“Most people begin to relapse through shifts in thoughts, personality traits, or behaviors,” explains Anna O’Kinsky, APN, a psychiatric advanced practice nurse at Princeton House’s Eatontown and Hamilton sites. “Relapse planning helps patients understand that those changes will happen. We then identify what can trigger those changes and determine how to apply new ways of responding.”
According to O’Kinsky, it takes approximately 18 months for the brain to fully withdraw from substance use. During this time, someone in recovery may notice aggravations that didn’t seem present when they were using, or perhaps a buildup of daily frustrations increases stress levels. When they don’t focus on the bigger picture, depression may set in. This, in turn, can lead to sleep issues, the inability to take an active role in life, feelings of guilt and failure, and a resentment for recovery. At that point, it’s easy to lose control or go on autopilot and use again.
But this cycle can be interrupted when relapse planning is integrated into treatment from the start. The warning signs are different for each patient, so providing education and examining patterns can help identify changes in thoughts and behaviors. From there, providers can work with patients to build a customized toolkit for dealing with roadblocks.
As part of this process, O’Kinsky asks patients to complete a wallet card with their answers to these questions:
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I know I’m in trouble with recovery when: When I experience: I tend to think: I tend to feel: I have the urge to: I do: Recovery activities I can use to manage this are: |
For a printable PDF version of this wallet card for your patients, click here.
O’Kinsky also offers this advice for behavioral health providers treating those in recovery:
- Help patients understand that change is uncomfortable.
- Focus on compassion and avoid negativity around setbacks.
- Know that a patient relapse does not reflect a provider’s ability.
- Likewise, in a relapse situation, patients can beat themselves up or build themselves up.
- It’s a decision that should be considered before relapse happens.
- Acknowledge the positive steps throughout the recovery journey, even when setbacks happen or a patient is not ready for abstinence. This harm reduction approach celebrates strengths and is a softer way to motivate further change.
“Recovery is like going up and down in an elevator,” says O’Kinsky. “Patients have to take it one day at a time and identify where their thoughts, feelings, and actions are on each day. With time, that ride can lead to a place with more joy and more peace in life.”
