The views expressed here are my own and are not necessarily shared by any employer or educational institution I may be affiliated with...but they definitely should be.
I'm going to go out on a limb here and say every treatment facility in the United States has a class, group, or workshop called "Relapse Prevention." It may be the biggest lie in the the recovery industry. A quick google search of relapse rates after rehab will tell you that something around 60% of graduates from a given treatment facilities will relapse between in the first 1 to 3 years. Of the remaining 40% about half will relapse by the 5 year mark and about half of those survivors will relapse by 10. Though results may very a bit from program to program the numbers hold fairly steady. I think it's fair to ask just what relapses are being prevented? The answer it seems is none at all. Yet that's what we say we are doing. That's what we tell the fresh faced first timer who looks at us determined he will never set foot in treatment again, that's what we tell the frequent flyer who is determined to do it differently this time and they fill out the work sheets we give them with triggers, coping skills and numbers to call, they write prevention plans and role play scenarios and most of them use again before the year is through. So what are we teaching them if it's not how to prevent a relapse? When we say things like "relapse is part of some people's stories but it doesn't have to be part of yours" what is it we are trying to say? The one overriding lesson of every relapse prevention class, the very purpose of the topic itself is to teach the clients one thing, when you eventually relapse, it's not our fault, it's yours. It's a lesson they learn well. It's a lesson we teach them over and over again.
Not everything taught in a relapse prevention class is useless. How to access sober support, coping skills for triggers, tips to survive the holidays, these are all things a person in recovery may put to good use, they just don't seem to prevent relapse. So what do we do with these people who are desperate for our help? Do you hear a list coming? I hear a list coming.
1) stop pretending relapse is abnormal. Most people enter a treatment facilitiy long before their last use so don't treat the clients as if they are the only one to ever slip up.
2) Instead of pretending to prevent a relapse teach them how to survive one. In the case of an opiate dependent person make sure they have Narcon and train them how to use it.
3) put aside the idea that recovery begins that day after one's last use. The truth is recovery begins when one decides it's time to change.
4) instead of talking about Relapse Prevention, talk about Abstinence Goals. Abstinence is an important goal of recovery but it is not the goal of recovery. A client who has gone from daily drinking to drinking 3 times a month has made significant progress towards their abstinence goal of no alcohol, but has failed three times to prevent relapse. Which is more likely to motivate them to continue trying? They might be excited to tell you about the proges they have made towards their abstinence goal, and they may be open to your help in continuing the progress. On the other side, they may be ashamed if they think they have failed and may be more likely to hide it from you and continue using in secret.
Each relapse can be a learning or a shaming experience for the client, which one may depend on how you the professional decides to handle it.
