Relapse Prevention for Dual Disorders

Dr. DawnElise Snipes ★AllCEUs★ Unlimited Counselor Training
Dr. DawnElise Snipes ★AllCEUs★ Unlimited Counselor TrainingDirector AllCEUs Continuing Education & Certification Training um AllCEUs.com
Relapse Prevention Part I
Dr. Dawn-Elise Snipes PhD, LMHC, LPC, NCC
Objectives
 Define Relapse
 Identify Relapse Warning Signs
 Identify Strengths
 Learn about how your issue developed
Relapse Definition
 Relapse is the return to something that has been previously
stopped
 Relapse is multidimensional
 Emotional
 Mental
 Physical
 Social
 Review your Distress vs. Happiness worksheet.
 A relapse is when you start returning to any of these people,
places, things, behaviors or feeling states.
Emotional Relapse
 In emotional relapse, your emotions and behaviors
become negative and unpleasant.
 You start finding it difficult to experience pleasure
 What triggers your negative emotions
(Anger/resentment/jealousy/guilt; anxiety/fear/stress;
depression)
 Things/Media
 People
 Places
 Events
Emotional Relapse
 Negative emotions make us uncomfortable
Identify the emotion, explore why you are feeling that way and take
steps to fix the problem
You can become stuck in the emotion, sometimes
 Nurturing and blowing it out of proportion
 Compounding it with other emotions like anger and guilt
 Personalizing it
 Trying to escape from it
Remember that emotions are just cues like a stoplight.
You feel how you feel in the moment
You can choose to change or improve the next moment
Preventing Emotional Relapse
 Practice mindfulness
 Increase positive experiences (real and guided imagery)
 Keep a gratitude journal
 Avoid personalizing something that may not be about you
 Remember that…
 Negative emotions are the mind’s way of telling us to get off our butts
and do something—Like our car’s idiot light or hunger pangs
 Dwelling on, nurturing, avoiding or hiding from negative emotions
never makes anything better
 You can *choose* to feel and fix, or relapse and repeat
Activity
 List 10 things that you chose to get anxious or angry about over
the last week
 Why did you get upset? (What was your mind telling you needed
to be fixed)
 Did holding on to the upsetness do any good?
 What was your initial reaction, and was it helpful?
 What could you do differently next time to either
 Change/fix the situation (Improve the next moment)
 Change how you feel about the situation (Walk the middle path)
 Let it go (Radical Acceptance)
Mental Relapse
 In mental relapse there's a war going on in your mind.
 Part of you wants to stay positive, but part of you is struggling
with tolerating the distress.
 The signs of mental relapse are:
 Focusing on the negative
 Having a pessimistic/helpless/hopeless attitude
 If you had an addiction, you may also be:
 Thinking about people, places, and things you used with
 Glamorizing your past use
 Lying to yourself and others
 Justifying your behaviors
 Minimizing the impact of one (drink/hit/bet etc.)
 “Screw It” attitude
Mental Relapse
 What types of things trigger negative thoughts?
 Things/Media
 People
 Places
 Events
 What thoughts do you have that make you feel
 Angry/irritated/resentful
 Guilty
 Envious
 Scared/Anxious/Worried/Stressed
Identifying Unpleasant Thoughts
Loss of Control/
The Unknown
Failure Isolation/
Rejection
Death
Angry/
Irritated
/Resentful
Guilty
Envious/
Jealous
Scared/
Anxious/
Worried/
Stressed
Identify and address the thoughts that trigger the emotions related to each
fear/threat
Preventing Mental Relapse
 KISS: Keep It Simple Stupid
 Trying to change too many things at once can lead to failure
 Often some of simplest things can have the greatest impact
 Prevent and address vulnerabilities that can make you
focus on negative or have a strong, negative emotional
reaction
 Good Orderly Direction
 Your life is a road map
 The destination is recovery and happiness
 Before you act, think whether that keeps you on the right road, or is
an unplanned detour
 Maintain Head-Heart-Gut Honesty (Rational, Emotional, Wise Mind)
Social Relapse
 Symptoms
 You have returned to the old people and places who co-sign on your
b.s.
