I grew up watching Disney Channel – the Camp Rock movies starring Demi Lovato were two of my favorites. Like any Disney program, it tried to teach the importance of being yourself. But I learned more from watching Demi navigate her personal life. I learned that eating disorders, depression, and addiction were problems that someone my age could struggle with. I learned that with treatment, you could move forward and become an advocate and a role model for those still struggling.
And recently, I learned that sobriety isn’t a constant. Relapses happen frequently and can happen to anyone, which is why it’s important to have a chart structure that keeps multiple episodes of care for single patients well-organized.
Demi admits to breaking her 6-year sobriety in her new song Sober. It’s a song that highlights the emotional turmoil that occurs with a relapse – guilt, distress, shame, and confusion. A relapse affects the person who relapsed. It affects their loved ones who thought they were getting better. Both groups often rely on a clinician or therapist to help them sort through their feelings afterward and get back on track.
But what happens from a clinician’s perspective?
Relapses are a Clinical Issue
Relapses happen and are a normal part of treatment. Clinicians know that. And they know what they’re doing. There are a few steps clinicians take with their clients to help them back into recovery:
Understand the relapse
When someone decides to break sobriety, they may be in denial about the seriousness of the action they’re taking or they may have been in a situation with too much temptation. By understanding the details of the relapse, the clinician can begin to identify any issues that need to be addressed
Assess the client’s treatment program
If the client was consistently receiving treatment at the time of their relapse, their program may be insufficient for them. After the clinician assesses the treatment plan, they can determine if there needs to be any changes.
Identify any other psychiatric conditions
The client’s relapse could have been the result of a coexisting condition the client/clinician were unaware of. In the aftermath of the relapse, the clinician will want to assess the client’s mental health again to ensure there are no other psychiatric conditions.
Focus on what the client is feeling now
The clinician will ask their client how they’re feeling after the relapse or what about this instance was different than other times they successfully refrained from using a substance. Asking these questions helps the client to better understand their own relapse.
Help the client take responsibility
It’s important for the clinician to hold their client accountable for the relapse. The client might blame the situation they were in or people in their life for them relapsing, but they need to realize that they’re responsible.
Offer the client hope
Just because a client has had a relapse doesn’t mean that they can never be sober. The clinician will remind the client that they can still be sober, and encourage them to keep trying despite this setback.
But Clinicians are Human Too
Clinicians help the person who’s relapsed and their loved ones pick up the pieces afterwards. But they struggle too when a client relapses. A clinician may feel guilty if a client relapses and think that it’s because they didn’t do their job well enough. Or, they may become angry at the client and blame them for not being able to maintain their sobriety.
Taking the Next Steps
These complex feelings are normal, and there are a few things a clinician can do to handle them:
Allow yourself to be frustrated
It’s normal and acceptable to be upset that your client has relapsed. It can be challenging to watch them struggling to deal with the emotional and physical side effects of a relapse after they had been making progress. Take time to be upset – either alone or by confiding in a trusted colleague.
Remember that growth is a process
Growth takes time – it’s not a singular event that happens at once. You need to remind yourself that a relapse is part of the process of recovery, it doesn’t mean that your client will never regain sobriety. It’s a long process.
It’s normal to feel guilty after a client has relapsed, but make sure to take time for yourself as well. Try a new restaurant, read a book, take a walk – do something that brings you pleasure. When you take care of yourself, you’ll be able to offer better care and support to your clients.
Looking at the numbers
In their Fall 2015 issue, Addiction Professional included results from a survey of 550 clinicians. Based on their observations, the clinicians were asked what percentage of individuals in their community they thought would relapse in less than a year. Over half of the clinicians who responded said 50-70%.
Relapses are common during a client’s treatment program. But with a supportive community and guidance from their clinician, they can successfully regain their sobriety.