Relapse Prevention

Relapse continues to be a very serious problem facing the substance abuse, mental health and criminal justice fields. Research suggests that nearly half of all chemical dependency clients relapse at least once. Many of these clients are not in denial, acknowledge their addictions and want to change their lives so they can stay off drugs. The problem is that they do not know how to do so, resulting in an inability to cope with the numerous temptations to use alcohol and drugs that confront them once they leave treatment. Clearly, relapse is a real threat and is too important to be ignored.

Despite the prevalence and importance of the problem many treatment agencies and drug courts do not have a specific relapse prevention track for clients, or are not using use proven and effective relapse prevention approaches. 

 Recovery Training and Self Help (RTSH)

Recovery Training and Self-Help (RTSH) is a comprehensive relapse prevention strategy. It combines four strategies, and can be used effectively in the context of continued care and/or follow-up counseling services provided in the course of addiction recovery. RTSH can be used as part of either residential or outpatient programs. RTSH employs a group format which combines cognitive – behavioral, social support, and lifestyle change approaches. RTSH enables clients to learn how to identify and deal with  specific threats to recovery. The RTSH program teaches individuals self-sustaining alternative responses to these threats. These new responses are elements of a new pattern of behavior, and a recovering lifestyle.

Cue Extinction

Cue Extinction is a relapse prevention technique that when incorporated into a comprehensive relapse prevention program has been found to be effective in supporting clients to maintain recovery. The Cue Extinction program teaches techniques that help clients reduce their craving for drugs, even when confronted with the situations and stimuli that triggered the urge in the past. It can be used effectively on an outpatient as well as in a controlled residential program.

Cue Extinction simulates a temporary craving for drugs by having clients recall and describe situations that have made them want to use drugs in the past. By repeatedly exposing clients to their own personal triggers, and teaching them tools for dealing with the cravings that arise from these triggers without letting them resort to using drugs, the program causes cravings gradually to weaken and possibly even disappear.

Why are these to relapse prevent approaches recommended over others?

A variety of relapse prevention approaches are currently in use around the country. Among them are approaches based on cognitive behavioral, social support, 12 step, lifestyle change, cure extinction and pharmacotherapeutic techniques.

The two approaches in the NIDA Relapse Prevention Package were chosen because careful scientific testing have proven that, they work: they help recovering persons stay off drugs. Treatment programs that are committed to approaches such as NA and AA will find that the two approaches recommended here are compatible with them.

Materials to Support the Transfer and Maintenance of Learning in the Workplace.

Participants attending the workshop receive the support materials listed below. These materials are valuable resources that will help treatment programs successfully implement and maintain the approaches.  

An Introduction to Relapse Prevention, which discusses the nature and causes of relapse, gives reason for doing relapse prevention, and describes the two tested relapse prevention approaches. 

Administrator Manuals; The administrator guides (pictured below) for each approach discuss administrative and planning issues that program managers interested in adding relapse prevention to their programs should consider. These issues include staff training, fitting relapse prevention into the limited time most programs have to work with clients, and adjusting the model to fit specific program philosophies.

Cue Extinction Handouts; The Six Cue Extinction Tool Scripts, Identifying Urges and Triggers Script, Coping With Craving Ratiing Forms, and Urge and Craving Management Log.

The Recovery Training and Self Help: Relapse Prevention and After Care Manual.  Provides specific instructions on how to organize and implement RTSH. It addresses problems that service providers are likely to encounter and describes how to address them. Each of the 24 curriculum units is presented in detail, including session objectives, background information on the unit topic, key points, suggested format for group meeting, and the handouts for each unit. It is an incredibly valuable resource. 

Evidence Based – Proven Effective – Designed For Transfer