Relapse PreventionBy: Ahmed Albehairy, M.DConsultant 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 Lapse Failure to continue Event of use after a the process of period of change. abstinence.- Warning signs. - Little or no warning signs. - End quickly or leads to relapse.- Out come. - Out come.
Relapse PrecipitantsI- 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 Management4- 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.