 You have withdrawn from your social supports
 You have become self-centered
 You have withdrawn
 What triggers your social relapse
 People
 Places
 Things
 Events
Preventing Social Relapse
 Contact your social support(s) on a daily basis for the first
3 months
 Keep a business card in your wallet with the names and
numbers of 3 social supports
 Change your phone number (if possible) and destroy
contact information for people who might trigger a relapse
 Find at least one prosocial activity to do each week ---
volunteer, church, go to the gym
Physical Relapse
 Physical relapse is characterized by:
 Fatigue
 Increased anxiety
 Difficulty sleeping
 Neglecting physical health (sleep, exercise, nutrition, medication)
 If there was also addiction…
Cravings
Dreams about the drug
Preventing Physical Relapse
 HALT
 Hungry
Nourish your body with proper nutrition
Nourish your mind with activities and things that increase “happy chemicals”
 Angry/Anxious
Reduce chronic stress
 Lonely
Nurture social supports to buffer stress
Be willing to ask for help
 Tired
Get sufficient quality sleep
Address issues such as sickness and pain that prevent quality sleep
Review Strengths
 What is life like when you are happy?
 What is different?
 What is the same?
 List three ways you cope with stress.
 What activities do you like to do?
 What are your positive qualities and strengths?
Review Prior Relapses
 What was happening before the relapse?
 What triggered the relapse?
 Relapses occur when old behaviors are more rewarding or
stronger than new ones.
 What became more rewarding than your recovery program?
 Before you relapse, what changes in
 Your emotions
 Your thoughts
 Your behaviors
 Your interactions with others?
 What have you learned?
Relapse Prevention Planning
 Include time in the morning and at night to use
mindfulness skills to “get grounded”
 Identify and prevent or mitigate vulnerabilities each day
 Avoid alone, idol time if your mind tends to wander to dark
places
 Incorporate positive experiences each day
 Set realistic daily goals
 Give yourself credit for positive accomplishments
Summary
 Relapse triggers can be emotional, mental, physical or
social
 For each trigger you identified, describe at least 1 way you
can deal with it
 Practice mindfulness each day can help you become aware
of your personal, daily vulnerabilities for relapse
 For each general category, identify 3 things you can do to
continue on your journey toward happiness
1 von 19

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Relapse Prevention for Dual Disorders

  • 1. Relapse Prevention Part I Dr. Dawn-Elise Snipes PhD, LMHC, LPC, NCC
  • 2. Objectives  Define Relapse  Identify Relapse Warning Signs  Identify Strengths  Learn about how your issue developed
  • 3. Relapse Definition  Relapse is the return to something that has been previously stopped  Relapse is multidimensional  Emotional  Mental  Physical  Social  Review your Distress vs. Happiness worksheet.  A relapse is when you start returning to any of these people, places, things, behaviors or feeling states.
  • 4. Emotional Relapse  In emotional relapse, your emotions and behaviors become negative and unpleasant.  You start finding it difficult to experience pleasure  What triggers your negative emotions (Anger/resentment/jealousy/guilt; anxiety/fear/stress; depression)  Things/Media  People  Places  Events
  • 5. Emotional Relapse  Negative emotions make us uncomfortable Identify the emotion, explore why you are feeling that way and take steps to fix the problem You can become stuck in the emotion, sometimes  Nurturing and blowing it out of proportion  Compounding it with other emotions like anger and guilt  Personalizing it  Trying to escape from it Remember that emotions are just cues like a stoplight. You feel how you feel in the moment You can choose to change or improve the next moment
  • 6. Preventing Emotional Relapse  Practice mindfulness  Increase positive experiences (real and guided imagery)  Keep a gratitude journal  Avoid personalizing something that may not be about you  Remember that…  Negative emotions are the mind’s way of telling us to get off our butts and do something—Like our car’s idiot light or hunger pangs  Dwelling on, nurturing, avoiding or hiding from negative emotions never makes anything better  You can *choose* to feel and fix, or relapse and repeat
