Relapse Prevention and Accountability
Dr. Dawn-Elise Snipes
Counselor Toolbox Podcast
CEUs/OPD/CPDs are available for this presentation at https://allceus.com/member/cart/index/product/id/964/c/ in the US or for clinicians in Australia at https://allceus.com/member/cart/index/product/id/964/c/
Objectives
~ Review techniques for writing a relapse prevention plan that emphasizes accountability
What is Accountability
~ Accountability is the ability to demonstrate follow through on a promise or contract
~ How do you hold your kids accountable?
~ How do you hold employees or contractors accountable?
~ How do you hold yourself accountable?
~ Why is it more difficult to be accountable to yourself?
Congratulations
~ Upon entering treatment, have clients develop a relapse prevention plan (which will be modified and built upon)
~ Introduction (Page 1)
~ Have client āintroduceā themselves. āI am Rose. I am a loving, loyal, determined mother of 3 beautiful children, and I am dedicated to maintaining my recovery for the following reasonsā(State the personal benefits of recovery):
~ When I am in recovery, I am [emotionally], because ___
~ When I am in recovery, I am [mentally] , because ___
~ When I am in recovery, I am [physically], because ___
~ When I am in recovery, my relationships with my kids is ____, because ___
~ When I am in recovery, my relationships with my friends is ____, because ___
~ When I am in recovery, my relationships with ā¦
~ The 3 most important reasons I am in recovery areā¦
Relapse Prevention Planning
~ Types of Relapse
~ Emotional
~ Mental
~ Behavioral
~ Written Relapse Prevention Plan
~ Identify your personal relapse warning signs and interventions (Page 2)
~ Emotional
~ What feelings indicate that you are falling back into old patterns?
~ Mental/Attitudinal
~ What attitudes or thoughts indicate that you are falling back into old patterns?
~ Behavioral
~ What behaviors indicate that you are falling back into old patterns?
Relapse Prevention Planning
~ Written Relapse Prevention Plan
~ Identify triggers and vulnerabilities and methods for prevention and mitigation (Page 3)
~ Emotional (Anger*, Anxiety*, Depression, Griefā¦)
~ Mental (Distress Intolerant Thoughts)
~ Physical (Exhaustion, hunger, pain)
~ Social (People or social situations that trigger you, Social situations that put you on edge (parties, crowdsā¦))
~ Environmental (sights, sounds, smells, times of day, places, decorations/holidays, anniversariesā¦)
RPP contā¦
~ Written Relapse Prevention Plan
~ Identify 5 people and/or organizations who could be a vital part of your recovery, why, and how and when you will contact them.(Page 4)
~ Create a vision of a rich and meaningful life to guide the development of a comprehensive recovery lifestyle plan, because relapse prevention is about building a recovery lifestyle, not just preventing triggers. (Page 5)
Accountability
Putting It Together
~ The actual plan (Page 6 and beyond)ā¦Set SMART goals and rewards
~ Time management plan that includes (see Page 5)
~ When you will sleep and how you will ensure it is quality sleep
~ How you will ensure you are eating a nutritious diet and drinking enough water
~ Your work schedule
~ Household chores and other misc. to-dos
~ When you will spend time with the children
~ When you will connect with your inner circle
~ Time for recreation
~ A twice daily mindfulness check-in with accountability buddy
~ Recovery related activities (aftercare, support groups, coaching)
Putting It Together
~ The actual plan (Page 6 and beyond)ā¦Set SMART goals and rewards
~ A contract with family/roommates to practice mindfulness, use red flags and be respectful of triggers
~ A financial plan
~ A statement of things you will NOT do during the next 12 months without extensive consultation. (i.e. make major decisions or purchases, get into a relationship, change jobsā¦)
Techniques for Accountability
~ It is more productive to hold people accountable for doing something than NOT doing something
~ Aim for progress not perfection
~ Make incentives rewarding to the person
~ Ask the person what has worked in the past
~ Walk the fine line between accountability and micromanaging or helicoptering
Techniques for Accountability
~ Accountability Techniques
~ Activity buddy (workouts, meetings)
~ Text or email check-ins (HIPAA caveats)
~ Participatory planning and meetings with the support system
~ Signed meeting slips
~ Contingency contracts (Ifā¦thenā¦)
~ Chips (12-Step)
~ Logging app to be shared with (coach, sponsor, therapist)
~ Forum or chat room daily check-in (HIPAA caveats)
~ Drug testing / Weigh ins (this is a negative accountability)
Accountability Apps
~ Stickk
~ Beeminder
Summary
~ Relapse prevention planning should begin at admission (when the person has stopped using, or made the decision to try to change)
~ Relapse prevention plans are ineffective if they are not followed
~ It takes at least 6 months to get in the groove of a recovery lifestyle
~ Accountability will help people maintain motivation through social, behavioral and/or financial reinforcement
~ Self-accountability rarely works 100% of the time so it is imperative to involve at least 1 other person~ https://allceus.com/CE/course/view.php?id=211