Overview of Structured Relapse Prevention (© 2009 CAMH)
Both the initiation of change and maintenance of change phases make use of client self-monitoring forms. These forms record weekly homework assignments (i.e., anticipated triggers, proposed coping responses, actual coping used and outcomes) and document weekly goal setting, daily recording of urges and temptations (PDF only), level of confidence experienced, details of any lapse or relapse that occurs, and specific coping exercises.
The Situational Confidence Questionnaire (SCQ-8) (PDF only) is administered periodically throughout treatment to monitor the client’s growth in confidence in coping with substance use triggers across each of eight risk areas for relapse.
These self-monitoring tools can help focus further homework assignments on specific types of substance use triggers with which the client reports a continuing lack of confidence. An attempt is made to raise the client’s confidence and self-efficacy in all major areas of identified risk before he or she is discharged from treatment.
The initiation and maintenance phases also include a comprehensive set of 18 coping skills training exercises to help clients reflect on strengths and areas for improvement. Each of these reflective exercises begins with a short introduction, and topics include coping with cravings, early coping strategies, increasing social support, refusing alcohol and other drugs, assertiveness, sexual relationships and dating, and money issues. Many of these exercises can also be used with clients who have concurrent substance use and mental health problems; however, specially adapted versions of five of the topics are included in the SRP manual as well.
- Motivational interviewing
- Individualized treatment planning
- Initiation of change
- Maintenance of change
Self-monitoring tools and coping skills exercises
Structured Relapse Prevention for clients with concurrent disorders
Adapting SRP to diverse clinical settings and client needs