Running head: Relapse Prevention Group 1

A Psychoeducational Group for Relapse Prevention in Agency Settings

James M. Ryan
South University

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Addiction has come to be recognized as a legitimate illness among the ranks of other
chronic conditions including hypertension, diabetes, and heart disease with biological, social,
and psychological components (National Institute on Drug Abuse, 2008). Combating this disease
has proven to be extremely difficult with relapse rates ranging from 40-60% of individuals
diagnosed substance related disorders (National Institute on Drug Abuse, 2008). In response, the
number of treatment facilities available to individuals with Substance Use Disorders, as
classified by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition), has
exploded in recent decades. As with other mental health disorders evidenced-based practices and
treatment-protocols have been developed to address this growing needs, with relapse prevention
proving to be a vital part of the treatment process, particularly for those diagnosed with alcohol
and polysubstance use and abuse issues (Irvin, Bowers, Dunn, & Wang, 1999, abstract).
The National Institute of Health has declared addiction an epidemic, a health crisis of
massive proportions, devoting an entire segment of its infrastructure to the treatment of addiction
(National Institute on Drug Abuse, 2008). Rates of relapse among addicts have been determined
to equivalent to many other chronic conditions, as the following table from the National Institute
on Drug Abuse (2008) demonstrates:
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In response to these dramatic findings, clinicians and treatment facilities must be equipped with
the necessary tools to address the problems that relapse pose.
The following Psychoeducational group has been designed to address four major areas of
concern in relapse prevention treatment approaches: self-care, particularly nutrition and sleeping
patterns; regrets, addressing the topics of forgiveness, depression, and hope; resentments,
discussing anger and what can be done with it; and consequences, with particular focus on what
need using fulfilled for the client, and how to identify non-destructive behaviors to replace
addiction and meet the identified need.

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Purpose
The purpose of this group proposal is the development of a solution-focused, strength-
based protocol for the treatment of Substance Use Disorders. It has been designed to be
implemented within the standard treatment period of 28-30 days, based upon the average length
of treatment allotted by managed-care corporations and insurance companies. In addition, the
material covered within the four weeks had been identified in the current literature as particularly
relevant to the prevention of relapse in individuals diagnosed with the aforementioned disorder
type (Dejong, 1994, abstract).
Goals
The goals for the Relapse Prevention group proposed herein are as follows:
1. The identification of detrimental health-related, lifestyle choices, and the replacement of
those behaviors with positive alternatives, for the purposes of reducing cravings and
increasing the physiological health of the brain and body of the client.
2. Addressing past patterns of thinking and acting that have contributed to feelings of
worthlessness and self-loathing. Addressing these thought processes reduces the likely of
self-sabotaging behaviors by the clients, and increases the likelihood of honesty and
compassion in future relationships, necessary as support for the continued maintenance of
sobriety following treatment.
3. Identifying unhealthy expressions of anger, and resentments carried from past
experiences in order to process them within the safety of the treatment environment in
order to reduce their potential triggering effect following treatment. This process allows
for clients to explore past hurts, for example: abuse and neglect perpetrated by a care-
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giver, and process the pain from these experiences. The process allows for clients to learn
effective methods of coping with challenging experiences and emotions that may
otherwise serve as triggering events later in their recovery.
4. Finally, consequences will be addressed within the framework of the aforementioned
goals, allowing clients to identify their relationship with themselves, their drug of
choice, and others- for the purpose of defining the means by which they previously met
their needs. After successfully identifying the needs associated with their former
relationships, clients are given the opportunity to identify healthy alternatives available to
them. These substitutions are critical for successful recovery, due to the fundamental
nature of needs and their role in determining behavior in human-beings.
Structure
The structure of a group is largely dependent upon the context surrounding it. In the case
of this Relapse Prevention Group, members will be selected based upon their presence at the
treatment facility. The generalizability of the group goals and structure allows for modifications
to accommodate extremely diverse populations. The general requirement would be based upon
having substance use and abuse issues and admission to a residential treatment facility for such
issues. The brevity of the four week model allows for members to participate in the entire
process, based upon the general length of treatment allotted for substance abuse. Groups will be
designed for an hour-long period, based upon standards generally implemented in substance
abuse treatment, although the material is adaptable for longer or shorter periods of times as
needed. Recruitment and screening will be the sole responsibility of the staff and administration
of the facility in question.
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The group leader(s) must be trained-professional counselors. Group therapy efficacy is
based upon the skills of the therapist conducting the group- the therapist matters more than the
intervention (Corey, 2012, p. 15). The adaptability of the material can be a deficit if the therapist
is not appropriately trained to facilitate the process, maintaining its goal-oriented direction,
throughout the experience. In addition, the educational requirements of the psychoeducational
format demand a knowledgeable facilitator, with reasonable mastery of the material, an ability to
answer client questions, and address client concerns. Generally, master therapists have higher
therapeutic-outcomes based upon research evidence (Shaw & Murray, 2014, p. 43).
Group rules are adaptable to any given group format. The flexibility of the material
allows for supplementation of experimental activities, educational films/videos, lecture-style
presentations, and smaller process-oriented groups as well. A final requirement for the use of this
group is the implementation of outcome measure, readily available and previously vetted, for
instance: the Outcome Rating Scale and/or the Session Rating Scale, as seen in Appendix A and
B of Shaw and Murrays article Monitoring Alliance and Outcome with Client Feedback
Measures (2014, p. 56-57). This is in order to ensure the efficacy of the treatment, and
effectiveness of the therapist.
Conclusion
The need for relapse prevention in the treatment of Substance Use Disorders is well-
documented, and commonsensical. Clients must be made aware of the nature of the disease of
addiction, and equipped with the tools to fight it before leaving treatment. The Relapse
Prevention Group outlined above allows for clinicians to introduce their own theoretical
perspectives in the achievement of the stated group goals. In addition, the responsibility and
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structure of an existing facility allows for the implementation of this group into preexisting
framework without development of costly programs, measures and marketing.

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References
Corey, G. (2012). Theory and practice of group counseling (Eighth ed.). Belmont, CA:
Brooks/Cole Cengage Learning.
Davidson, T. (2014). Strength: A system of integration of solution-oriented and strength-based
principles. Journal of Mental Health Counseling, 36(1), 1-17.
Dejong, W. (1994). Relapse prevention: An emerging technology for promoting long-term drug
abstinence. Substance Use and Misuse, 29(6), 681-705.
Irvin, J. E., Bowers, C. A., Dunn, M. E., & Wang, M. C. (1999). Efficacy of relapse prevention:
A meta-analytic review [Abstract]. Journal of Consulting and Clinical Psychology, 67(4),
563-570. http://dx.doi.org/10.1037/0022-006X.67.4.563
National Institute on Drug Abuse. (2008, July). Relapse rates for drug addiction are similar to
those of other well-characterized chronic illnesses [Fact sheet]. Retrieved March 21, 2014,
from National Institute on Drug Abuse: The Science of Drug Abuse and Addiction website:
http://www.drugabuse.gov/publications/addiction-
science/relapse/relapseratesdrugaddictionare-similar-to-those-other-well-characterized-
chronic-ill
Shaw, S. L., & Murray, K. W. (2014). Monitoring alliance and outcome with client feedback
measures. Journal of Mental Health Counseling, 36(1), 43-57.