Addiction Assessment and 

Intervention Services

When is the Risk of Relapse the Highest?

In my experience, the risk is greatest is in the first few days or weeks after discharge from a treatment centre. Research seems to confirm that the first 30 days after treatment is the high-risk period.

The addict feels so good and clean and alive again, as they exit treatment. Unfortunately, this very feel-good affect can set them up to "top up" the natural high of recovery - or bust out of the mold. On the other hand there is the temptation (with euphoric recall) to just use again and see if it will be different this time - maybe they can control the addiction and/or the negative impact in their lives.

For a recent patient who completed a 90 day inpatient programme, and relapsed the same night after discharge, the problem was what he called the "bubble". He felt too cut off from reality. Too safe and secure - with very limited access to his drug of choice.

In debriefing this patient, however, it was clear that there were many other factors at play. For example, he hoarded pocket money given to him during the programme (from his mother as agreed) and so he had a nice down-payment for his first "planned" relapse.

Relapse is never an event but usually a gradual process with multiple multiple factors - and relapse is an integral part of the disease of addiction - and just as complex.

What is the Best Relapse Prevention Intervention?

The answer is simple, yet takes planning, work and humility. Join a Twelve Step group and hang out with those in good recovery and get a sponsor as soon as possible.

I've been teaching and preaching this since working in my first rehab in 1984 - and this recipe has never really changed much in most of the treatment programmes across the world. In spite of this message, and available ongoing care groups and services, the addict in early recovery is very vulnerable, on the one hand, and on the other hand, still wants to do recovery and life on their own terms.

Defiance, pride, feeling stigmatized, ingrained habits, a web of old connections and other factors make the transition phase into reality very challenging. Some emerge from treatment very reluctant to go to NA, AA or other Twelve Step groups - including ongoing care services provided by the rehab.

The Role of the Recovery Coach

The case study and factors sketched above, clarify the need for the Recovery Coach in many cases. How can the Recovery Coach help?

• Supportive Accountability: Provide a supportive relationship to help the individual, family and employer take action on the recovery planned in treatment.
• Stretch: Challenge the individual to take the risks required to get into and stay in solid recovery.
• Relapse Prevention: Identify early warning signs of possible relapse, in order to be proactive.
• Coaching: Coach the individual based on the Twelve Steps (my preferred approach), if this is part of the agreed recovery plan - and especially when there is no sponsor yet.
• Foster Initiative: Create an open space for the individual to determine an agenda for sessions.
• Systematic Action and Change: Formulate tasks with the individual to foster recovery.
• Exploring Talents and Strengths: Building confidence and self-worth is key to off-setting the damages that addiction does to the emotions, thinking and personality.
• Relapse Intervention: In the event of a relapse, we need to take prompt action, debrief, reassess the recovery plan and sometimes take drastic action to break the downward spiral. This could include detoxification, assessment for medication or re-admission to an outpatient programme or treatment facility.

Recovery Coaching can be an open-ended agreement with the client or a specified period of time or number of sessions. This service is not only for the person in recovery, but also for the family that has been devastated by the addiction and often played an enabling role in during the addictive process. As mentioned before, addiction is a systemic disease and therefore sustainable change requires the involvement of all who need to be a part of the "solution".

Contact me via the tab to the right to discuss your needs.