According to a foundational study on Relapse Prevention (RP), the therapy “seeks to identify high-risk situations in which an individual is vulnerable to relapse and to use both cognitive and behavioral coping strategies to prevent future relapses in similar situations” (Marlatt & Witkiewitz, 2005).
RP helps patients limit relapses in their recovery by teaching them to anticipate scenarios that may trigger their addictive behavior. It also teaches skills to cope with these triggering situations. Some factors that contribute to relapse include one’s personal moods and environmental triggers.
When teens are in a negative emotional state, research has shown they are more likely to relapse. Research has shown that feeling lonely, depressed, angry, and stressed are all correlated with relapse. For example, a teen who experiences a rejection at school, or a major break-up, may feel an urge to turn to familiar drugs they used to use to numb the pain. During treatment, relapse prevention helps patients learn how to recognize these emotional states, and how to manage them quickly before they spiral into one’s former target behaviors.
Other triggers that provoke relapse come from the environment. Witnessing friends using drugs, seeing a syringe or an ad for alcohol, or passing by a place that reminds one of drug use can all be triggering for a former addict. (On the other hand, spending time with friends who don’t drink or use drugs actually decreases the risk of relapse!) To cope with these potential scenarios, the patient and therapist create Relapse Prevention Plans in advance. Plans may include deleting potentially harmful contacts from one’s phone and avoiding places and people that encourage one’s former habits. It also includes skills in which one can cope with these situations if they do end up occurring. During treatment, RP Plans help the patient become armed with coping skills and strategies to handle these high-risk situations.
RP is also a key part of treatment for teens with mental health issues, no matter the level of care. Any adolescent who takes medication for a diagnosed disorder is vulnerable to relapse if they don’t consistently follow their prescribed regimen. Lack of medication adherence is a common problem among teens with psychiatric disorders. Adolescents may skip pills intentionally or neglect to take them as often as prescribed. Because the illness is not consistently being treated, the teen’s symptoms usually come back. This is why every teen—including those with mental health issues—needs an RP Plan in their discharge plan and home contract.
Administration of Relapse Therapy
The RP curriculum can be administered in both residential treatment (RTC) and outpatient programs (including IOP and PHP). Patients receive RP treatment in an individual or group setting.
In teen rehab centers, clinicians usually feature Relapse Prevention in weekly group sessions. In the group environment, teens can encourage and gain confidence from each other’s recovery journeys. The group setting also allows for the exchange of ideas. As teens discuss their vulnerabilities, and talk about certain situations and scenarios in their lives that have the potential to trigger relapse (or have led to relapse in the past), other members of the group learn to consider those triggers in their own personal lives as well.
Relapse is very common after recovery. In fact, Marlatt and Donovan (1985) found that a third of people successfully discharged from treatment relapse in the first 90 days after they leave. Thus, it’s necessary to consider how to cope ahead with high-risk emotions and situations while still in the safe environment of treatment. Limiting the extent of relapse helps patients sustain long-term change in their recovery from addiction.