Integrated Relapse
Prevention
Is avoiding relapse twice as difficult
in Dual Recovery?
1
Understanding Relapse as . . .

. . . the PROCESS of returning to
substance use and/or active symptoms
after a period of abstinence / stability
2
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

4
Relapse “Clues”

Attitude
changes
Negativity
 “Not caring”
 Disowning
personal
responsibility

5
Relapse “Clues”

Mood
changes
Moodiness
 Anger
 Boredom
 Mania
 Depression



6
Relapse “Clues”

Changes in thinking
Rationalization
 Justification
 Denial
 “Stinkin’ thinkin’”
 Deprivation /
entitlement
 Irrational thoughts
 Delusional thoughts

7
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.)
8
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
9
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
11
Building a LONG-TERM
Dual Recovery Plan

May include many things:









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

Contains a list of names and phone
numbers of people supportive of
your dual recovery

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

14
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

15
Daily Relapse Prevention Inventory

At the end of each day,
take the time to review
these questions:


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. _______________________________
_______________________________
18
THE END
Until next time . . .
19
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link to Integrated Relapse Prevention