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Structured relapse prevention

Relapse prevention is based on a model that sees relapse as a natural part of the process of change and as an opportunity for people to enhance their understanding of their behaviour. Relapse prevention treatment models include various cognitive and behavioural approaches that address specific steps in the relapse process.

Structured relapse prevention (SRP) helps people learn how to cope with daily substance use triggers and risk situations.

Where is SRP used?

SRP is designed for individuals or groups with moderate to severe substance use problems who are willing to work with a therapist toward changing their use of alcohol or other drugs.

SRP has been used as a stand-alone 8–12 session outpatient intervention, as an aftercare component to inpatient treatment and as a tool for counselling clients who are ambivalent about changing their substance use.

SRP has also been used with individuals and groups in various service contexts, such as substance use treatment services, employee assistance programs, probation and parole settings and mental health settings.

SRP program components

A complete SRP program includes:

  • clinical assessment with personalized feedback
  • one or more motivational interviewing appointments before SRP counselling begins
  • an individualized treatment plan developed with the client. The plan includes:
    • a treatment contract
    • a hierarchy of substance use triggers the client will address through homework assignments
    • client goal-setting and self-monitoring
  • 8–12 counselling sessions (individual or group) consisting of:
    • initiating change homework assignments
    • maintaining change homework assignments.

Download a treatment contract template [pdf].

Download the Identifying Problem Substance Use Situations template [pdf].

Download the Initiation of Change homework assignment template [pdf].

What happens in SRP sessions?

SRP is a flexible program designed to accommodate clients' different needs and treatment goals.

SRP counselling focuses on engaging the client to:

  • assess goals and commitment to change
  • design an individualized treatment plan
  • identify personal strengths and resources
  • learn to anticipate substance use triggers and to develop alternative coping skills
  • develop confidence by practising coping skills in real-life risk situations
  • make connections between substance use and other life situations
  • self-counsel by anticipating risk situations and planning coping strategies.

Watch this video about relapse prevention planning in behavioural addiction.

Evidence summary

Dr. Helen Annis developed this cognitive-behavioural approach to outpatient substance use counselling in the late 1980s at the Addiction Research Foundation (now part of the Centre for Addiction and Mental Health). See:

Annis, H.M, Schober, R. & Kelly, E. (1998). Matching addiction outpatient counseling to client readiness for change: The role of structured relapse prevention counseling. Experimental and Clinical Psychopharmacology, 4(1), 37–45. doi: 10.1037/1064-1297.4.1.37

Resources

Guides and manuals

Herie, M.A. & Watkin-Merek, L. (2006). Structured Relapse Prevention: An Outpatient Counselling Approach (2nd ed.). Toronto, ON: Centre for Addiction and Mental Health.

Tools

Assessment tools

Inventory of Drug-Taking Situations (IDTS-8) [pdf]

Situational Confidence Questionnaire (SCQ-8) [pdf]

Templates

Daily Diary template [pdf]

Early Coping Strategies template [pdf]

Feedback about Goal Setting and Commitment to Change template [pdf]

Initiation of Change homework assignments template [pdf]

Treatment Contract template [pdf]

 


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