Relapse prevention is a multi-faceted discipline, but the link between success and mental health well-being is undisputable. Often, the reason that individuals become addicted to drugs and alcohol, is that the addiction serves to treat underlying and pre-existing mental health conditions such as depression, anxiety, schizophrenia, and borderline personality disorder. In considering both primary treatment and relapse prevention thereafter, in the last twenty years clinicians have begun to incorporate treatment of the substance addiction with the underlying mental health disorder. The term for this combined treatment is “Dual Diagnosis”.
“Individuals with co-existing severe mental illness and substance abuse disorders encouraged the first identification of what became known as Dual Diagnosis, in the 1980’s. The term co-occurring disorders (COD), is utilised by SAMSHA (the Substance Abuse and Mental Health Services Administration) to refer to these disorders occurring concurrently. Patients with co-occurring disorders have one or more disorders relating to both substances and mental health.
The recognition of dual diagnosis impacts relapse prevention preparations both in primary treatment and subsequent outpatient rehab by integrating the substance abuse and mental health components. After the initial acute stages of addiction and alcoholism treatment at SafeHouse Rehab Center, during which the individual’s detox regime provides strategies to withdraw and cease using, mental health counselling is speedily provided for support, and to develop an understanding of the underlying mental illness. Knowledge around relapse prevention can and should be drip-fed to the client as early as possible. This knowledge, which slowly morphs into acceptance, serves to empower the individual’s attempts to maintain abstinence after leaving an inpatient program. As the individual transitions to outpatient status, relapse prevention via ongoing counselling is important to maintain the continuity established during initial rehabilitation. As life’s challenges such as returning to work and family issues and impact, support received from on-going counselling helps mitigate the dangers and reduces the likelihood of a return to substance use to cope. Relapse prevention in action.
Understanding the connection between mental health and substance use also encourages the individual to utilize multiple sources of outpatient support in addition to individual counselling. These may include self-help groups, friends, family, work, and community. Those who have experienced success in the inpatient setting are often at particular risk from experiencing loneliness and isolation when they leave treatment, addressing loneliness, isolation and boredom is key in relapse prevention, as these are often a relapse triggers, and can undermine an individual’s resolve in recovery.
Accordingly multiple sources of available support should be identified and made available. Post-rehab planning is vital during the final weeks of treatment at SafeHouse. Multiple sources of ongoing support reinforces to the former user that he or she is not alone in dealing with the struggles, and joys, associated with remaining substance free. Joining with others also heightens awareness of the psychological/social factors which still exist, and may have contributed to original substance use. This multi layered relapse prevention support helps the recovering addict and alcoholic develop new coping strategies for stress and helps to maximise relapse prevention.
Gerrie Kalaidjian – MA, MBA
Mental Health Counsellor and South Thailand Aftercare Facilitator