Written By Melinda Lericos, LPC
I am Melinda and I run our relapse prevention and wellness planning groups at Thalia House. To say relapse prevention is my passion in eating disorder treatment would be an understatement. Many providers fear talking about relapse because they don’t want to trigger thoughts of relapse or remind clients of their old behaviors. However, I truly believe that if we do not prepare our clients for the potential of relapse and provide them with tools to recognize and reduce those behaviors we are setting our clients (YOU) up to fail at their recovery.
It is for this very reason and passion that I have spent the past several years running our relapse prevention group at Thalia House while curating a curriculum that I know sets our clients up to succeed in their recovery, even when it is not easy to stay committed or it doesn’t “feel good” to keep choosing.
I frequently get asked the question, “What do you cover in your relapse prevention group?” To answer that question, I have decided to start a blog series on our relapse prevention group to cover 1) what you, as a client, can expect to cover and 2) how this group can be used with your individual outpatient team. This blog post will serve as the initial overview into the flow of the group and I will expand from here. As the series continues, click on the links in this page to learn more about each area of the group process.
Our group starts with an educational foundation of stages of change and styles of motivation. We work together to identify where each person is currently struggling to move forward in their recovery and what their unique motivators are for their life without ED. We then work together to demystify the idea of a “perfect recovery.” We explore the continuum of relapse towards recovery and normalize the ups and downs, the non-linear path, that leads to living a whole-hearted and values-driven life. Together we break away the shame of “doing recovery right” and we create space for things to be whatever they are in this moment.
From there we take some time to figure out what things will inevitably make the recovery process not perfect. We identify internal emotional triggers and external environmental triggers. We gain insight into how our behaviors try to keep those triggers exiled but ultimately end up harming us. Along with internal and external triggers we address conflict management and conflict resolution. Relationships are a HUGE part of recovery (and relapse). Learning how to navigate conflict in relationships inter-personally and intra-personally is vital to long-term sustainable recovery.
After we get a handle on all of the ways we anticipate the desire for behavior use to arise, we take an inventory of how we justify using our behaviors. We break down all the reasons, all the excuses, for returning to negative coping skills and we create a plan of new skills to use when we get stuck in these patterns.
Once we have a deep understanding of what triggers us to use behaviors, what justifications we create to continue using behaviors, and what motivations we have to challenge our eating disorder / what we have to lose if we go back to using we move into the last part of the curriculum: Wellness planning. In wellness planning we look at 6 areas: Nutritional, Physical, Behavioral, Cognitive, Emotional, and Interpersonal. In each area, every individual identifies signs that would alert others to behavior use. This is used to create accountability within the support system. We explore what functions or needs would be met by using behaviors in each area. We look at resistance to change and create a plan with skills to help bring each client back into recovery and out of their behaviors. We also look at resilience factors to relapse such as medication management, sleep, exercise and more.
The hope is that this plan can be shared with providers and support systems to aid in long term behavior change and accountability for those who will be doing life with our client in the future.