Hand in hand with the idea of motivational interviewing and the conducting of succinct assessments is the concept of relapse prevention or relapse management. Many therapeutic ventures, such as groups, counselling, and programs are modelled around the idea of relapse prevention. Once a decision for change is made and assessment completed, the most useful approach to take with young people is Relapse Prevention.
Historically in AOD literature a distinction was made between the terms "lapse" and "relapse". "Lapse" was thought to be a return to use of any kind, and is obviously more easily applied to those aiming for abstinence. In comparison, the term "relapse" was used to describe the process where a person would return to previous levels or patterns of problematic AOD use. Obviously, with the increased acceptance of harm minimization as a more realistic treatment goal the term lapse has become a less used term.
Relapse is a common occurrence, with some studies claiming that up to 61 percent of people will have multiple periods of relapse. Relapse commonly occurs within one month following treatment, however it is not unusual for dependent people to relapse 12 months after treatment. The commonly accepted figure of about 50% relapse within the first year after treatment.
Obviously, the nature of the treatment (residential, family work, casework, counselling, recreational, pharmacotherapy etc) and associated processes (active continuing care), the severity of dependence and the presence of social supports will often determine this final figure, however, it is fair to say that relapse is the most likely outcome from any episode of treatment. In working with young people with AOD related issues it is critically important to help young people plan and respond well to this somewhat likely result.
This relapse does not occur in a vacuum, but there are many contributing factors. Generally, people will relapse when issues arise in one of three areas and thus relapse prevention focuses on these main areas of relapse, which are:
- intra-personal - eg feelings and moods
- inter-personal - eg relationships
- situational / cues - eg places, times
Thinking back on your work with young people in this area:
What do you think might be some of the feelings, moods and memories that could be related to the return to substance use by a young person?
What might be some of the interpersonal cues related to the return to substance use by a young person?
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Working with Young People with Alcohol or Other Drug Issues: A self-paced learning package Published: 2006 Funded by NSW Drug & Alcohol Workforce Development Council. Written & compiled by Kristy Delaney, YAPA, and Matt Stubbs & John Howard, Ted Noffs Institute. Additional material by Nick Manning, YAPA, & by Shopfront Youth Legal Centre. Opinions are the author's.
Be careful! YAPA and the authors took reasonable care to ensure that this information was correct at the time of publishing. However health information, and government regulations, laws and standards are complex and changing. The authors may not have health, safety, or legal qualifications, and information provided is general - it is not specific health, legal or professional advice. Do not rely on it - check with other publications and authorities and if necessary get qualified, medical, legal or professional advice for your situation.