  • 7. Activity  List 10 things that you chose to get anxious or angry about over the last week  Why did you get upset? (What was your mind telling you needed to be fixed)  Did holding on to the upsetness do any good?  What was your initial reaction, and was it helpful?  What could you do differently next time to either  Change/fix the situation (Improve the next moment)  Change how you feel about the situation (Walk the middle path)  Let it go (Radical Acceptance)
  • 8. Mental Relapse  In mental relapse there's a war going on in your mind.  Part of you wants to stay positive, but part of you is struggling with tolerating the distress.  The signs of mental relapse are:  Focusing on the negative  Having a pessimistic/helpless/hopeless attitude  If you had an addiction, you may also be:  Thinking about people, places, and things you used with  Glamorizing your past use  Lying to yourself and others  Justifying your behaviors  Minimizing the impact of one (drink/hit/bet etc.)  “Screw It” attitude
  • 9. Mental Relapse  What types of things trigger negative thoughts?  Things/Media  People  Places  Events  What thoughts do you have that make you feel  Angry/irritated/resentful  Guilty  Envious  Scared/Anxious/Worried/Stressed
  • 10. Identifying Unpleasant Thoughts Loss of Control/ The Unknown Failure Isolation/ Rejection Death Angry/ Irritated /Resentful Guilty Envious/ Jealous Scared/ Anxious/ Worried/ Stressed Identify and address the thoughts that trigger the emotions related to each fear/threat
  • 11. Preventing Mental Relapse  KISS: Keep It Simple Stupid  Trying to change too many things at once can lead to failure  Often some of simplest things can have the greatest impact  Prevent and address vulnerabilities that can make you focus on negative or have a strong, negative emotional reaction  Good Orderly Direction  Your life is a road map  The destination is recovery and happiness  Before you act, think whether that keeps you on the right road, or is an unplanned detour  Maintain Head-Heart-Gut Honesty (Rational, Emotional, Wise Mind)
  • 12. Social Relapse  Symptoms  You have returned to the old people and places who co-sign on your b.s.  You have withdrawn from your social supports  You have become self-centered  You have withdrawn  What triggers your social relapse  People  Places  Things  Events
  • 13. Preventing Social Relapse  Contact your social support(s) on a daily basis for the first 3 months  Keep a business card in your wallet with the names and numbers of 3 social supports  Change your phone number (if possible) and destroy contact information for people who might trigger a relapse  Find at least one prosocial activity to do each week --- volunteer, church, go to the gym
  • 14. Physical Relapse  Physical relapse is characterized by:  Fatigue  Increased anxiety  Difficulty sleeping  Neglecting physical health (sleep, exercise, nutrition, medication)  If there was also addiction… Cravings Dreams about the drug
  • 15. Preventing Physical Relapse  HALT  Hungry Nourish your body with proper nutrition Nourish your mind with activities and things that increase “happy chemicals”  Angry/Anxious Reduce chronic stress  Lonely Nurture social supports to buffer stress Be willing to ask for help  Tired Get sufficient quality sleep Address issues such as sickness and pain that prevent quality sleep
  • 16. Review Strengths  What is life like when you are happy?  What is different?  What is the same?  List three ways you cope with stress.  What activities do you like to do?  What are your positive qualities and strengths?
  • 17. Review Prior Relapses  What was happening before the relapse?  What triggered the relapse?  Relapses occur when old behaviors are more rewarding or stronger than new ones.  What became more rewarding than your recovery program?  Before you relapse, what changes in  Your emotions  Your thoughts  Your behaviors  Your interactions with others?  What have you learned?
  • 18. Relapse Prevention Planning  Include time in the morning and at night to use mindfulness skills to “get grounded”  Identify and prevent or mitigate vulnerabilities each day  Avoid alone, idol time if your mind tends to wander to dark places  Incorporate positive experiences each day  Set realistic daily goals  Give yourself credit for positive accomplishments
  • 19. Summary  Relapse triggers can be emotional, mental, physical or social  For each trigger you identified, describe at least 1 way you can deal with it  Practice mindfulness each day can help you become aware of your personal, daily vulnerabilities for relapse  For each general category, identify 3 things you can do to continue on your journey toward happiness