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Relapse Prevention Plan

PCN-501 Relapse Prevention Plan

Read the Jed case study and create a relapse prevention plan for Jed. Keep in mind that you would typically create a relapse prevention plan in collaboration with the client to ensure the greatest chance for success; however, in this instance, you will create one for Jed based on what you can glean from the case study.

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Client Name: __________________________ Age/Date of Birth: _____________________

Date of Plan: __________________________ Next Date of Review:* __________________

*This can be 30, 60, or 90 days.

Biopsychosocial Summary:

Provide a brief description of the client’s presenting symptoms.

<Add the client’s presenting symptoms here.>

Part 1: Harmful/Destructive Behaviors Chart

Complete the chart below by including a minimum of three behaviors as well as associated rewards and consequences related to relapse and abstinence behaviors.

Harmful/destructive behaviors that the client will need to avoid to prevent a relapse Possible rewards for not maintaining abstinence to prevent relapse Possible costs for returning to use and the associated consequences
1. 1. 1.
2. 2. 2.
3. 3. 3.

Part 2: Current Risks of Relapse

In this section, you will identify the steps to reduce the risk of relapse. Describe how you might assist Jed to identify high-risk situations, and specific triggers leading to relapse.

1. What steps has the client already taken to reduce the risk of relapse? What is the client’s agreement to abstain from substance use/misuse?

2. What are some high-risk situations that may trigger a relapse for the client? List three specific situations that may lead to relapse.

3. What are some high-risk behaviors or irrational thinking that may create the urge to return to previous harmful behavior leading to relapse?

Part 3: Relapse Response Plan

In this section, you will create a response plan to use when the client is faced with triggers and urges to lapse into using behavior. Complete the chart below and include coping strategies, client’s skills to redirect thoughts, and immediate actions to take before using substances.

List three people that the client identifies for a supportive network List three new activities that increase coping skills and strategies to assist in replacing high-risk thoughts and behaviors List three actions for new activities the client indicates will be taken if a pattern of negative behaviors emerges
1. 1. 1.
2. 2. 2.
3. 3. 3.

Part 4: Continued Health and Well-Being

1. Describe community and support resources that are available to the client. Identify how often and the amount of support group meetings the client will participate in (any type of recovery support meeting) to improve health and sobriety.

2. Identify at least two strategies the client can do to improve his family relationships and describe how this is important to the success of the relapse prevention plan?

3. Describe how the ethnic and cultural aspects of the client may impact the relapse prevention plan?

4. Develop with the client an emergency contact sheet that the client may carry with them. Create a contact card with the client to list the people and resources to have available to use prior to a lapse or relapse to use substances.

Client Signature Date
Counselor Signature

© 2017. Grand Canyon University. All Rights Reserved.

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