills offer a huge advantage.
Coping with craving. Young people and their supporters should be made aware that craving is normal and can be outlasted. Distraction is often useful, but the young person may also want a quiet space to retreat to until the craving subsides.Relapse Prevention Assignment Paper
Identify the build-up to relapse. Lapses usually occur at the end of a long chain of small decisions rather than happening ‘out of the blue’. Marlatt & Gordon (1997) call them ‘apparently irrelevant decision’s that result in a drift into a lapse. Identifying the early stages of the slide is very important.
When someone has a problem with alcohol or another drug, they may decide to make changes to their behaviors, beliefs, relationships, habits, and thought patterns in order to address the problem. Often, this includes abstinence from using the substance and/or a decision to become sober (abstaining from all alcohol and drug use). When a person has committed to and begun to make these changes, they can be said to be “in recovery” from their problem. According to the Substance Abuse and Mental Health Administration (SAMHSA), “Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.” While there may be other definitions of recovery, this is a commonly used one.
Addiction, Dependence, and Relapse
People can become dependent on and/or addicted to a substance: Dependence means psychologically needing a substance to feel OK or function and/or using a substance despite consequences; addiction means physically needing the substance, demonstrated by higher tolerance and withdrawal symptoms if the person stops using the substance. Many factors contribute to dependence and addiction, including genetic susceptibility, personal and family history, current environment (e.g., how available are substances? how tempting is it it use them? are many of the person’s peers using?), and patterns of use (i.e., increasing quantities and frequency of substance use increases the risk of addiction and dependence).Relapse Prevention Assignment Paper
When a person becomes addicted to a substance, their brain undergoes changes in how it functions. The first year of sobriety is known as “early recovery,” and over this period, the person’s brain function gradually returns to more “normal” functioning that would be seen in people who are not addicted to a substance. However, recovery of normal brain function can take a long time. Thus, early recovery can be challenging, and relapses are often experienced. A relapse is a return to a problem behavior. A person may also experience a “lapse,” which can be seen as a shorter-term and/or less serious form of relapse. For example, an alcoholic who has one beer at a party but then goes back to sobriety has had a lapse, but if that person had the beer at the party and then went on a 3-day bender, that would be considered a relapse. Lapses don’t always lead to relapses. Sometimes, lapses are helpful in making a person more aware of their triggers and ways they need to work on being prepared to handle them. Other times, lapses can fool a person into thinking they can use the substance again and that “things will be different this time,” when often, this will lead back to problematic use.Relapse Prevention Assignment Paper