Relapse Prevention Information
In the course of illness, relapse is a return of symptoms after a period of time when no symptoms are present. Any strategies or treatments applied in advance to prevent future symptoms are known as relapse prevention.
Purpose of Relapse Prevention
When people seek help for mental disorders, they receive dual diagnosis treatment that, hopefully, reduces or eliminates symptoms. However, once they leave dual diagnosis treatment, they may gradually revert to old habits and ways of living. This results in a return of symptoms known as relapse. Relapse prevention aims to teach people strategies that will maintain the wellness skills they learned while in treatment.
Relapse prevention in mental disorders is crucial not only because symptoms are detrimental to quality of life but also because the occurrence of relapse increases chances for future relapses. In addition, with each relapse, symptoms tend to be more severe and have more serious consequences.
Relapse is a concern with any disorder, whether physical or psychological. Cancer is a prime example of a physical condition where relapse is common, either after a short period or many years of remission (being symptom-free). Psychological disorders can follow a similar pattern, and certain psychological disorders tend to have a higher rate of relapse than others. Addictive disorders, such as alcohol and drug abuse, smoking, overeating, and pathological gambling, are well known for high levels of relapse. Many addictions involve a lifestyle centered around the addictive behavior. In such cases, individuals must not only discontinue the addictive habit, they must also restructure their entire lives in order for changes to last. Such vast changes are difficult at best, approaching impossible in the worst scenarios. For example, an individual with a drug addiction may live in a neighborhood where drugs are prevalent but may lack the resources to move. According to recent statistics, relapse rates are approximately 33% for people who gamble pathologically (within three months of treatment), 90% for people who quit smoking, and 50% for people who abuse alcohol. Within one year of treatment, people struggling with obesity typically regain 30% to 50% of the weight they lost.
Affective disorders, such as depression and anxiety, also have high rates of relapse. People with affective disorders are thought to engage in self-defeating, negative thought patterns that occur more or less automatically. These thought patterns affect behavior, resulting in unproductive or negative consequences. Negative consequences are regarded by such individuals as proof that their original self-defeating thoughts must be correct. The thought-behavior pattern becomes a repetitive cycle, with negative thoughts resulting in negative behavioral outcomes, and consequences of negative behavior encouraging more self-defeating thoughts. This cycle is extremely difficult to break because it becomes a habitual way of responding to the world that occurs almost without awareness. Relapse rates for depression are reportedly as high as 80% so relapse prevention is critical..
Relapse among people who commit sex offenses is a constant safety concern for those in the community. However, some statistics show that this population has a very low rate of relapse. A recent report by Robin J. Wilson and colleagues indicated rates as low as 3.7% to 6.3%. This same report stated that, among various criminal offenses, those who commit sex offenses relapse at lower rates than those who commit general offenses. Other professionals may not necessarily agree with this study, however. Those who commit sex offenses are considered at a higher risk for relapse if they display little insight into the impact of their crime. Those at high risk of committing a sex offense are not typically released back into the community.
For many types of disorders, initial dual diagnosis treatment is often effective at eliminating the unwanted behavior. However, these effects are rarely maintained long-term without some type of relapse prevention planning. Results of medications are similar; symptoms are alleviated, but once the medication is discontinued, symptoms return unless the individual has had some type of training in coping with his or her disorder and that training has been effective.
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