Relapse prevention following participation in treatment is not always easy. Many patients leave treatment with high hopes of doing well and the notion that they will not slip or relapse. Often the belief is that because at the time of discharge they are eating and following their meal plan and verbalizing their thoughts and feelings that all will go well. This is what we want and desire for patients. However, it is important for the patient to know that there will be challenges.
One hurdle the patient may face is eating with friends and family. During treatment, patients eat with their peers who are also struggling with a similar situation. Through this, they find support and understanding in each other because they comprehend and experience many of the same challenges. Eating, weight restoration, abuse and negative body image thoughts and feelings are just a few examples of these commonalities. When the patient discharges, he or she may not feel as supported through meal times because they may no longer be experiencing it with other people who fully understand the difficulty they are facing. Family and friends can help by participating in family group and family therapy and patients can help themselves by continuing participation in PHP and IOP following residential treatment. This allows the individual to step down in treatment slowly and continue interacting with peers while also increasing interaction with family, friends and even co-workers. At this level of care, patients eat some meals at home and others with their peers at the treatment center. This gives them the opportunity to face the challenge of meal time at home and then process it with their therapist. Socialization outside the walls of the treatment center also increases at a slower rate, which, in turn, decreases the chance for the patient to feel overwhelmed by social pressures like work, shopping and eating at restaurants.
Another challenge patients may have to overcome post discharge is re-entering the world outside of treatment and finding out that society has made little change in regard to understanding the negative effects of body image. This may force the patient to face social pressures that very well could have been one factor in causing their eating disorder in the first place. In treatment they are somewhat protected from the outside world, so this change in environment can be shocking and overwhelming. To reduce these feelings, the patient should remind one’s self that taking things slow is a good start to relapse prevention.
Balancing life after treatment can also be challenging for some patients. They may want to go back to working full time, as well as partake in other social activities and extra curriculars right away. Doing all this while trying to stay in recovery or, continuing to fight for it if stepping down to a lower level of care, can be a mistake because the patient has been in treatment working not only on eating, but also socializing, experiencing feelings about self and others, and learning new ways to cope. This is tested in great intensity after treatment and if the patient takes on too much can cause an extreme amount of pressure, making it difficult for them to focus on the coping skills they have been taught in order to get through it.
Each patient will face different challenges after treatment, which is why having a relapse prevention plan prepared prior to discharge is vital to success in maintaining recovery when the time comes. At Living Hope we do our best to work through possible challenges with each patient while creating the plan together so that they feel confident and have practiced possible methods to overcome them. These might include knowing one’s triggers, coping strategies, and support system; to name a few. It is important to be specific and for each patient to know what works and does not work for them. We encourage them to let friends and family know how to help and to provide them with knowledge about their disorder so if a relapse or slip happens, they are equipped with the tools to respond in an effective manner.
DeAndria Rideau, Ph.D., LPC