Relapse means returning to a previous state. It is vital to understand that relapse does not just mean a return to addictive behaviors, nor does it mean just using. Relapses can happen in terms of people's mood, thinking patterns and behaviors. In actuality, a person's thinking patterns and behavior often become problematic long before they start showing symptoms of addiction or depression again. Some people call this return to old ways of thinking, behaving and feeling as “relapse warning signs” or “lapses.” In my mind, it is actually the beginning of a relapse. That doesn't mean that the behaviors have to be continued to the point of using again. A relapse can stopped and corrected at any point. The earlier these old behaviors and ways of thinking are stopped, the less more likely the person is to stay healthy and happy. In this episode we will discuss ways to remain mindful in order to address any potential issues before they start impacting recovery.
Show Notes
Relapse Prevention for Co-Occurring Disorders
Part of the Co-Occurring Disorders Recovery Coaching Series
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
Objectives
Define Relapse
Explore the acronym DREAM
Define and identify vulnerabilities
Define and identify exceptions
Develop a relapse prevention plan
Why I Care/How It Impacts Recovery
Relapse indicates that the old behaviors have returned either because
New skills were ineffective
Old behaviors were more rewarding
Recovery involves understanding what triggers each individual person’s relapse
Dare to DREAM
Determination
Resilience
Exceptions
Awareness of vulnerabilities
Motivation
Determination
Recovery is not easy
People need a high level of tenacity to get through the rough points
In their addicted selves, people behave impulsively.
Recovery involves being able to forgo the easy or immediate reward to achieve longer term goals
Resilience
The ability to bounce back
Part of resilience is hardiness
Commitment can be considered motivation
Control
How much control is rewarding?
How can too much or too little control be unmotivating?
Challenge
Why is it rewarding when something is challenging?
Why are things that are easy not as rewarding?
Resilience
Qualities of Resilience
Self-Awareness and Self-Care
Healthy Habits (Vulnerability Prevention)
Distress tolerance
Rational, accurate cognitive habits
Social Engagement
Generosity
Integrity
Authenticity
Humility/Compassion
Identifying as a survivor, not a victim
Resilience
Qualities of Resilience
Meaning
Purpose
Gratitude
Hope
Optimism
Attention and Focus
Curiosity
Flexibility
Persistence
Problem Solving Skills
Here and Now focus
Exceptions
Nothing is done all the time
Exceptions are what people are doing when they are NOT engaging in the target behavior
To identify exceptions, ask questions like…
Before this problem started
What was different?
How did you deal with stress?
In the past 6 months when you were not [engaging in the target behavior]
What was different?
How did you deal with stress?
Exceptions
Once you identify exceptions, help the client
Strengthen those
Do those things more
Awareness of Vulnerabilities & Relapse Warning Signs
Strengths/Vulnerabilities
Sleep
Nutrition
Medication
Chronic pain
Hormones
Estrogen
Testosterone
Social Supports
Awareness of Vulnerabilities & Relapse Warning Signs
Relapse warning signs are the way people act when relapse is imminent
Have people describe their addicted and sober selves
When the behaviors of their addicted selves start to emerge it is a warning that
Current strategies are not working
Current skills and strategies are not being used in lieu of old behaviors
Motivation
People do the most rewarding
Motivation is Multidimensional
Motivation differs for each behavior
Example: Depression, Addiction, Relationship
Dimensions
Emotional
Cognitive
Physical
Social
Environmental
Motivation is Changeable
Stages of Readiness for Change
Precontemplation
Contemplation
Preparation
Action
Maintenance
Relapse*
Motivation is not linear
Mindfulness will help people identify when their motivation is waning
Relapse Prevention Planning
Develop a plan that
Minimizes vulnerabilities
Incorporates mindfulness
Contains an emergency response plan
Apply It
Identify 3 ways you could have used this information in the past week.
What was the situation?
What did you do?
How effective was that for you?
Short term
Long Term
If you would have had this new information, what could you have done differently?
How would that have changed the outcome?
How can you start integrating this knowledge into your routine
Summary
People in recovery have
Determination
Resilience
Exceptions (understanding of)
Aware of their vulnerabilities and relapse warning signs
Motivated to live a recovery lifestyle
Relapse Prevention planning
Minimizes vulnerabilities
Incorporates mindfulness
Contains an emergency response plan
More Information and Resources
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