A significant part of helping a client achieve long-term recovery from alcohol disorder is acknowledging that they will have setbacks along the way typically due to stress and relapse. Recovery seldom goes from drinking to not drinking in one step, it just doesn’t happen like that. Relapse is a process, not a single event. It is a windy road of good and bad days whilst learning how to handle symptoms all the way. Understanding setbacks can prevent the client from falling back into the cycle and feeling helpless once again.
Knowledge is power and the object is to understand and accept the process and remove much of the fear of not knowing what is happening. For most clients overcoming relapse is the main reason they seek professional treatment. They have often tried to stop drinking on their own only at least and more often several times and they continue to experience setbacks (Melemis, 2015, p.325). If the client understands post-acute withdrawal it’s easier to avoid relapse, because the early stage of relapse is easiest to pull back from. In the later stages, the pull of relapse gets stronger and the sequence of events moves faster.
Relapse Prevention
Melemis (2015) conceptualizes relapse prevention with four distinct ideas. The first is acknowledging that relapse is a gradual process with distinct stages. Through treatment, clients can learn to recognize the early stages, in which the chances of success are greatest. The second idea is that recovery is a process of personal growth with stages that carry their own potential for risk of relapse. The third idea is that cognitive therapy and mind-body relaxation can help facilitate the development of healthy coping skills and thoughts. Finally, the fourth idea is that relapses can be explained in terms of a few basic rules (p.326). Educating clients on these few rules can help them focus on what is important.
Stress
Stress is a common cause of relapse. Stress at work or from other sources creates emotional difficulties that can lead to relapse, especially early in treatment. Clients often learn to cope with stress with the use of alcohol so they must learn methods to cope with stress or other factors that they previously relied on alcohol to overcome or mitigate (Perkinson, 2016, p.126). The first step in creating a relapse prevention plan is to assess for chronic stress. Chronic stress may lead to depression and or anxiety and can affect numerous aspects of a client’s overall health. An important objective would be to provide behavioral, emotional, and attitudinal information. Have the client acknowledge the stress and the implications it may be having not only on relapse but on other areas of their life. An effective treatment going forward should include the following.
- Facilitate the client’s understanding of the genetic, social, and family factors that led to alcohol dependency.
- Help the client learn and develop stress management techniques that include healthier alternative responses to stress.
- The use of modeling, role-playing, and behavioral reversal can help the client learn new patterns of behavior. Replacing negative thoughts with positive ones can improve mental health.
- Help the client conceptualize their stress in perspective and maintain a positive attitude during difficult times.
- Journaling thoughts feelings and experiences the client undergoes when stress or other risk factors arise may help identify specific inaccurate thought processes.
- Helping the client recognize interpersonal conflict that may provide an opportunity to relapse.
Therapy and Counseling for Addiction
Effective addiction treatment involves providing individuals with social support and teaching them coping and problem-solving skills to help them effectively manage stress during their recovery process. As Perkinson rightly points out, it’s important to have a relapse plan in place as it’s not realistic to think that one will never have setbacks during their journey (p.317). If you’re seeking individual counseling, I can work with you to develop a practical plan that helps you cope with stress and other triggers that commonly lead to relapse.
References
Perkinson, R. (2016) Chemical Dependency Counseling: A Practical Guide. (CBC) 5th. Edition. Sage Publications, Thousand Oaks, CA ISBN-13: 978-1506307343
Jongsma, A.E., Peterson, L.M. & Bruce, T.J. (2014). The Complete Adult Psychotherapy Treatment Planner 5th ed. John Wiley & Sons, Inc. Hoboken NJ
ISBN 978-1-118-06786-4
Melemis S. M. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale journal of biology and medicine, 88(3), 325–332.
