Creating a Relapse Prevention Plan
“Relapse prevention began with the work of Marlatt and Parks (1982) and Marlatt and Gordon (1985) who noted that after success with the treatment of various behavioural problems – such as smoking, drinking, overeating, drug addiction, obsessive compulsive disorder and gambling – clients very often fell back into their old behaviours. In fact, between 50% and 90% of clients who are successful in the reduction of overeating, smoking and other problem eventually relapse.
Relapse is not the same as treatment failure, in which there is little or no progress at all. Rather, the terms “lapse” and “relapse” refer to slight or almost total increases in problem behaviours, after improvement has already been shown. In all likelihood, this occurs because we don’t focus formally on consolidating and maintaining treatment gains. Thus, an important final step in any anger management program is preparing clients, in advance, for the likely scenario that anger will reappear.”(Kassinove & Tafrate, 2002, p. 245-246)
A relapse prevention plan can assist clients in managing setbacks as they occur throughout the process of change. Relapse prevention is a form of self-management. Without such a plan, a ‘lapse’ may provoke a return to old behaviours.
According to Parks & Marlatt (2000) the cornerstone of relapse prevention is the acquisition of effective coping skills. Coping skills enable the client to better understand and manage lapses as they occur. Coping skills can be developed via the following processes.
It may be helpful for clients to establish an initial awareness and understanding of the likelihood of lapses occurring throughout their change process. By acknowledging that lapses are probable and common, clients are less likely to catastrophise the lapse or abandon treatment due to a perceived lack of progress.
Clients can benefit from sharpening their awareness of high-risk triggers. Particular people, situations or environments are likely to be more challenging for clients who are seeking to manage their anger. By raising awareness of these triggers, clients can commit to engaging in pre-confrontational strategies. This means that clients can mentally and physically prepare for triggers, through relaxation, soothing self-talk and other cognitive strategies.
Cognitive distortions that lead to all-or-nothing thinking can challenge the client who experiences a lapse. As such, it can be valuable to work with clients on being able to acknowledge shades of grey. That is, to be able to experience a lapse without abandoning the long-term plan.
Caring for one’s self can play a vital role in the way in which a lapse is firstly perceived, and then managed. Clients who are well rested, healthy and have managed their time and priorities well are far better positioned to approach the management of a lapse with a confident mindset.
Client Resource: Tips for Managing Anger Relapses
Everyday stressors, such as work, children and tight schedules can heighten anxiety and contribute to feeling overwhelmed. When we are stressed, we are less likely to respond in a measured and considered fashion to provoking situations, choosing instead to respond with impulsive expressions of our immediate feelings.
To avoid this result, it can help to be mindful of your schedule. Avoid taking on responsibilities or favours that you don’t have time for. Use spare time to pursue leisure and relaxation activities. Prioritise your self-care and maintain a balanced lifestyle. Of course, the achievement of these aims can be difficult when the demands on our time are so great.
Nonetheless, without paying careful attention to our lifestyle habits, we are vulnerable to the effects cumulative stress can have on our ability to manage expressions of anger.
Thinking Only of Short-Term Gains
A confrontational or provoking situation can ignite reactions in individuals that have far-reaching and long-term effects on relationships. This often occurs during the heat-of-the-moment as tensions and anxieties blind us to the longer-term consequences. It can therefore be highly beneficial to plan, plan, plan for an anticipated encounter.
An awareness of likely triggers enables you to predict which situations are likely to be challenging or confrontational for you. Imagine, for example, that you have just received another credit card bill in the mail – you have overspent and know that your partner will not be pleased. Instead of waiting for your partner to react before formulating your response, you could spend a few moments considering how you could best respond to this likely future event.
You may, therefore, decide it is best to take accountability, to apologise and offer a commitment to lessen spending in the future. This, of course, is preferable to a response made in haste that is defensive, attacking, or derogatory.