Aims of this module
This module will give youth AOD practitioners:
- An understanding of the process in which lapses and relapses happen
- Skills to assist young people identify what situations might put them at risk of relapse
- Tools to build skills and practice strategies to avoid or reduce the impact and occurrence of lapse and relapse.
Considerations for different practice contexts
Relapse prevention is a framework and set of behavioural strategies that can be implemented across all areas of youth AOD practice.
Relapse prevention training is generally not appropriate for young people who are intoxicated or actively psychotic. If the young person has impaired cognitive functioning and/or an acquired brain injury modifications will be required. The process of relapse encompasses many decisional factors. For relapse prevention training to be effective, young people require a degree of cognitive ability that allows them to understand the relapse process, a degree of learning ability for the acquisition of new skills, and sufficient memory for the implementation of strategies.
Clinic based settings
Young people and their families often attend the clinic for AOD counselling. All treatment should include some relapse prevention work. It is often very helpful to explain the relapse process so as both the young person and the people that support them, understand that lapses and relapses don’t “just happen”, they are part of a process. Relapse is a common part of making changes and acknowledging this enables strategies to be put in place to avoid relapses happening. This requires the young person to develop insight into their strengths and challenges, learn new ways of coping and be able to put these into action when needed.
Relapse prevention is important in outreach treatment in the community. Goal setting around substance use is supported with learning new skills and practicing with the worker things such as substance refusal. Together with the outreach AOD worker the young person can explore how and where their substance use impacts their life and make lifestyle changes to support meeting desired goals. For example, a young person who smokes cannabis when they are bored; treatment may include assisting the young person to meaningful activities (work, study or leisure) so that they are occupied for more of their time.
Specific programs for relapse prevention can be incorporated into a range of day programs. A broad range of skill development strategies such as; stress and anger management, time management, communication, assertiveness training and problem solving can support a person in preventing relapse. Much of the relapse prevention work and skills training is most effective when done in group settings.
When young people are in residential services, whether that be detoxification, rehabilitation or longer residence based programs, relapse prevention is an essential part of treatment. Whilst in a residential program the young person is often away from drugs and alcohol. It is imperative that they set realistic substance use goals for when they leave the supported environment of the residential service and understand what their individual triggers for relapse may be and develop and practice new ways of coping with theses situations.
Working through a relapse prevention process with a young person may often be perceived by the young person as a lack of faith in their abilities. However, these interventions are based on both the young person and the practitioner acknowledging that a possible lapse is a common experience that should not be viewed negatively, but instead viewed as an experience from which to learn (YSAS 2002).
An analogy of having a life jacket on a boat can be applied. It is compulsory that life jackets are on all passenger boats. Acknowledging that life jackets are on board, does not assume that the boat is going to sink. Conversely, it is assumed they will not be needed, however it is essential that passengers have access to them just in case an accident occurs.