Conversations about relapse can be confronting. This is especially true when it is discussed at the ideal time; that is, early in the recovery phase and prior to relapse occurring. The young person may feel extremely resolved in their goal to not use their substance of choice again and firmly believe they will never relapse. Yet, the practitioner has a responsibility to discuss relapse and introduce the idea of relapse prevention.
It can be a challenging balance for the practitioner to introduce the concept of relapse prevention. The practitioner needs to be very careful not to portray a position that encourages relapse or enables the young person to relapse by reinforcing excuses. It is essential to create an atmosphere of trust so that relapse, and potential relapse, can be openly discussed without negativity. When relapse does occur, the practitioner needs to convey empathy, concern and a problem-solving attitude while enabling the young person to feel accountable and responsible for the choices they make or have made.
It is helpful for practitioners to be clear about their own feelings toward relapse. It is not uncommon for practitioners to experience similar responses to their clients when a client relapses. For example the practitioner may feel disappointment, failure and disheartenment. Reframing relapse into a natural part of the recovery process and accepting relapse as a precious learning experience that can lead to growth in recovery are essential components of helping a young person understand what their relapse is about. Positive messages can be genuinely conveyed to a young person who may be vulnerable after relapsing.
As with any learning, learning to change behaviour is not just about an outcome. It is as much about trying and figuring out what works and what doesn’t work. It is about creative thinking around problem solving and developing new ways of thinking. While a young person may experience a lapse or relapse (that is, an unwanted outcome), it is likely they exercised a range of skills and novel ideas in their attempt. While these may not have worked on this occasion, they can become useful skills in the future. Analysis of what was done prior to the lapse or relapse occurring (rather than focusing on the outcome) is essential and practitioners can provide positive feedback from such an analysis.
It is useful for practitioners to consider that habitual or dependent substance use by a young person has most likely performed a function for that young person at some point in time. For some, there is a period of grieving following cessation. The young person might miss the feeling of being intoxicated and the lifestyle, people and places associated with using. It is likely that the young person will feel conflicted when trying to acknowledge that life is “so much better” when they are not using. It is essential that throughout this process, the practitioner is able to actively support the young person and normalise these feelings for them (YSAS 2002). Identifying and celebrating successes and positive outcomes throughout the recovery is essential and practitioners may need to ensure they can highlight these with the young person.