rELapSe
prevention specialists
By Roland Williams, B.S., N.C.A.C. II, C.A.D.C., A.C.R.P.S.
Among the many roles that the Relapse Prevention Specialist plays in treatment and recovery, the primary goal is to help relapse patients to achieve quality recovery instead of chronic relapses. This is not easily done, but we have seen some remarkable success. Those who experience relapse over and over again are often branded as failures in treatment facilities as well as 12-step meetings. They often return to recovery feeling defeated and ashamed. We work diligently with this population and help to restore confidence and self-esteem, and it is amazingly gratifying when that happens. I have seen helpless, hopeless, and confused people in the midst of yet another relapse who respond to Relapse Prevention Therapy (RPT), thereby substituting new hope in their lives and futures, vanquishing the relentless defeat and shame.
We also work to provide Relapse Prevention Education (RPE) to all clients and colleagues. Commonly, a certified relapse prevention specialist (CRPS) may provide in-service training to various treatment facilities. These specialists bring specific expertise to staff members who find themselves frustrated with the relapse-prone client. Staffers may lack effective clinical interventions that will assist the client to regain and maintain recovery. The CRPS can provide targeted, individualized exercises that are designed to stop the pattern of relapse, identify and manage relapse warning signs and develop recovery activities that will support continued sobriety. Every chemical dependency treatment facility should have at least one CRPS on staff.
A CRPS can often be in private practice or, just as frequently, working as part of a treatment team. The CRPS has been able to carve out a niche in the field of chemical dependency treatment by providing effective, focused treatment for a specific population. There will always be a need to address relapse issues when discussing recovery, for, unfortunately, the recidivism rate is discouragingly high for addicts and alcoholics seeking recovery. Relapse is very commonplace for a variety of reasons. One of the most powerful is that relapse is a potentially fatal disease, trapping patients between two alternatives, both deadly. If there is death on both hands, many patients choose temporary, though possibly fatal, satisfaction rather than denial that brings pain and conceivable death before recovery. More than a few patients in relapse don't get a second chance at recovery. Therefore, our role in behavioral health and recovery is crucial.
Relapse Prevention Training
All interdisciplinary teams would benefit from having a CRPS as a member. Not only can these specialists add valuable feedback to case conferences, but they can assist in developing effective intervention strategies. It is important that treatment facilities have staff members with specific areas of expertise such as dual diagnosis, cultural diversity and relapse prevention. Perhaps most important to patients, there will always be a need for people trained to identify and address specific issues such as relapse. The CRPS is taught to identify and manage immediate problems that threaten a client's recovery. The Level II, Advanced Certified Relapse Prevention Specialist (ACRPS) is trained to use 15 psychotherapy methods for changing the core personality patterns that drive the relapse process.
During the past several years we have seen a big move in chemical dependency treatment, the result of having been abruptly shaken out of the existing paradigm paralysis. We had to reconsider
The old days of being able to recommend a client to a 28-day "rehab" are over, for the notion that "one size fits all" is obsolete. Inpatient vs. outpatient, residential vs. therapeutic community, harm reduction vs. total abstinence, AA vs. rational recovery are all common debates in a field that was once very narrow minded, offering few, if any, choices for treatment and recovery.
Today it is apparent that treatment needs to be individualized, brief and effective. For instance, outcome studies rather than personal preferences dictate what will work and what won't. New professionalism such as credentials, rather than personal experiences, have become the standard for counselors. The old standard of having years of membership in Alcoholics Anonymous no longer sufficiently qualifies anyone to be a counselor; this is a critical field for which people need training. Employers are very selective, looking for clinically specific treatment plans with a concrete, measurable and targeted outcome. In fact, everything, not only the goals, but also the field has changed. Even the term "behavioral health" speaks to the newer, broader spectrum of services. As the field grows, those intending to stay around need to grow with it, even anticipating possible new directions. If we are to make a difference to patients, giving them a reason to survive, it is imperative that we are able to meet these new demands.
Helping to meet the challenges of the future are the growing programs that train counselors to receive professional credentials. The CRPS credential and now the Level II, Advanced Certified Relapse Prevention Specialist (ACRPS) indicate that a counselor has had 20-44 hours of intensive training with Terence Gorski and his faculty, learning 7-15 specific clinical skills. Those with these credentials have demonstrated competence in the model to the satisfaction of "Center for Applied Sciences" (CENAPS) staff. This certification offers counselors the opportunity to enhance their professional lives in addition to improving the field as a whole. Naturally, the end results of this training will translate to far more than a discrete number of skills; the ultimate gain will be realized in the lives of patients who may have run out of options.
For years I thought that I knew what relapse prevention was. In fact, I was sure that I was providing comprehensive relapse prevention to clients in need. Furthermore, I have consulted with or otherwise been involved with several treatment facilities that claimed to provide relapse prevention as part of their programs. However, with further training, I found that most counselors and programs are providing only basic education at best. Though relapse prevention training is brief, it is also strategic and effective, utilizing behavioral and cognitive modification techniques to enhance patients' enduring recovery.
I learned firsthand that employers want very specific descriptions of a relapse prevention plan because such plans are the avenue to seeing positive results in the lives of clients. It wasn't until I took the CENAPS training that I truly learned what all this additional study and preparation meant. I had an abundance of very good knowledge, but I was unable to put that knowledge to its most effective use in practical application. Though there may be many people claiming to be Relapse Prevention Specialists, based on my experience, I would recommend only those that have the certification.
Whether it's in group therapy, individual counseling, didactic lectures or care coordination, the CRPS provides a much-needed perspective for both the client and the field of relapse prevention. Of all the patients I work with, I get the most personal satisfaction from seeing a relapse-prone client get back on the path of recovery, knowing it will probably be the last time for this person to find it necessary to seek help because of relapse
Roland Williams is clinical coordinator of Chemical Dependency Services at Good Samaritan Hospital in San Jose, California as well as president and founder of Free Life Enterprises Counseling and Consulting Services. He not only teaches addiction studies and relapse-prevention courses, but is also the author of Relapse Prevention Counseling for African Americans and The Relapse Prevention Workbook for African Americans, both published by Herald House/Independence Press. Mr. Williams is considered an expert regarding relapse-prevention therapy and cross-cultural counseling, currently traveling nationwide to conduct training seminars.