Alcohol Awareness Month: What is a Relapse Prevention Plan? Part Two

In Part One of this short series, we discussed aftercare plans, with a focus on the importance of a robust relapse prevention plan, and in this article, we’ll share a template for a relapse prevention plan based on the Living in Balance Model developed by the Hazelden Foundation.

A Template for Relapse Prevention

In general, a good includes a self-care routine that increases emotional and psychological self-efficacy, which is the belief that they can identify and resolve problems they face effectively and efficiently. Once a person in recovery establishes a baseline of self-awareness in the recovery process, their plan helps them by doing three things. It helps them identify triggers, manage triggers, and know what to do if they relapse.

Preventing Relapse: All About Triggers

Identifying Triggers

All recovering people have certain people, places, emotions, and things they associate with alcohol or drug use. These are their triggers.

Triggers can lead to relapse in three steps:

• Automatically leading to thoughts about drinking
• Thoughts about drinking lead to craving for alcohol
• Craving for alcohol can lead to relapse

Triggers can be internal or external. A relapse prevention plan should account for both.

Internal triggers include:

• Emotional states associated/connected to past drinking/using
• Emotional states experienced while drinking/using
• States that elicit thoughts about drinking, including shame, fear, anxiety, boredom, sadness, loneliness, anger/agitation

External triggers include:

• People associated with past drinking/using:
  • Those present while drinking/using
  • Those who participated in drinking/using
• Places associated with drinking:
  • Restaurants, bars, etc. where drinking/using occurred
  • Areas of town where drinking/using occurred
  • Locations of negative memories associated with drinking/using
• Things associated with drinking/using:
  • Specific types of glasses, i.e. tumblers, beer mugs
  • Paraphernalia from bars, such as ashtrays, beer signs, etc.
  • Alcohol advertising
  • Seeing other people drinking/using
• Activities associated with drinking:
  • Social events: birthday parties, graduations, work events
  • Holidays: Winter Holidays, 4^th of July, others
  • Sports Events: at home or at the ballpark/stadium
  • Seeing live music

Managing Triggers

1. Identify them. Here’s how:
   • Review the bulleted lists above
   • Use them to write a comprehensive list of triggers
   • Divide the list into internal and external triggers
2. Avoid them, if possible. Here’s how:
   • Write a list of actions steps to take to prevent experiencing triggers
   • Get the help of a therapist or recovery peer
   • Be specific, and make them actionable, i.e. “Take a different route to work to avoid the party district,” or “Delete phone numbers from former drinking partners,” or “Stop going to the Friday office get-together.”
3. Interrupt Some triggers cannot be avoided. Here’s how to prevent them from leading to relapse:
   • If someone at work creates frustration, plan a recovery friendly activity before/after you have to see them: a well-timed support group meeting, or a well-timed activity session, such as mindfulness, exercise, or any healthy activity that promotes recovery
   • If a situation you can’t avoid, or a day of the week – payday Friday, for example – elicits emotions or patterns of thought that can lead to relapse, prepare for it ahead of time by checking in with your mind, body, and emotions, and debrief it afterwards by checking in with your mind, body, and emotions.
   • Thought stopping: When you feel the emotions that lead to relapse form, immediately engage in a mindfulness practice such as deep breathing, the five senses exercise, or immediately engage in some form of activity you know works: taking a walk, working out, going for a bike ride, playing music, or journaling, or go to #4, below.
4. Talk about them. Here’s how:
   • Make a list of at least three people to call or text when triggers happen
   • When emotions related to triggers form, call the people on the list
   • Talk to them openly and honestly about what’s going on
   • Meeting face-to-face to talk, if possible, can be more powerful than a phone call, but a phone call or text can work as well.

What to Do If You Relapse

If you relapse, do these things, which should be clear in your relapse prevention plan:

• Stop alcohol or drug use as soon as you can
• Take responsibility for your actions
• Accept accountability for your actions
• Contact your sponsor, counselor or therapist
  • Ask for help
• Reach out to your home support system: friends, family, loved ones
  • Ask for help
• Return to community support meetings
  • Ask for help
• Schedule individual or group counseling sessions
  • Ask for help
• Get back on your recovery plan as soon as possible

If you relapse, do not:

• Beat yourself up about it
• Think of it as a failure
• Think of yourself as a failure
• Use it as an excuse for prolonged alcohol/drug use

Your relapse prevention plan should remind you that what matters is that you get back on your program as soon as possible.

Relapse Prevention and Long-Term Recovery

Relapse happens. This is a hard fact to accept, but it’s essential to accept it. People in recovery who relapse should realize this:

You’re not the first and you won’t be the last.

People who relapse learn that what matters is not that they relapsed, but that after they relapsed, they got themselves back on their recovery plan, with the help of their relapse prevention plan. They learn they didn’t have to go back to square one, and that all their experience and knowledge still work: they now have a deeper perspective on the entire recovery process.

This is all true even if it’s necessary to go back into residential treatment. With the help of their social and clinical support team, people who relapse can get back on their program, whether its outpatient, community support, or otherwise, analyze what led to relapse – with the help of the relapse prevention template above – and make plans to interrupt the stages of relapse if they recognize them in the future. That’s what getting back on their program means, and that’s the best way to achieve sustainable, long-term recovery if a relapse happens.