Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC

Executive Director, AllCEUs

~ Define Relapse

~ Identify triggers and warning signs of relapse

~ Review Relapse Syndrome and possible interventions

~ 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

Relapse Syndrome

~ Relapse generally follows a predictable and readily identifiable pattern

~ Return of denial “I’ve got this.” “I’m fine.”

~ Teach support people about recovery and relapse. Encourage them to probe about problems.

~ Write down problems on a daily basis and share this list with someone.

~ Avoidance of defensive behavior…Focusing more energy on fixing others than on working on self and failing to do relapse prevention exercises.

~ Surround themselves with support people who will encourage them to continue working on their relapse prevention program.

~ Maintain a “negative image” reminder of what it is like when they are symptomatic

~ Develop and review a cost/benefit analysis of their coping behavior.

~ Crisis Building…problems begin to pile up and it becomes more and more difficult to see options. The person develops tunnel vision and loses the ability to perform constructive planning

~ Remind them to take one day at a time.

~ Review coping behavior.

~ Encourage acceptance of personal limits.

~ Remind them that it is the thoughts about an event and not the event that is “bad” or “good”).

~ Immobilization When a crisis builds up, the person becomes crushed and trapped by the problems and incapable of initiating action A sense that nothing can be solved may develop.

~ Use the Serenity Prayer.

~ Use the support people that they have developed.

~ Review the concept of lapse as opposed to relapse (accept the reality that they may make some small mistakes but this does not mean that they have failed).

~ Confusion and overreaction While the problems continue to grow and the person feels stuck, he often becomes confused and angry leading to irritability, a general sense of tension, and sense that others are out to get him.

~ Identify the source of the feelings.

~ Accept responsibility for problems.

~ Possible professional intervention.

Relapse Syndrome

~ Depression. As the anger begins to build, so does a sense of hopelessness and begins to turn the anger inward in the form of depression.

~ Focus on those things that the person can control

~ Identify strengths

~ Set SMART goals to develop self-efficacy

~ Seek social support

~ Behavioral loss of control The person becomes unable to control or regulate personal behavior and a daily schedule.

~ Develop a routine

~ Regroup and redifine those people, things and activities that are truly important to a meaningful life

~ Make a task basket (or list)

~ Set more SMART goals to start taking steps forward

10 Most Common Triggers of Relapse

~ Withdrawal symptoms (anxiety, nausea, physical weakness)

~ Post-acute withdrawal symptoms (anxiety, irritability, mood swings, poor sleep)

~ Poor self-care (stress management, eating, sleeping)

~ People (old using friends)

~ Places (where you used or where you used to buy drugs)

~ Things (that were part of your using,