Relapse Prevention, Aftercare, and Long-Term Follow-Up

Abstract

This chapter provides an overview of relapse prevention and strategies to long-term patient follow-up (aftercare programs), including approaches to working with alcohol-dependent patients who resume heavy alcohol use.

Negotiating goals of treatment has already been discussed (Chapter 4) recognizing that abstinence is not the only option. Indeed, many patients are not ready to engage in treatment that sets a goal of abstinence but may accept the need to reduce drinking. Recent research has confirmed that substantial reductions in drinking may be associated with sustained clinical improvements. The World Health Organisation (WHO) has defined four drinking risk levels (veryhigh-,high-, moderate-, and low-risk) and clinical benefit has been associated with reduction of at least two risk levels reaching low-risk drinking or moderate-risk for those who were initially drinking at very-high-risk levels.