1. Relapse Prevention
By: Ahmed Albehairy, M.D
Consultant Psychiatry

2. Relapse Prevention
-Maintenance stage of the change process.
-Recovery .
-Relapse & lapse.
-Relapse precipitants.
-Relapse prevention process.

3. Recovery:
Recovery =
Abstinence
+
Change of Intra & Interpersonal fields
+
Time.

4. Recovery:
Recovery is affected by:
- Damage of the substance.
- Co-morbid psychiatric disorders.
- Individual perceptions.
- Motivation.
- Support system.
- Culture background.

5. Recovery:
Types :
- Full recovery.
- Partial recovery .

6. Relapse and lapse
Relapse Lapse
Failure to continue Event of use after a
the process of period of
change. abstinence.
- Warning signs. - Little or no
warning signs.
- End quickly or
leads to relapse.
- Out come. - Out come.

7. Relapse Precipitants
I- intrapersonal determinants.
II- interpersonal determinants.
III- other important aspects.

8. Relapse Precipitants
I- intrapersonal determinants.
- Negative emotional state .
- Physical state.
- Positive emotional state.
- Testing of personal control.
- Usage and temptation.

9. Relapse Precipitants
II- interpersonal determinants.
- Relational conflicts.
- Social pressure to use substance.
- Positive emotional state associated
with others.
- Lack of social or family stability.
- Lack of production in work or leisure
time.

10. Relapse Precipitants
III- other important aspects.
- Degree of improvement caused by
drug use.
- Psychiatric impairments.
- Length and modality of treatment.
- Involvement in a crime.
- Family and peer support.
- Skills deficit, coping skills, social skills,
impulsivity.

11. Relapse Precipitants
III- other important aspects( cont.)
- Cognitive variables( attitude towards
recovery, self perception of ability to cope
with high risk situations, level of cognitive
functions).
- Craving and withdrawal sx.
- Spiritual variables ( shame ,sense of guilt,
sense of emptiness)
- Negative attitude of the care giver.
- Inadequate after care.

12. Relapse Prevention Management:
1- help the patient to identify his high risk relapse
function and develop to deal with team.
2- help the patient to understand the relapse as a
process and as an events.
3- help the patient to understand and deal with alc.
or drug ‘s cues as well as craving.

13. Relapse Prevention Management
4- help the patient to understand and deal with
social pressure to use.
5- help the patient to develop and enhance a
supportive network.
6- help the patient in dealing with precipitant
factors.
7- role of medical treatment.????

14. Community Based Treatment:
- Definitions and conceptualizations.
Community action programmes
( 1ry,2ry,3ry prevention, NGOs,
Government).

15. Community Based Treatment:
Community Care:
- Process, Pathways.????
- Family.
- Stake holders.
- Patients, high risk populations.
- Ex- addict.
- Cooperation with authority ( police, court,
legislations).
- Medications.

16. ‫شكرا علي حسن‬