link to Integrated Relapse Prevention

Integrated Relapse Prevention Is avoiding relapse twice as difficult in Dual Recovery?

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Understanding Relapse as . . . 

. . . the PROCESS of returning to substance use and/or active symptoms after a period of abstinence / stability

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Understanding Relapse as . . . 

. . . ALWAYS a risk when dealing with two, cooccurring “chronic, relapsing conditions” 3

Relapse “Clues” 

Behavior changes Decreasing what helps;  Increasing risktaking, or what doesn’t help 

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Relapse “Clues” 

Attitude changes Negativity  “Not caring”  Disowning personal responsibility 

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Relapse “Clues” 

Mood changes Moodiness  Anger  Boredom  Mania  Depression 

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Relapse “Clues” 

Changes in thinking Rationalization  Justification  Denial  “Stinkin’ thinkin’”  Deprivation / entitlement  Irrational thoughts  Delusional thoughts 

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Identifying High-Risk Situations 

Individualized (different for everyone)  Negative feelings, attitudes, thoughts, behaviors  Social pressures  Treatment-related problems  Relationship problems  Urges / Cravings / Temptations / “Teasing the addict”  Others (boredom, weekends, $$, physical pain, holidays, etc.)

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Managing High-Risk Situations 

Individualized (different for everyone)  Analyze the risk factors  Identify “precursors,” the steps leading up to the high-risk situation  Strategize for recovery success

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Managing High-Risk Situations 

Individualized (different for everyone)  Write down a plan  Share the plan with others  Identify gaps in skills /opportunities  Problem-solve and fill gaps 10

Building a LONG-TERM Dual Recovery Plan 

Can be looked at as “aftercare” following a treatment episode, or as “maintenance” of existing gains

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Building a LONG-TERM Dual Recovery Plan 

May include many things:   

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Counseling Medication / seeing a psychiatrist AA / NA / DRA meetings, other groups Working with a sponsor / mentor Daily reading of recovery literature Halfway / ¾-house, long-term housing Antabuse Educational / vocational efforts ? 12

Emergency Recovery Card 

Designed to be carried in wallet or purse

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Contains a list of names and phone numbers of people supportive of your dual recovery

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May include professional treatment providers, natural supports, AA / NA / DRA contacts 13

Relapse Response Planning “Progress, not perfection” (although, “Progress not permission” as well!)  Dialectical approach, need to not let guilt / shame be an obstacle to getting back on track 

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Relapse Response Planning 

Some important pieces . . . STOP IMMEDIATELY  Reach out to “safe” people  Get crisis care if necessary (Detox, PES, CRS, Hospital ER)  Get back to doing what works  Conduct a Relapse Autopsy, and adjust recovery plan 

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Daily Relapse Prevention Inventory 

At the end of each day, take the time to review these questions: 

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Were there any clues today that indicate movement toward relapse of substance use or re-activated symptoms? Were there any high-risk situations today that could trigger a relapse of substance use or symptoms? 16

Daily Relapse Prevention Inventory 

If “yes” is the answer to either of these questions, make a plan to do the necessary adjusting to support dual recovery moving forward . . . 17

Back to our initial question . . . Q. Is avoiding relapse twice as difficult in Dual Recovery?

A. _______________________________ _______________________________

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THE END Until next time . . .

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