Home > New developments preventing relapse for drug and alcohol dependent adults.

Hill, Robert and Harris, Jennifer and Cloherty, Monique and Cooper, Warren and Graham, Jamie Sue and Wanigaratne, Shamil [National Treatment Agency (UK)] . (2009) New developments preventing relapse for drug and alcohol dependent adults. London: National Treatment Agency.

URL: http://www.nta.nhs.uk/pirl-preventing-relapse.aspx

A compendium of psychological therapies for preventing relapse; a sessional programme based on new developments in CBT approaches to relapse prevention for substance using clients in either group or individual sessions.

Introduction:
This gives an overview of the ten modules, the theoretical and research base to them together with training requirements. The ten modules are clustered into:
• Modules for drug users and alcohol users (1-6)
• Modules for clients with more complex needs or more chaotic drinking and drug use (7-10).

Staff logbook:
This is a log of experiences and a checklist of skills and competencies of the staff co-facilitating any of the modules described below. It records whether staff members have read the necessary information and materials for the topic, whether they have received training in the topic, observed the session delivered by someone already trained and whether or not they have co-facilitated each of the sessions before taking responsibility for leading on running a module.

Module 1: Three Ways of Managing Your Emotions:
For drug and alcohol users. This module offers three ways of managing emotions, using cognitive, behavioural or mindfulness approaches. It aims to develop a better understanding of emotions and how to cope better with painful emotions.

Module 2: Thinking Choices:
For drug and alcohol users. This module consists of six sessions:
• Blowing things out of proportion
• Jumping to conclusions
• Over-generalisation
• Inner bully
• Negative glasses
• Thinking in extremes.
The aims of the sessions are to increase understanding of how ways of thinking are important to how we feel and what we do, how unhelpful ways of thinking can be changed and how thinking choices can help us cope better.

Module 3: Mindfulness:
For drug and alcohol users. This module introduces participants to the practice of mindfulness and hopefully develop their awareness of how this could be used in dealing with painful emotions or tensions.

Module 4: Coping with Cravings and Distressing Situations
For drug and alcohol users.,This consists of four separate sessions:
• Dealing with ambivalence
• High-risk situations
• Distraction
• Individual planning
• Craving busting.
The aim of the sessions is to develop general skills to survive craving, and difficult situations and emotions. The topics include an introduction to the cycle of change model, understanding what ambivalence means in terms of recovery, working through the pros and cons of using and not using, and developing individual plans for identifying and coping with high-risk situations.

Module 5: Resources4Recovery
For drug and alcohol users. This module consists of five sessions:
• Building life enjoyment
• Building a new role
• Building meaning and life satisfaction.
The aims of the sessions are to develop an awareness of the importance of personal resources for recovery, to identify activities, relationships and skills, and to develop specific plans to build essential personal resources for recovery from dependent substance misuse.

The remaining two sessions are aimed at developing personal skills and resources for recovery:
• Building confidence without drugs or alcohol
This session aims to develop the participants’ understanding of social and interpersonal situations where they may have used substances to feel more confident, and to learn coping skills in these situations so that they do not reach for drugs or alcohol
• Building sobriety
This session helps to identify essential activities and relationships to maintain sobriety and recovery, and to develop a specific plan to build at least one essential personal resource or additional resource for sobriety and recovery.

Module 6: Managing Everyday Memory Problems
For drug and alcohol users. This one-session module aims to:
• Develop an understanding of how memory works
• Develop an understanding of how drugs and alcohol can affect memory
• Be introduced to strategies to manage memory difficulties.
Additional training in memory and information processing is required for this module.

Module 7: Triggers and Risks
For alcohol or drug users with more complex problems or chaotic use. This one-session module aims to identify triggers and risks in others through the use of case examples.

For alcohol and drug users with more complex problems or chaotic use. This is similar to Module 8 but focuses on the individual’s own triggers and risks through interactive exercises. It builds on existing resources as well as introducing new skills for managing triggers and risks.

Module 8: Emotion Surfing:
For alcohol and drug users with more complex problems or chaotic use. This one-session module builds on one of the strategies described in Module 1 for managing emotions (Mindfulness) and offers a different approach from those described in Module 2 (ways of thinking to help overcome negative emotions). Emotion Surfing is concerned with powerful feelings that may lead to urges to do something self-destructive. It aims to teach the client “acceptance” of the emotion and to develop an ability to step aside from the experience of negative feelings, particularly those leading to self-harm. Additional training to build experience in mindfulness medication and elements of dialectical behaviour therapy may be required, before training others.

Module 9: Safe Sensation Seeking:
For alcohol and drug users with more complex problems or chaotic use. This one-session module aims to help clients to understand what sensations they are trying to attain when using drink or drugs and to learn to reproduce this feeling themselves without having to use or increase their use of drugs and alcohol.

Module 10: Goal Planning:
For alcohol and drug users with more complex problems or chaotic use. This one-session module aims to help clients in:
• Decision making (weighing up decisions, being impulsive)
• Judgement (applying consequence from action)
• Goal planning (both short and long-term)
• Maintaining attention (easily distracted)
• Appropriate social behaviour (inhibition, doing or saying things without thinking).
• Abstract thinking (such as time, money etc understanding new ideas, seeing relationship between a new problem and existing strategies solutions)


Item Type:Evidence resource
Publication Type:Manual
Drug Type:Alcohol or other drugs in general
Intervention Type:Psychosocial treatment method, Education and training
Source:National Treatment Agency (UK)
Date:2009
Publisher:National Treatment Agency
Place of Publication:London
EndNote:View
Accession Number:HRB (Electronic Only)
Related URLs:
Subjects:N Communication, information and education > Education and training > Affective and interpersonal education > Skills building
J Health care, prevention and rehabilitation > Health care administration > Health care quality control
HJ Treatment method > Substance disorder treatment method > Substance disorder relapse prevention method
N Communication, information and education > Education and training
B Substances > Drugs and alcohol in general
HJ Treatment method > Psychosocial treatment method
F Concepts in psychology > Emotion
A Substance use, abuse, and dependence > Natural history of substance use > Relapse
F Concepts in psychology > Skills > Coping skills

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