Relapse Prevention

By: Ahmed Albehairy, M.D

Consultant Psychiatry

Relapse Prevention

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

Recovery:

Recovery =

Abstinence +

Change of Intra & Interpersonal fields +

Time.

Recovery:

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

Recovery:

Types :

- Full recovery.

- Partial recovery .

Relapse and lapse

Relapse Relapse

Failure to continue the process of

change.- Warning signs.

- Out come.

LapseLapse

Event of use after a period of

abstinence.- Little or no

warning signs.- End quickly or

leads to relapse.- Out come.

Relapse Precipitants

I- intrapersonal determinants.

II- interpersonal determinants.

III- other important aspects.

Relapse PrecipitantsI- intrapersonal determinants.

- Negative emotional state .

- Physical state.

- Positive emotional state.

- Testing of personal control.

- Usage and temptation.

Relapse PrecipitantsII- 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.

Relapse PrecipitantsIII- 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.

Relapse PrecipitantsIII- 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.

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.

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.????

Community Based Treatment:

- Definitions and conceptualizations.

Community action programmes

( 1ry,2ry,3ry prevention, NGOs, Government).

Community Based Treatment:

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

legislations).- Medications.

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