Relapse Prevention

Relapse continues to be a very serious problem facing the substance use, mental health and criminal justice fields. Research suggests that nearly half of all chemical dependency clients relapse at least once. Many of these clients are not in denial, acknowledge their addictions and want to change their lives so they can stay off drugs. The problem is that they do not know how to do so, resulting in an inability to cope with the numerous temptations to use alcohol and drugs that confront them once they leave treatment. Clearly, relapse is a real threat and is too important to be ignored.

Despite the prevalence and importance of the problem many treatment agencies and drug courts DO NOT have a specific relapse prevention track for clients, or are not using proven and effective relapse prevention approaches.

NIDA’s Proven & Effective RP  Approaches

Recovery Training and Self Help (RTSH) for the Treatment of Opiate and Heroin Addiction

Recovery Training and Self-Help (RTSH) is a comprehensive relapse prevention strategy. It combines four strategies, and can be used effectively in the context of continued care and/or follow-up counseling services provided in the course of addiction recovery. RTSH can be used as part of either residential or outpatient programs. RTSH employs a group format which combines cognitive – behavioral, social support, and lifestyle change approaches. RTSH enables clients to learn how to identify and deal with  specific threats to recovery. The RTSH program teaches individuals self-sustaining alternative responses to these threats. These new responses are elements of a new pattern of behavior, and a recovering lifestyle.

Recovery is not just the cessation of drug use; usually it also demands adjustments to a new way of life within the culture of the larger community. To make a truly new way of life and not just relocate the old one, people need much more than to learn how to avoid people places and things.  People must have guidance, acquire new skills, develop new relationships and become part of supportive communities.  Clients can find support for that emerging lifestyle by participating in four distinct sets of activities that make up the RTSH program.

Cue Extinction

Cue Extinction is a relapse prevention technique  based on traditional learning and behavioral modification theories that has been empirically tested and, when incorporated into a comprehensive relapse prevention program has been found to be effective in supporting clients to maintain recovery.

The Cue Extinction program teaches techniques that help clients coping with cravings produced by drug-related stimuli until the power of these cues to evoke the craving is reduced or eliminated, even when confronted with the situations and stimuli that triggered the urge in the past. It can be used effectively on an outpatient as well as in a controlled residential program.

Cue Extinction simulates a temporary craving for drugs by having clients recall and describe situations that have made them want to use drugs in the past. By repeatedly exposing clients to their own personal triggers, and teaching them tools for dealing with the cravings that arise from these triggers without letting them resort to using drugs. The program causes cravings gradually to weaken and possibly even disappear.

Why are these to relapse prevent approaches recommended over others?

A variety of relapse prevention approaches are currently in use around the country. Among them are approaches based on cognitive behavioral, social support, 12 step, lifestyle change, cure extinction and pharmacotherapeutic techniques.

The two approaches in the NIDA Relapse Prevention Package were chosen because careful scientific testing have proven that, they work: they help recovering persons stay off drugs. Treatment programs that are committed to approaches such as NA and AA will find that the two approaches recommended here are compatible with them.

What Are People Saying About the Workshop

Materials to Support the Transfer and Maintenance of Learning in the Workplace.

Participants attending the workshop receive the support materials listed below. These materials are valuable resources that will help treatment programs successfully implement and maintain the approaches.  

An Introduction to Relapse Prevention, which discusses the nature and causes of relapse, gives reason for doing relapse prevention, and describes the two tested relapse prevention approaches.

Administrator Manuals; The administrator guides (pictured below) for each approach discuss administrative and planning issues that program managers interested in adding relapse prevention to their programs should consider. These issues include staff training, fitting relapse prevention into the limited time most programs have to work with clients, and adjusting the model to fit specific program philosophies.

Cue Extinction Handouts; The Six Cue Extinction Tool Scripts, Identifying Urges and Triggers Script, Coping With Craving Ratiing Forms, and Urge and Craving Management Log.

The Recovery Training and Self Help: Relapse Prevention and After Care Manual.  Provides specific instructions on how to organize and implement RTSH. It addresses problems that service providers are likely to encounter and describes how to address them. Each of the 24 curriculum units is presented in detail, including session objectives, background information on the unit topic, key points, suggested format for group meeting, and the handouts for each unit. It is an incredibly valuable resource.

Workshop Policy, Procedures & Expectations

  1. Register for the onsite workshop.
  2. Within 24 – 48 hours of receiving the confirmation of your registration we will send you an email with the following information; a link to the Relapse Prevention Participant Needs Assessment Survey to be completed prior to attending the workshop, and some articles and other materials related to Relapse and Relapse Prevention.
  3. Attend the onsite Relapse Prevention Workshop.

In order to receive continuing education units CEU’s,  participants are required to attend the workshop(s) on time, and not leave prior to the conclusion of the workshop(s).

Here is what other participants around the country have been saying about the Relapse Prevention workshops.

“There are many POPULAR Relapse Prevention approaches out there, I really like that these two have been PROVEN EFFECTIVE”. New York

“Very practical and much needed approaches.” Delaware

“I really liked the RTSH approach, comprehensive, yet easy to implement.” Delaware

“This is a much-needed approach of substance abuse involvement in response.” New Orleans

“The information on relapse prevention is vital for counselors.”       New York

“This is what I’ve been looking for to implement but haven’t had the time to research and implement.” Cincinatti

“Great! first workshop I’ve felt was relevant to my population”         San Francisco

“I like the different techniques used and will use as tools with clients.” New York

“This uses approaches I already know but applies them in a systematic manner. “Multiple Cities

“A great training for directors and coordinators of programs to take back to their staff.” Boston

“My hopes were to find new methods and they were reached.”         San Francisco

“This is what councils and substance abuse treatment need, get the word out.” Arizona

“I like the Gorski materials but this gives me concrete tools that I can use in my program.” Multiple Cities

“Informative and enlightening.” San Diego

Evidence Based – Proven Effective – Designed For Transfer