Integrated Relapse Prevention Is avoiding relapse twice as

Integrated Relapse Prevention Is avoiding relapse twice as difficult in Dual Recovery? 1

Understanding Relapse as. . . l. . . the PROCESS of returning to substance use and/or active symptoms after a period of abstinence / stability 2

Understanding Relapse as. . . l. . . ALWAYS a risk when dealing with two, cooccurring “chronic, relapsing conditions” 3

Relapse “Clues” l Behavior changes Decreasing what helps; l Increasing risktaking, or what doesn’t help l 4

Relapse “Clues” l Attitude changes Negativity l “Not caring” l Disowning personal responsibility l 5

Relapse “Clues” l Mood changes Moodiness l Anger l Boredom l Mania l Depression l l l 6

Relapse “Clues” l Changes in thinking Rationalization l Justification l Denial l “Stinkin’ thinkin’” l Deprivation / entitlement l Irrational thoughts l Delusional thoughts l 7

Identifying High-Risk Situations l Individualized (different for everyone) l Negative feelings, attitudes, thoughts, behaviors l Social pressures l Treatment-related problems l Relationship problems l Urges / Cravings / Temptations / “Teasing the addict” l Others (boredom, weekends, $$, physical pain, holidays, etc. ) 8

Managing High-Risk Situations l Individualized (different for everyone) l Analyze the risk factors l Identify “precursors, ” the steps leading up to the high-risk situation l Strategize for recovery success 9

Managing High-Risk Situations l Individualized (different for everyone) l Write down a plan l Share the plan with others l Identify gaps in skills /opportunities l Problem-solve and fill gaps 10

Building a LONG-TERM Dual Recovery Plan l Can be looked at as “aftercare” following a treatment episode, or as “maintenance” of existing gains 11

Building a LONG-TERM Dual Recovery Plan l May include many things: l l l l l Counseling Medication / seeing a psychiatrist AA / NA / DRA meetings, other groups Working with a sponsor / mentor Daily reading of recovery literature Halfway / ¾-house, long-term housing Antabuse Educational / vocational efforts ? 12

Emergency Recovery Card l Designed to be carried in wallet or purse l Contains a list of names and phone numbers of people supportive of your dual recovery l May include professional treatment providers, natural supports, AA / NA / DRA contacts 13

Relapse Response Planning l “Progress, not perfection” (although, “Progress not permission” as well!) l Dialectical approach, need to not let guilt / shame be an obstacle to getting back on track 14

Relapse Response Planning l Some important pieces. . . STOP IMMEDIATELY l Reach out to “safe” people l Get crisis care if necessary (Detox, PES, CRS, Hospital ER) l Get back to doing what works l Conduct a Relapse Autopsy, and adjust recovery plan l 15

Daily Relapse Prevention Inventory l At the end of each day, take the time to review these questions: l l Were there any clues today that indicate movement toward relapse of substance use or reactivated symptoms? Were there any high-risk situations today that could trigger a relapse of substance use or symptoms? 16

Daily Relapse Prevention Inventory l If “yes” is the answer to either of these questions, make a plan to do the necessary adjusting to support dual recovery moving forward. . . 17

Back to our initial question. . . Q. Is avoiding relapse twice as difficult in Dual Recovery? A. _______________________________ 18

THE END Until next time. . . 19