One of the most common misconceptions about drug addiction and treatment is that drug rehabilitation is over once the person suffering from substance abuse disorder has completed his treatment plan. It is important to realize that drug addiction is a chronic disorder. This means that the possibility of relapsing is very high. The National Institute on Drug Abuse has stressed that the relapse rates for substance use disorders are similar to the relapse rates of other common chronic medical conditions such as diabetes, hypertension, and asthma. To counter the high possibility of relapse after drug addiction treatment, substance abusers who have gone through drug rehab treatment can consider going through relapse prevention therapy (RPT).
What is Relapse Prevention Therapy?
Relapse prevention therapy (RPT) is a cognitive-behavioral approach that aims to teach individuals suffering from substance use disorder on how they can anticipate and eventually cope with relapse. RPT can be used as a stand-alone treatment plan or as an aftercare program to help recovering addicts sustain the gains they have achieved during the initial substance abuse treatment.
How did Relapse Prevention Therapy Come About?
In the 1970s, Dr. Alan Marlatt and colleagues discovered common factors that put an individual at high risk of relapse while they were studying aversion therapy. Considering their findings, Dr. Marlatt, et.al. had a revolutionary idea that they can develop a treatment that can assist patients to recover from relapses once they happened; thus, the birth of Relapse Prevention Therapy.
What are the Focus Areas of Relapse Prevention Therapy?
The focus areas of RPT can be grouped according to the following categories:
Coping Skills Training
Coping skills training is the heart of relapse prevention therapy as it teaches patients through behavioral and cognitive techniques the following:
- Understanding that relapse is a process,
- Identifying and effectively coping with high-risk situations,
- Coping with urges and cravings,
- Implementing damage control measures during a lapse to significantly reduce its negative effects,
- Staying engaged and active in treatment even after relapse, and
- Learning how to create a more balanced lifestyle.
Cognitive therapy techniques help patients identify and alter cognitive distortions that increase their vulnerability to relapse. One of the most common cognitive distortions is denial as many recovering addicts refuse to accept that they are susceptible to relapse. Considering this cognitive distortion, it becomes difficult for them to be accountable for their actions when they succumb to temptation.
Cognitive therapy strategies also help clients to reframe how they think about the process of change. Recovering addicts often see relapse as a failure but with relapse prevention therapy recovering addicts are taught that every mistake and setback can be a learning opportunity rather than a failed end.
Changing and improving the patient’s lifestyle to support long-term sobriety is also an important intervention strategy under RPT. Lifestyle modification includes establishing a regular sleeping schedule, exercising regularly to improve mood, managing stress and reducing anxiety, practicing relaxation techniques, and promoting overall wellbeing.
What are the Specific RPT Intervention Strategies?
Below are the specific RPT intervention strategies that aim to enhance the patient’s awareness of cognitive, emotional, and behavioral reactions to prevent a lapse into escalating into a full-blown relapse, among others:
- Identifying and coping with high-risk situations.
- Enhancing self-efficacy or strategies that increase the recovering addict’s sense of mastery and of being able to handle difficult situations without lapsing.
- Eliminating myths and placebo effects or counteracting the patient’s misconception about the effects of alcohol or drugs.
- Lapse management or strategies that focus on stopping the lapse and fighting the effects of abstinence violation to deter uncontrolled relapse episode.
- Cognitive restructuring or strategies that will help patients to restructure their thought patterns in the treatment process.
What is the Global RPT Intervention Strategies?
While the specific RPT intervention strategies described above can teach recovering addicts to cope with high-risk situations, they are not enough to develop a more comprehensive and effective program of habit change, which is why it is critical to adopt the following global RPT intervention strategies:
- Helping the recovering addicts to develop a more balanced lifestyle so they can improve their ability to manage and cope with stress.
- Teaching recovering addicts how to identify and anticipate early warning signs to lessen the risk of relapse.
What are the Benefits of Relapse Prevention Therapy?
Considering how RPT works, this treatment and aftercare strategy provides the following advantages to the recovering addict:
- Increased self-awareness
- Decreased negative thought patterns and cognitive distortions
- Improved ability to identify trigger warnings that make them susceptible to relapse
- Enhanced coping skills that can help in effectively addressing negative emotional states and other potential high-risk situations
- A better understanding of the relapse process
- Better self-control
- Improved ability to identify and change cognitive distortions
- Improved ability to reframe negative and self-defeating thoughts and perceptions into positive and empowering ones
- Improved ability to manage drug cravings and urges
- Improved ability to create lifestyle changes that will support long-term sobriety
What do Studies Show on the Efficacy of Relapse Prevention Therapy?
In the many studies conducted on the effectiveness of relapse prevention therapy for smoking, alcohol, marijuana, and cocaine addiction, the results reveal the following:
- RPT was more effective compared with control groups that received no treatment.
- RPT was equally effective as other active treatments such as supportive therapy, social support group, and interpersonal psychotherapy in improving the substance use outcomes.
- RPT is more effective than available relapse management options in reducing the frequency, intensity, and duration of lapse episodes (slips) if they do occur.
- RPT is effective in sustaining treatment effects over long-term follow-up periods.
- RPT is effective for reducing substance use and improving psychosocial adjustment.
Is Relapse Prevention Therapy for Everybody?
Relapse prevention therapy is for recovering addicts who have at least completed the detoxification process if it will be used as a stand-alone drug addiction treatment. If RPT would be used as part of the aftercare treatment program, then there is no issue unless the recovering addict has a low level of intelligence (below average and lower).
Note that since RPT utilizes a cognitive-behavioral approach to treatment, the following group of patients may not be a good fit for RPT:
- Those with significant cognitive limitations.
- Those with unaddressed impulse control problems.
- Those who have certain conditions that do not allow them to work in a group format or those who struggle with a structured approach to therapy.
What are the Qualifications of a Competent RPT Therapist?
Qualified RPT therapists can come from diverse backgrounds. They can be mental health professionals like psychologists, professional counselors, and clinical social workers or certified addiction counselors. To know whether the RPT therapist you are considering is reputable, make sure that he or she is a licensed therapist. Also, make sure that he or she has acquired extensive training and experience.
How to Find a Relapse Prevention Therapy Provider?
To find a therapist or a treatment facility that offers Relapse Prevention Therapy, you may visit the SAMHSA’s National Helpline.