Assessing a young person’s history of substance use, past and current functioning and mental health status are critical for creating individualised treatment goals that incorporate relapse prevention.
Prior to beginning relapse prevention work, it is important the practitioner enquire as to the young person’s understanding of what constitutes and lapse or relapse and that this is mutually clarified. It is also important to understand what recovery means to the young person. The practitioner may ask the young person, “if it were to occur, what do you think lapse or relapse would look like?”. This may also be a good time to define what is meant by the terms lapse and relapse, and the practitioner can provide assurance to the young person that just because someone has a lapse, this does not mean they have, or will, relapse (see definitions at the beginning of this module).
The use of documented SMART goals can help ensure the practitioner and the young person have a common understanding of what is meant. Goals can then be regularly reviewed to ensure they are still relevant and check if they need to be modified.
Concurrently, it is important for the practitioner to clearly understand the young person’s motivation for change and expectations regarding this change. The practitioner can assist the young person in clarifying what the likely outcomes of change will be and ensure their expectations are realistic. It may be that the young person believes that ceasing their substance use will “fix” all the problems in their life. If the young person believes this, and it does not occur, then they may form the belief that recovery isn’t worth aiming for.
Once goals have been clarified, and expectations have been discussed, the practitioner and the young person can work together creating and implementing a treatment plan around relapse prevention. This plan will involve learning and practicing new skills within sessions and also in the young person’s own environment. It will also incorporate harnessing existing supports, developing better supports and making lifestyle changes.
In summary, the practitioner can assess four key factors that will influence their susceptibility to relapse. In particular the work will assess the strength of the original resolution; the degree of attachment to the substance using lifestyle; the young person’s capacity to cope and exercise control in high-risk situations; and, the strength of support and resources the young person has. This can be formulated and conveyed to the young person and help develop awareness of their propensity to lapse or relapse.
