Addiction Recovery: Here Is How To Manage High Risk Situations

Managing High-Risk Situations
by Terence T. Gorski
Written for Journey Magazine- May 1, 2009

The third tradition of AA states that “the only requirement of AA membership is a desire to stop drinking”.  However, those of us who work in the field of chemical dependency know that desire alone is not enough to recover, nor prevent relapse.  Desire must be coupled with commitment, education, tools, and action.

Relapse Prevention Counseling (RPC) provides the tools and recommended actions to assist our clients in increasing their chances to recover and prevent relapse.  RPC presents seven powerful clinical processes that quickly identify and mange high-risk situations that cause relapse.  Special emphasis is placed on the management of irrational thoughts, unmanageable feelings, self- destructive urges, and self-defeating behaviors.  RPC presents a counseling process that is appropriate for people in all stages of recovery who are facing situations that put them at immediate risk of relapse.

Relapse prevention is a critical component to recovery planning.  Relapse prevention is the process of preparing for, mitigating, responding to, and recovering from a potential or actual relapse.  It is a dynamic process.  Although prevention is the goal, it is not the only component of relapse prevention.  Identifying, mapping, and managing personal reactions to high risk situations are important parts of a relapse prevention plan.

Making the Commitment to Stop Using

When embarking on recovery, we ask our clients to make an honest commitment to stop using alcohol or other drugs.  We want our clients to see that it is in their best interest to stop using and by reviewing the problems that motivated them to enter treatment we show them the relationship between their current problems and their alcohol and drug use.

Many clients with the best of intentions make the commitment to stop using, only to succumb in a moment of weakness.  Because we are well aware of the power of addiction to entice even the most stalwart back to use, we ask our clients to set up a monitoring and accounting system to back up their commitment.  We also ask that they enter into a written Abstinence and Treatment Contract that puts into writing the commitments they are making to develop a recovery and relapse prevention plan.  When they sign the agreement, they are putting their personal integrity on the line.
Planning to Stop Relapse Quickly If It Occurs
One of the goals of RPC is to prepare the client to stop using alcohol and other drugs quickly if they do start using.  The chances that they will recognize their relapse and take steps to stop using are dramatically increased if they have a prepared written plan for what to do.

Identifying High Risk Situations

High risk situations are those situations or incidences that make us want to use alcohol or drugs after we’ve made a commitment not to.  We do not get into these situations by accident, but rather set ourselves up to get drawn into them.  Once in the situation we do not know what to do.  We make excuses as to why or how we ended up in the situation, that it’s not our fault and we didn’t plan it to happen.  Planning is an essential part of preparing to prevent relapse.  If we fail to plan, we are unarmed in our defense to manage or mitigate relapse.  Identifying high risk situations is the first planning activity.

Identifying high risk situations can be difficult.  Not all high-risk situations put all of us at risk.  High risk situations are personal to each of us and not all high risk situations will elicit the same response.

We need to be prepared for those situations that pose a threat to our recovery.  We may not appreciate the effect certain situations will have on our recovery and just how vulnerable we are.  Through preparation we recognize potential high risk situations and are proactive in preparing our defense with various intervention options.  High risk situation management is a proactive approach to relapse prevention that helps identify high risk situations and the critical junctures where intervention can occur before a relapse episode, or quickly stop a relapse should one occur.

Mapping and Managing High-Risk Situations

We need to thoroughly understand our high risk situations.  The greater the level of detail in mapping, or recording the high risk situation, the greater the depth of preparedness we will have if and when we find ourselves in the high risk situation.  We need to map high risk situations and objectively assess the true risks and identified intervention options that can be readily implemented to avert and prevent relapse.  A high risk situation management plan can shed light on our vulnerabilities, inconsistencies in priorities, and the gaping holes in our well intentioned plans.

We begin by learning what a high risk situation is, review the common high risk situations that can cause relapse, and identify and clarify the immediate high risk situations that could cause us to use alcohol or drugs in spite of our commitment not to do so.  This initial assessment establishes a basis on which to build viable layers of response protections into our recovery.

In order to manage high risk situations we must know what our high risk situations are and how we get into them.  We can identify high risk situations by reviewing a list of common high risk situations and identifying those that apply to us.  We then need to personalize those high risk situations that we’ve identified by assigning a title and personal description that make them easy to remember and recognize when they happen.  The next step is to map the situation.  This is a description of exactly what we do and how other people react to what we do that makes us want to use alcohol or other drugs despite the commitment not to.  Remember, the more detail you can record in the mapping process, the better prepared you will be in the actual situation.

A good situation map describes exactly what you and other people do in a way that lets you clearly see it happening in you mind.  When developing a situation map it is helpful to go visual and see the situation as if it were happening in front of you.  Try to see what you are doing and saying in the correct sequence.  Think about each consecutive action.  Once you have mapped the situation you then need to look for gaps or wholes in the action and identify what is missing.  It is critical that you can see all of the details, exactly as they occur, to have a thorough situation map.  The close the map is to reality, the better prepared you will be if the situation should occur.

Managing Personal Reactions to High Risk Situations
High risk situations can activate deeply entrenched habits of thinking, feeling, acting and relating to others that make us want to use alcohol or other drugs.  To effectively manage these high risk situations we must learn to understand and control the way we react in these situations.  Our chances of managing high risk situations without using alcohol or drugs increase as we get better at recognizing and managing our thoughts, feelings, urges, actions and social reactions that make us want to use.
Developing a Recovery Plan
We must have a recovery plan that helps us to avoid relapse.  People who successfully recover tend to do certain basic things.  You may not do all of the things that someone else does, but once you understand yourself and your recovery needs you will be able to build an effective personal program for yourself.  Your program should include a regular schedule of activities, designed to match your unique profile of recovery needs and unique high risk situations.

The challenge of recovery is never really over.  It seems that once we start a recovery process we are either growing or we’re stalled, or regressing.  There is no standing still.  We either commit ourselves each day to improve and refine our recovery skills, or we become complacent and slowly move toward relapse.  We must make a conscious choice each day about which path to follow.  Choose recovery and you will move from a place of pain and fear, to a place of power and serenity.

Terence T. Gorski is proud to announce that he has taken the position of Director of Relapse Prevention Services with Challenges in Fort Lauderdale -www.challenges-program.com, Florida and can be contacted at 352-279-3068.  His Publications for RPC are available at www.relapse.org or 1-800-767-8181.  He is still available for advanced clinical training and conference presentations by calling Tresa at 352-596-8000 – www.cenaps.com or tresa@www.cenaps.com

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