Relapse Prevention Strategies for Addiction and Mental Health Disorders

This episode, presented by Dr. Dawn-Elise Snipes, focuses on comprehensive strategies for relapse prevention in individuals dealing with addiction and mental health disorders. It begins by defining different types of relapse—emotional, mental, physical, and behavioral—emphasizing that relapse is a process, not a sudden event. The discussion highlights the importance of identifying early warning signs and triggers, including emotional cues like anger and anxiety, mental cues such as cognitive distortions and negativity, physical cues like sleep problems and pain, and social cues like isolation and non-compliance with support systems. A key distinction is made between understanding *what* clients do and *why* they do it, stressing that addressing the function of a behavior is crucial for finding effective replacements.

The presentation then moves into practical, group-based activities designed to help clients develop self-awareness and coping skills. These include games like 'Family Feud' to identify warning signs, worksheets for creating personalized 'emergency sheets' with solutions, and 'recovery signals' charts to track progress in areas like sleep, appetite, and mood. The concept of 'recovery triggers' is introduced as a counterpoint to relapse triggers, encouraging clients to intentionally incorporate positive sensory and environmental cues into their lives. Goal awareness is also emphasized, prompting clients to define their vision of a happier, healthier life and identify daily actions that move them towards or away from these goals.

Further into the episode, Dr. Snipes addresses Post-Acute Recovery Syndrome (PARS), explaining its common symptoms like an inability to think clearly and sleep disturbances, and providing activities to help clients understand and mitigate these challenges. Mindfulness is presented as an essential tool to prevent 'autopilot' responses, encouraging non-judgmental acceptance of the present moment and a willingness to improve the next. The distinction between avoidance and distress tolerance is clarified, with the latter being a skill to manage intense emotions until one can think more clearly. The PAVES acronym (Pushing away, Activities, Visualization, Encouragement, Sensations) is offered as a mnemonic for distress tolerance techniques.

The episode concludes by integrating principles from Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT), particularly the concept of 'unhooking' from negative thoughts by changing language (e.g., "I'm having the thought that I'm stupid" instead of "I am stupid"). This approach encourages clients to accept thoughts and feelings without judgment and then proactively explore how to improve the next moment. Overall, the presentation provides a holistic and actionable framework for clinicians to guide clients in building robust relapse prevention plans, fostering self-efficacy, and sustaining long-term recovery by focusing on self-awareness, skill development, and environmental support.

emotional relapse is when people start feeling you know poorly again and we all have bad days you know that's not what I'm talking about in terms of relapse it's when our the person's mood really significantly declines for a notable period of time more than a couple of days they may be on an emotional relapse

mental relapse is when that stinking thinking comes back in those negative thoughts pessimism when we're talking about a anxiety or depression any of those cognitive distortions if they start coming to the forefront and being more prominent again

behavioral relapse is when we start doing things that we know are not in our best interest we start doing those things that we did before that may have led us to where we were

until we figure out why you're doing them we can't figure out something better and then brainstorm the best ways to address those things

recovery triggers are things that remind you to do the next right thing to keep moving forward towards your goals

recovery is about heading toward a happier healthier life as the person defines it so they've got to define it

mindfulness is so incredibly important because it keeps us from turning autopilot back on

distress tolerance is saying right now is not the time to deal with this because I'm in my emotional mind I've worked up I may not be thinking clearly or this is not the appropriate place and time to deal with it

we want people to change their language when we say I am stupid versus I'm having the thought that I'm stupid

mindfulness is non-judgmental acceptance of the present moment it's just looking at what's going on or asking yourself how am i doing right now not saying I should be doing better or I shouldn't feel this way it's just it is what it is