- [Narrator] In the next interview,
you will see a clinician helping his client
develop a relapse prevention plan.
- Thanks for coming in today Roger,
I thought today maybe we could work on this card.
It's called a relapse prevention card.
And now, how many months sobriety are you?
- Seven.
- Seven months, and so we want to do some things
to help you maintain that sobriety,
and this card, what it'll help to do is look at
what are some healthy habits, things you can
engage in that are in replace of alcohol
that you can do, it will also list
what some of your triggers are and high-risk situations.
And so we'll just go through and fill out the different
things and basically what you can use this card
if you're a point where you think you might want to use,
this would help give you some thoughts about other things
you could do, we'll even list like phone numbers
for people that you can call, like a sponsor
or some other support people that could help you.
Then these, there are support people,
it can be anybody who supports your sobriety
that you could call for support.
This down here is the healthy habits
and healthy pleasure section.
And healthy habits are things that you do
over and over again that are good for you.
They're not necessarily always something you enjoy,
but they're good for you and they help lead
to these healthy pleasures, and these are
some things that feel good and are good for you.
So the healthy habits lead to the healthy pleasures.
So the healthy habits are basically like
stepping stones that you'll take to reach this
overall goal of things you want to maintain.
So I don't know if it might be helpful to list like the
healthy pleasures first and then we can look
at what steps need to get taken to get there.
What are some things that you enjoy doing?
- Working out.
- Okay, is there something else, other healthy kind of
healthy habits that you like?
- Spending time with my children.
- Okay, what about, I know you like to go to movies
and go out to eat and that kind of stuff,
that seems like something you are taking
at least once or twice a week usually, right?
- Mhmm.
- Would that be one that you'd like to continue to do?
- Yeah.
- And then our big goal has been
to obtain your license, right, to get that back?
- Yeah.
- So I don't know if you want to put
"to obtain license" maybe on one of the steps for that one.
So the first one, so the first healthy pleasure
is working out, right?
- Mhmm.
- So what kind of things do you need to do,
what kind of steps need to be taken over and over
again all the time so that you can reach that
to keep going to work out?
So at least they kind of get you,
it sounds like once you're in the door you're okay,
but sometimes getting there can be the problem.
So, maybe that having somebody support you
to get you to the gym, which could be our
outreach people or myself or somebody else
could help with that, so would sobriety be
a piece that needs to go in there as well?
- Yeah, for all of this.
- For all of it?
Okay.
Well maybe we can just put that
in the far side, like maintain sobriety?
What about your medications?
Do they impact all these different things too?
- I think so, it's even out of just
like we were talking all the time
about my concentration.
- Mhmm.
- Because of the illness...
- So, if you were off of meds, do you think
you'd be able to, you know, like
enjoy the license and do the movies, AA-
- No because off my meds I'm in a manic high.
- Okay, so maybe we'll want to put it there.
So it sounds like it affects all the other ones,
so managing sobriety and taking
medications sort of impacts all of it.
- [Narrator] In the next segment,
you'll see a clinician working with a client
to develop a relapse prevention plan
in a less formal counseling session.
- Bill, tell me about where you're at with alcohol
these days, it's been a while since you've used.
- It's been about, I haven't used it in eight months now.
- Again, what we want to do is to carefully examine
the sequence of events in your last slip
and find that earlier place where you can set the alarm bell
and say, "wait a minute, this is getting dangerous."
- Yeah, this is getting to be too much, in other words.
- Exactly.
- Maybe, cause when I drank before, I could have died,
I realize that now because I got off my meds
and I was (inaudible).
- And you ended up back in jail, didn't you?
- No, I didn't end up in jail this time.
Last time, the year following before that,
I ended up in jail in the past but I broke that cycle.
Now I ended up this time I ended up at a friend's house
and I ended up being thrown on the street,
but I didn't end up in jail, thank God you know.
- So you were able to cut it a little bit shorter this time.
- Yeah.
- Okay. And I think that the way we plan these things
is to try and be at sooner and sooner points and
you don't get into the same
- You don't get into the same habit,
- Level of - You break the cycle.
- Right, not as much loss.
- No.
- If you make the shift at some point again
to wanting a drink, that, I think, is something
to really focus on as a intervention, as a time to target.
If you find yourself making the shift
out of knowing that you want sobriety,
that's when I think the danger signals really pick up.
Because, up until that point, you know
the things to do, right?
You're used to the right thing.
- Right, use my tools, use the right tools,
use what I got, you know.
- Let's say that it progresses to the point
where you decide you want a drink.
A drink starts to have its grip on you.
Do you think you still have some
room at that point to reach out?
- Yeah, if it starts to get a good hold of me
and I find myself going in the opposite direction,
I'll turn around and I'll say
I've been through the past, I've been through the mill,
you know, I've been homeless, I've been penniless
and I went sometimes days, weeks, a month without eating,
and I realized that worse things
are waiting for me out there.
I could end up in jail, I could end up dead in the grave.
I've got to realize this disease kills, you know,
and if I don't, you know, stop drinking
it will eventually kill me so
that's what I've got to realize.
I'm realizing that now.
- So, one of the internal strategies that you use
that is successful is reminding yourself of the
bad things that have happened before.
- Yeah. - When you start to believe
that you want a drink again.
- Yeah, I just think of the past and what happened
and what I lost and what I could have.
- And are there also some things,
so that's something you can do within yourself and
within your own thoughts to try and
combat the urge to drink, when you start to think
that you want to use is remind yourself of
how it's hurt you in the past.
Are there things that you can do with others?
Is there help that you can seek at that point?
- I could seek help.
You know, by using my tools that I've gotten.
I can seek help by using people, you know,
using them for good advice and stuff,
using their advice, taking it, storing it.
Take what I need and throw the rest away like.
- Do you imagine that it would be hard
to admit to somebody if you had decided you wanted to drink?
That it'd be hard to tell that to
your sponsor or to the staff?
- It used to be at first but it's getting easier
each time I do it, it's not as hard as it used to be.
At first it was really hard,
but it's getting easier now, I'm learning
to open up more and trust people,
you know, let people in.
- Is there a certain sort of code word that
you can use to tip those people off that it's getting there?
- Yeah, I'll tell them I'm coming, I'll tell them
I feel like I'm wanting to go out and drink,
I'll tell them can we sit down and talk for a while?
- I think that's one of the most important things
in this stage is continuing to learn from
the slips that you've had and each time that it gets close,
each time that you feel an urge, grow from that.
Don't view that as a failure,
don't view that as a setback,
view that as an opportunity to grow and acquire
- More knowledge about what... - I realize now that, you know
by going forward, I'm learning more about the disease
and I'm learning more that I can kick this thing.
I'm learning more about the disease
where I know what's bad for me, it's no good,
it's just poison, slow poison.